Comparison of Bowen Therapy and Post-isometric Relaxation Technique in Patients With Text Neck Syndrome

NCT07480746 | Completed DMC

• 1 other identifier: Ayesha Iftikhar
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to compare the effectiveness of Bowen Therapy and Post-Isometric Relaxation Technique (PIRT) in the management of Text Neck Syndrome, a musculoskeletal condition caused by prolonged forward head posture during mobile phone or screen use. The study follows a randomized clinical trial design, ensuring that participants are randomly assigned to either the Bowen Therapy group or the PIRT group to minimize bias. The total study duration is nine months, including a six-week treatment phase and a three-week follow-up period. Assessments will be conducted at baseline, mid-intervention (3 weeks), post-intervention (6 weeks), and follow-up (9 weeks) to evaluate the short-term and sustained effects of both interventions. A consecutive sampling technique will be used, and participants who meet the inclusion and exclusion criteria will provide informed written consent before enrollment. The sample size was determined using G\*Power software (v3.1.9.7), based on previous research (Seemal et al., 2022), with an assumed large effect size (d = 1.0), α = 0.05, and 80% power. After accounting for a 20% attrition rate, a total of 42 participants (21 per group) will be included in the study. Overall, this study seeks to provide evidence on which therapeutic approach-Bowen Therapy or Post-Isometric Relaxation-is more effective in reducing pain, improving range of motion, and enhancing posture in individuals with Text Neck Syndrome.

Conditions

Text Neck Syndrome

Outcome Measures

Primary Outcomes (1)

• Change in Neck Pain Intensity Measured by the Numeric Pain Rating Scale

  Neck pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), an 11-point self-reported scale ranging from 0 (no pain) to 10 (worst imaginable pain). Participants will rate their average neck pain over the previous 24 hours by selecting a number from 0 to 10. The primary outcome is the change in NPRS score from baseline to 6 weeks, with higher scores indicating greater pain intensity and lower scores indicating improvement.

  Baseline and 6 weeks (post-intervention)

Study Arms (2)

Bowen Therapy Group

EXPERIMENTAL

Participants in this group will receive Bowen Therapy after baseline assessment of forward head posture, cervical range of motion, pain intensity, and functional limitation. The intervention will consist of three sessions per week for six weeks (total 18 sessions), each lasting approximately 30-45 minutes. A standardized Bowen Therapy protocol will be applied, focusing on the cervical and upper back/shoulder regions. Techniques include gentle rolling moves with the therapist's thumb over the sternocleidomastoid (SCM), scalenes, suboccipitals, upper trapezius, levator scapulae, and pectoralis muscles, performed while the patient is in prone or seated position. The procedure incorporates short pauses between moves to facilitate neuromuscular integration.

Other: Bowen therapy; Other: Post-Isometric Relaxation Technique (PIRT)

Post-Isometric Relaxation Technique Group

ACTIVE COMPARATOR

Participants in this group will receive Post-Isometric Relaxation Technique (PIRT) sessions, administered three times per week for six weeks (total 18 sessions), each lasting 30-45 minutes. The intervention involves the standardized application of PIRT on upper trapezius, sternocleidomastoid, levator scapulae, suboccipital, scalene, and pectoralis muscles. Each muscle will be positioned at its resistance barrier, and participants will perform a 5-10 second, 20% effort isometric contraction against therapist resistance, followed by 2-3 seconds of relaxation and gentle stretch toward the new barrier. The process will be repeated 3-5 times per muscle.

Other: Bowen therapy; Other: Post-Isometric Relaxation Technique (PIRT)

Interventions

Bowen therapy OTHER

Participants will receive Bowen Therapy sessions three times per week for six weeks. Gentle rolling moves will be applied to the cervical and upper back muscles to reduce pain, muscle tension, and improve posture.

Bowen Therapy Group; Post-Isometric Relaxation Technique Group

Post-Isometric Relaxation Technique (PIRT) OTHER

Participants will undergo PIRT sessions three times per week for six weeks, involving gentle isometric contractions and relaxation of targeted neck and shoulder muscles to improve flexibility and reduce discomfort.

Bowen Therapy Group; Post-Isometric Relaxation Technique Group

Eligibility Criteria

• Age: 18 Years - 35 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Adults aged between 18 to 35 years, inclusive of both genders. Craniovertebral angle less than 50 degrees indicating forward head posture. Self-reported neck pain onset or worsening associated with screen use e.g. pain and stiffness during or after prolonged device use.
• Neck pain intensity of at least 4 to 7 on Numeric Pain Rating Scale. Daily screen time of ≥4 hours per day including smartphones, tablet, laptop, and desktop use for at least 5 days per week.

You may not qualify if:

• Cervical radiculopathy or myelopathy. History of Cervical Spine Surgery. Recent (within three months) trauma to neck or shoulder region. Diagnosis of fibromyalgia, rheumatoid arthritis or any other inflammatory joint condition.
• Ongoing treatment for neck pain from another healthcare provider. Neurological conditions affecting muscle tone or coordination. Severe postural abnormalities from congenital conditions.

Sponsors & Collaborators

• University of Lahore: lead

Study Sites (1)

UIPT, UOL, Lahore

Lahore, Pakistan

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: November 17, 2025
• First Posted: March 18, 2026
• Study Start: December 11, 2025
• Primary Completion: February 11, 2026
• Study Completion: February 11, 2026
• Last Updated: March 20, 2026

Record last verified: 2026-03

Locations

PA (1)