Effect of Exercise Among Turtle Neck Syndrome in Pakistani Patients

Turtle neck also known as Text neck or anterior head syndrome is an overuse syndrome which occurs due to repetitive stress to neck, either by hanging it down or forward using phone or electronic devices. Typical signs and symptoms include pain and stiffness in the neck, shoulder pain and increase curvature of spine. It is becoming a global burden as people of almost all ages are getting affected. The objective of the study is to find out theEffect of Exercise among Turtle Neck Syndrome in Pakistani Population. A total of 100 participants will be included in the study having both males and females. The pain pattern will be assessed by Visual Analog Scale and Posture Grid Assessment tool will be used to assess posture before and after the treatment session. The study will be divided into three main sections or groups. One group will be treated by myofascial release only while other group will be treated by muscle energy technique for the management of turtle neck syndrome. Third group will receive both MFP and MET exercise. People having neck pain and those who will be willing to participate will be included in the study.

The participants will be divided into four groups namely group A, B, C and D. Initially all the participants will be assessed by posture grid assessment tool to check their postural deviations. People meeting the inclusion criteria will be recruited. Group A will receive Muscle Energy Technique (MET) exercise, Group B will receive Myofascial release (MFP) therapy, Group C will receive both MFP and MET and group D will receive conventional treatment. Pre and post Visual analog scale (VAS) will be used to check pain scale and posture grid assessment tool to check postural angles .Pre-assessment will be done on day one and post at the last day of session. The total duration of treatment will be four weeks. Consent will be taken from the patients. Only those patients meeting the inclusion criteria and screening questions will included in the study and those who will be willing to participate.

soft tissue release technique to release tension from muscles which relieves pain and increase range of motion

soft tissue release technique to release tension from muscles which relieves pain and increase range of motion

combination of two soft tissue release techniques to release tension from muscles which relieves pain and increase range of motion

Soft tissue release will be performed on the trapezius, sub occipital and sternocleidomastoid muscles. The visual analog scale will be used to check pain intensity. Algometer will be used to check the pain pressure threshold and tissue hardness. neck disability index will be used to check neck disability

Muscle energy Technique will be performed on the trapezius, sub occipital and sternocleidomastoid muscles. The visual analog scale will be used to check pain intensity. Algometer will be used to check the pain pressure threshold and tissue hardness. neck disability index will be used to check neck disability

combination of myofascial release and muscle energy technique will be performed on the trapezius, suboccipital and sternocleidomastoid muscles. The visual analog scale will be used to check pain intensity. Algometer will be used to check the pain pressure threshold and tissue hardness. neck disability index will be used to check neck disability

traditional physical therapy devices are used to relieve pain and spam. this will include a hot pack, ultrasound, and TENS (Transcutaneous electrical nerve stimulation)

For pain intensity visual analog scale will be used. a patient oriented scale ranging from 0-10. 0 means no pain, 1-3 means mild pain, 4-6 means moderate pain and 7-10 means severe pain.

to check disability, Neck disability Index will be used. It's a ten section questionnaire. Each item has scoring of 0-5. For each section the total possible score is 5. Points are summed to a total score. 0-4points (0-8%) no disability, 5-14points ( 10 - 28%) mild disability, 15-24points (30-48% ) moderate disability, 25-34points (50- 64%) severe disability, 35-50points (70-100%) complete disability

For tissue hardness, Algometer will be used. It's a device that calculates the hardness when given pressure against the stimuli. The value is measured in Newtons.

For Pain pressure threshold, Algometer will be used. It's a device that calculates the pain pressure threshold when given pressure against the stimuli. The value is measured in Newtons.

Inclusion Criteria: both males and females will be included patients having non specific neck pain usage of mobile more than six hours patients willing to participate Exclusion Criteria: pregnant females patients having cervical disc bulge or herniation disoriented patients patients not willing to participate patients having any deformity

Ajimsha MS, Al-Mudahka NR, Al-Madzhar JA. Effectiveness of myofascial release: systematic review of randomized controlled trials. J Bodyw Mov Ther. 2015 Jan;19(1):102-12. doi: 10.1016/j.jbmt.2014.06.001. Epub 2014 Jun 13.

Phadke A, Bedekar N, Shyam A, Sancheti P. Effect of muscle energy technique and static stretching on pain and functional disability in patients with mechanical neck pain: A randomized controlled trial. Hong Kong Physiother J. 2016 Apr 14;35:5-11. doi: 10.1016/j.hkpj.2015.12.002. eCollection 2016 Dec.