Forward Head PostureNCT07907458
Digital Use, 24-Hour Movement Behaviors, and Myofascial Release in University Students With Neck Pain
A study testing Integrated Myofascial Release in people with Forward Head Posture and Chronic Nonspecific Neck Pain, run by Karabuk University at 1 site in Turkey (Türkiye).
Trial summary
This study will examine how smartphone use recorded by the phone and daily sleep, sitting, and physical activity are related to neck posture, sensitivity to pressure, and body awareness in university students aged 18 to 30 years. Read more about this study
- Who is it for?
- Ages 18 to 30 years
- Conditions the study is for
- Forward Head Posture, Chronic Nonspecific Neck Pain
- What is being tested?
- Integrated Myofascial Release
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 56 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Nov 2026to 31 Oct 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 30 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- University student aged 18 to 30 years.
- Regular smartphone use and willingness to complete seven-day device-based smartphone and accelerometer monitoring.
- Written informed consent.
- For the randomized intervention: nonspecific neck pain for at least three months; average neck pain during the previous week of at least 3 on a 0-10 numerical rating scale; and craniovertebral angle of 50 degrees or less on standardized lateral photogrammetry.
Who cannot join
- Acute cervical trauma or history of cervical spine surgery.
- Neurological, inflammatory rheumatic, or specific orthopedic disease substantially affecting cervical posture or movement.
- Any condition preventing safe completion of monitoring or clinical assessments.
- For the randomized intervention: signs of cervical radiculopathy, myelopathy, or specific cervical pathology, or recent cervical manual therapy or physiotherapy.
- The wider observational assessment includes 100 students with or without neck pain; only 56 students meeting the additional neck-pain and posture criteria enter this randomized interventional record.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)1 site
Karabuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation
Karabük, Karabük Province
Ece Acar, PhD, PT, +905457925035, eceacar@karabuk.edu.tr
About this study
Official title: Associations of Objective Digital Use and 24-Hour Movement Behaviors With Cervical Posture, Pressure Pain Sensitivity, and Body Awareness and Effects of Integrated Myofascial Release on These Parameters in University Students
This study will examine how smartphone use recorded by the phone and daily sleep, sitting, and physical activity are related to neck posture, sensitivity to pressure, and body awareness in university students aged 18 to 30 years. One hundred students will complete seven days of smartphone and activity monitoring and clinical assessments. Among these students, 56 who have nonspecific neck pain for at least three months, average pain of at least 3 out of 10, and forward head posture will be randomly assigned to integrated myofascial release or a light-touch control. Both groups will receive six sessions over two weeks. An assessor who does not know the assigned group will measure outcomes before and after treatment and, where feasible, one month after treatment. The study will investigate whether myofascial release improves neck pain, pressure pain threshold, posture, movement, disability, and awareness.
Read the detailed description
This single-center prospective study at Karabuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, includes an observational assessment of 100 university students and an embedded assessor-blinded, parallel-group randomized controlled trial involving 56 eligible participants (28 per group). The interventional enrollment target is 56; the wider observational sample is 100 and is not an additional randomized arm.
Smartphone use will be recorded for seven consecutive days using Screen Time, Digital Wellbeing, or an equivalent device-based system. No message contents, contacts, photographs, passwords, or personal files will be collected. During the same period, a triaxial accelerometer will estimate sleep, sedentary behavior, light physical activity, and moderate-to-vigorous physical activity. Device placement, valid-day criteria, and processing will be standardized using a validated protocol for the selected device before data collection.
Cervical posture will be assessed with standardized lateral photogrammetry using the tragus and C7 to calculate craniovertebral angle. During a 20-minute standardized smartphone task, angle will be recorded at the start, 10 minutes, and 20 minutes. Clinical assessments include digital algometry, numerical pain ratings, cervical range of motion, the Turkish Body Awareness Questionnaire, Fremantle Neck Awareness Questionnaire, and Neck Disability Index.
Participants eligible for the randomized component will be allocated 1:1 using a computer-generated sequence with concealment by an independent person using sealed opaque envelopes or an equivalent secure method. Integrated myofascial release targets cervical-related structures including the suboccipital region, upper trapezius, levator scapulae, and sternocleidomastoid. Six sessions will be administered over two weeks. Control participants receive light manual contact in comparable positions for a comparable duration without targeted fascial stretching or therapeutic pressure. Outcomes are assessed before treatment, after six sessions, and where feasible at one month after treatment. Discomfort and adverse events will be recorded at each session.
Associations will be examined using correlations and multivariable regression. Twenty-four-hour movement behaviors will be analyzed as compositional data. Randomized outcomes will be analyzed using mixed-effects models with group, time, and group-by-time interaction, following the intention-to-treat principle. Effect sizes and 95% confidence intervals will be reported. Data collection will not begin before ethics approval and institutional permissions are in place.
- Being tested
- Integrated Myofascial Release, Light-Touch Control
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Integrated Myofascial ReleaseOther
Manual myofascial release of cervical-related structures, including the suboccipital region, upper trapezius, levator scapulae, and sternocleidomastoid, delivered by a trained physiotherapist in a standardized sequence. Three sessions per week for two weeks (six sessions).
Light-Touch ControlOther
Light manual contact in positions and for a duration comparable to myofascial release, without targeted fascial stretching or therapeutic pressure. Three sessions per week for two weeks (six sessions).
| Study group | Role | What they receive |
|---|---|---|
| Integrated Myofascial Release | Experimental | Twenty-eight participants receive integrated myofascial release targeting the suboccipital region, upper trapezius, levator scapulae, and sternocleidomastoid. Six sessions are delivered by a trained physiotherapist, three sessions per week for two weeks, using a standardized sequence and duration. Receives: Other: Integrated Myofascial Release |
| Light-Touch Control | Sham comparator | Twenty-eight participants receive light manual contact without targeted myofascial stretching or therapeutic pressure, in positions and for a duration comparable to the intervention group. Six sessions are delivered over two weeks, three sessions per week. Receives: Other: Light-Touch Control |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Pressure Pain Threshold
Pressure pain threshold measured with a digital algometer with a 1 cm2 probe at standardized cervical muscle sites. Repeated measurements at each site are averaged and reported in kPa. A higher threshold indicates lower mechanical pain sensitivity. The primary comparison is baseline to completion of six sessions.
Measured: Baseline and immediately after six sessions (2 weeks)
Secondary outcomes (7)
Change in Craniovertebral Angle
Craniovertebral angle in degrees measured by standardized lateral photogrammetry using the tragus and C7. A larger angle indicates less forward head posture. Assessed at the start, 10 minutes, and 20 minutes of a standardized smartphone task.
Measured: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Change in Neck Pain Intensity
Average neck pain over the preceding week measured using a 0-10 Numerical Rating Scale, where 0 means no pain and 10 means the worst imaginable pain. Lower scores indicate less pain.
Measured: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Change in Cervical Range of Motion
Active cervical flexion, extension, right and left rotation, and right and left lateral flexion measured in degrees using a clinical range-of-motion device or digital inclinometer. Each direction is analyzed separately.
Measured: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Change in Neck Disability Index
Turkish Neck Disability Index: 10 items, each scored 0-5; total 0-50. Higher scores indicate greater neck-related disability.
Measured: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Change in Body Awareness
Turkish Body Awareness Questionnaire assesses awareness of bodily processes and responses. Eighteen items rated 1-7 yield a total of 18-126, with higher scores indicating greater body awareness.
Measured: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Change in Neck Awareness
Turkish Fremantle Neck Awareness Questionnaire: nine items scored 0-4, total 0-36. Higher scores indicate greater disturbance of neck-related perception.
Measured: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Pressure Pain Threshold at Follow-up
Digital algometry at the same standardized cervical sites used at baseline, with repeated measurements averaged and reported in kPa; higher values indicate lower mechanical pain sensitivity.
Measured: Baseline and 1 month after completion of treatment (approximately week 6), where feasible
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Oct 2026
- Study start1 Nov 2026 (estimated)
- Primary completion31 Oct 2027 (estimated)
- Study completion31 Oct 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Forward Head PostureStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Assessor-blinded randomized trial embedded in a prospective assessment of 100 students. Fifty-six eligible students with chronic nonspecific neck pain and forward head posture will be allocated 1:1 to integrated myofascial release or light-touch control (28 per group).
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 56 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Karabuk University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Ece ACAR, Karabuk University
- Investigators
- Ece Acar, PhD, PT, Principal investigator, Karabuk University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07907458
- Sponsor's protocol ID
- KBU-DIGITAL-MFR-2026
- Status last verified
- Oct 2026
- First submitted
- 24 Oct 2026
- Last updated
- 30 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 30 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Associations of Objective Digital Use and 24-Hour Movement Behaviors With Cervical Posture, Pressure Pain Sensitivity, and Body Awareness and Effects of Integrated Myofascial Release on These Parameters in University Students
- ClinicalTrials.gov ID
- NCT07907458
- Acronym / sponsor ID
- KBU-DIGITAL-MFR-2026
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 56 participants (estimated)
- Lead sponsor
- Karabuk UniversityUniversity, hospital or other
- Study start
- 1 Nov 2026 (estimated)
- Primary completion
- 31 Oct 2027 (estimated)
- Study completion
- 31 Oct 2027 (estimated)
- First posted
- 30 Oct 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will examine how smartphone use recorded by the phone and daily sleep, sitting, and physical activity are related to neck posture, sensitivity to pressure, and body awareness in university students aged 18 to 30 years. One hundred students will complete seven days of smartphone and activity monitoring and clinical assessments. Among these students, 56 who have nonspecific neck pain for at least three months, average pain of at least 3 out of 10, and forward head posture will be randomly assigned to integrated myofascial release or a light-touch control. Both groups will receive six sessions over two weeks. An assessor who does not know the assigned group will measure outcomes before and after treatment and, where feasible, one month after treatment. The study will investigate whether myofascial release improves neck pain, pressure pain threshold, posture, movement, disability, and awareness.
Detailed description
This single-center prospective study at Karabuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, includes an observational assessment of 100 university students and an embedded assessor-blinded, parallel-group randomized controlled trial involving 56 eligible participants (28 per group). The interventional enrollment target is 56; the wider observational sample is 100 and is not an additional randomized arm.
Smartphone use will be recorded for seven consecutive days using Screen Time, Digital Wellbeing, or an equivalent device-based system. No message contents, contacts, photographs, passwords, or personal files will be collected. During the same period, a triaxial accelerometer will estimate sleep, sedentary behavior, light physical activity, and moderate-to-vigorous physical activity. Device placement, valid-day criteria, and processing will be standardized using a validated protocol for the selected device before data collection.
Cervical posture will be assessed with standardized lateral photogrammetry using the tragus and C7 to calculate craniovertebral angle. During a 20-minute standardized smartphone task, angle will be recorded at the start, 10 minutes, and 20 minutes. Clinical assessments include digital algometry, numerical pain ratings, cervical range of motion, the Turkish Body Awareness Questionnaire, Fremantle Neck Awareness Questionnaire, and Neck Disability Index.
Participants eligible for the randomized component will be allocated 1:1 using a computer-generated sequence with concealment by an independent person using sealed opaque envelopes or an equivalent secure method. Integrated myofascial release targets cervical-related structures including the suboccipital region, upper trapezius, levator scapulae, and sternocleidomastoid. Six sessions will be administered over two weeks. Control participants receive light manual contact in comparable positions for a comparable duration without targeted fascial stretching or therapeutic pressure. Outcomes are assessed before treatment, after six sessions, and where feasible at one month after treatment. Discomfort and adverse events will be recorded at each session.
Associations will be examined using correlations and multivariable regression. Twenty-four-hour movement behaviors will be analyzed as compositional data. Randomized outcomes will be analyzed using mixed-effects models with group, time, and group-by-time interaction, following the intention-to-treat principle. Effect sizes and 95% confidence intervals will be reported. Data collection will not begin before ethics approval and institutional permissions are in place.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Assessor-blinded randomized trial embedded in a prospective assessment of 100 students. Fifty-six eligible students with chronic nonspecific neck pain and forward head posture will be allocated 1:1 to integrated myofascial release or light-touch control (28 per group).
| Arm | Type | Receives |
|---|---|---|
| Integrated Myofascial Release | Experimental | Other: Integrated Myofascial ReleaseTwenty-eight participants receive integrated myofascial release targeting the suboccipital region, upper trapezius, levator scapulae, and sternocleidomastoid. Six sessions are delivered by a trained physiotherapist, three sessions per week for two weeks, using a standardized sequence and duration. |
| Light-Touch Control | Sham comparator | Other: Light-Touch ControlTwenty-eight participants receive light manual contact without targeted myofascial stretching or therapeutic pressure, in positions and for a duration comparable to the intervention group. Six sessions are delivered over two weeks, three sessions per week. |
Who may qualify
- Ages
- 18 to 30 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- University student aged 18 to 30 years.
- Regular smartphone use and willingness to complete seven-day device-based smartphone and accelerometer monitoring.
- Written informed consent.
- For the randomized intervention: nonspecific neck pain for at least three months; average neck pain during the previous week of at least 3 on a 0-10 numerical rating scale; and craniovertebral angle of 50 degrees or less on standardized lateral photogrammetry.
Key exclusion criteria (5 listed)
- Acute cervical trauma or history of cervical spine surgery.
- Neurological, inflammatory rheumatic, or specific orthopedic disease substantially affecting cervical posture or movement.
- Any condition preventing safe completion of monitoring or clinical assessments.
- For the randomized intervention: signs of cervical radiculopathy, myelopathy, or specific cervical pathology, or recent cervical manual therapy or physiotherapy.
- The wider observational assessment includes 100 students with or without neck pain; only 56 students meeting the additional neck-pain and posture criteria enter this randomized interventional record.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Integrated Myofascial ReleaseManual myofascial release of cervical-related structures, including the suboccipital region, upper trapezius, levator scapulae, and sternocleidomastoid, delivered by a trained physiotherapist in a standardized sequence. Three sessions per week for two weeks (six sessions). | Other | Integrated Myofascial Release |
| Light-Touch ControlLight manual contact in positions and for a duration comparable to myofascial release, without targeted fascial stretching or therapeutic pressure. Three sessions per week for two weeks (six sessions). | Other | Light-Touch Control |
Primary outcome
Change in Pressure Pain Threshold
Time frame: Baseline and immediately after six sessions (2 weeks)
Pressure pain threshold measured with a digital algometer with a 1 cm2 probe at standardized cervical muscle sites. Repeated measurements at each site are averaged and reported in kPa. A higher threshold indicates lower mechanical pain sensitivity. The primary comparison is baseline to completion of six sessions.
7 secondary outcomes
Change in Craniovertebral Angle
Time frame: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Change in Neck Pain Intensity
Time frame: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Change in Cervical Range of Motion
Time frame: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Change in Neck Disability Index
Time frame: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Change in Body Awareness
Time frame: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Change in Neck Awareness
Time frame: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Pressure Pain Threshold at Follow-up
Time frame: Baseline and 1 month after completion of treatment (approximately week 6), where feasible
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Oct 2026.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Ece Acar, PhD, PT principal investigator
Karabuk University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Integrated Myofascial Release in people with Forward Head Posture and Chronic Nonspecific Neck Pain, run by Karabuk University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 30 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Ece Acar, PhD, PT (+905457925035, eceacar@karabuk.edu.tr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Pressure Pain Threshold (time frame: Baseline and immediately after six sessions (2 weeks)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Oct 2026.