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Abstract
Background: Neck pain and forward head posture related symptoms due to smart phone and other such devices usage are increasingly observed and reported in university students, but there is a lack of definitive evidence regarding therapeutic value of simple self administered exercise strategies.
Objective: To compare effectiveness of self stretching versus self strengthening exercises on neck pain and disability in undergraduate students with text neck syndrome.
Methods: This experimental study was a three arm controlled trial conducted at Khawaja Fareed Campus of The Islamia University of Bahawalpur, Pakistan. 90 undergraduate students from different departments of Allied Health Sciences aged 18-25 years with daily screen time greater than 3 hours were assigned, in equal numbers, to self-strengthening (n = 30), self-stretching (n = 30) or control (n = 30) groups. The interventions were taught and trained to students who performed these exercises for 6 weeks as home based, self administered programs. Outcomes were collected before and after intervention i.e at the end of 6th week using a numerical pain rating scale (NPRS) and the Neck Disability Index (NDI).
Results: Both active interventions; self stretching and self strengthening significantly improved both outcomes. In the self strengthening group, mean daily neck pain decreased from 6.13 +/- 1.66 to 3.20 +/- 2.14 (p = 0.002) measured with NPRS and total NDI score improved from 17.17 +/- 8.40 to 8.27 +/- 7.09 (p = 0.001). In the self-stretching group, average daily neck pain decreased from 5.97 +/- 1.70 to 3.03 +/- 2.13 (p = 0.010) and total NDI score decreased from 16.77 +/- 7.52 to 9.57 +/- 6.48 showing a significant improvement (p=0.003). The control group results showed limited variation and its reduction in NDI was not statistically significant (p = 0.086). No significant between group difference was seen in post intervention total NDI score (p = 0.696), although stretching performed better on its work related item (p = 0.027).
Conclusion: Self stretching and self strengthening exercises both are feasible, low cost and clinically useful physiotherapy interventions for pain improvements among university students with text neck syndrome. None of the interventions demonstrated clear overall superiority across main outcomes, although both interventions gained significant superiority when compared with control group. So, either exercise program can be selected pragmatically according to preference, compliance and individual needs.