The effect of corrective exercises on length, strength, and endurance of neck muscles in female students 
with text neck syndrome: A randomized controlled clinical trial

Yaghobi, Fatemeh; Saki, Farzaneh; Pirani, Mahtab

[Home ] [Archive]

[ فارسی ]

Main Menu

Home

Journal Information

Articles archive

For Authors

For Reviewers

Ethics

Contact us

Search in website

Receive site information

Index

‌

Back to the articles list

Back to browse issues page

The effect of corrective exercises on length, strength, and endurance of neck muscles in female students with text neck syndrome: A randomized controlled clinical trial

Fatemeh Yaghobi

, Farzaneh Saki ^*

, Mahtab Pirani

Faculty of Sports Science, Bu-Ali Sina University, Hamedan, Iran , f_saki@basu.ac.ir

Abstract: (29 Views)

Background and aims: Excessive mobile phone use increases strain on the neck, leading to muscle weakness and imbalance in the neck and shoulder girdle. This study examined the effects of corrective exercises on neck muscle length, endurance, and strength in female students with text neck syndrome.
Methods: In this quasi-experimental pretest-posttest study, 70 female students aged 12–14 with text neck syndrome from Hamedan were purposefully selected and randomly divided into experimental and control groups (35 each). The experimental group underwent an eight-week corrective exercise program, while the control group received no intervention. Pectoralis minor muscle length, neck flexor and extensor strength, and endurance were measured before and after the intervention. Data were analyzed using repeated measures ANOVA and paired-sample t-tests.
Results: Significant time × group interactions and paired differences were observed for pectoralis minor length, neck flexor and extensor strength, and endurance, indicating improvements in the experimental group compared to the control (p < 0.05).
Conclusion: Corrective exercises enhance pectoralis minor length and neck muscle strength and endurance, mitigating forward head posture and neck pain. These exercises are recommended for students with frequent mobile phone use to improve muscular balance and alleviate symptoms of text neck syndrome.

Keywords: posture, adolescent, smartphone, exercise therapy

Full-Text [PDF 1665 kb] (13 Downloads)

Type of Study: Original | Subject: Disaster Medicine
Received: 2025/02/24 | Revised: 2025/09/18 | Accepted: 2025/07/1

References

1. Alshahrani A, Samy Abdrabo M, Aly SM, Alshahrani MS, Alqhtani RS, Asiri F, Ahmad I. Effect of smartphone usage on neck muscle endurance, hand grip and pinch strength among healthy college students: A cross-sectional study. International Journal of Environmental Research and Public Health. 2021;18(12):6290. doi:10.3390/ijerph18126290

2. David D, Giannini C, Chiarelli F, Mohn A. Text neck syndrome in children and adolescents. International Journal of Environmental Research and Public Health. 2021;18(4):1565. doi:10.3390/ijerph18041565

3. Shinde S, Bhende R. Evidence-based treatment strategies for "text neck syndrome ": A review. International Journal of Occupational Safety and Health. 2023;13(2):245-257. doi:10.3126/ijosh.v13i2.4867

4. Arun Jenikkin A SB, Shanmugananth E. Postural training exercises protocol effectiveness on posture, neck pain and disability in college students: : A randomized exprimental trial. Obstetrics and Gynaecology Forum. 2024;34(2s):42-48.

5. Neupane S, Ali UTI, Mathew A. Text neck syndrome - systematic review. Imperial Journal of Interdisciplinary Research. 2017;3(7):141-148.

6. Fiebert I, Kistner F, Gissendanner C, DaSilva C. Text neck: An adverse postural phenomenon. Work. 2021;69(4):1261-1270. doi:10.3233/wor-213547

7. Elvan A, Cevik S, Vatansever K, Erak I. The association between mobile phone usage duration, neck muscle endurance, and neck pain among university students. Scientific Reports. 2024;14(1):20116. doi:10.1038/s41598-024-71153-4

8. Yang H, Jeong C, Yoo Y, Heo J. Effects of three exercise programs on the length of pectoralis minor and forward head posture. Journal of The Korean Society of Integrative Medicine. 2017;5(3):21-28. [Korean] doi:10.15268/ksim.2017.5.3.02

9. Shah J, Soni K. Effectiveness of pilates along with conventional exercise program and conventional exercise program alone in subjects with text neck syndrome. International Journal of Science and Research 2021;10(3):1322-1326. doi:10.21275/SR21322101821

10. Sarraf F, Abbasi S, Varmazyar S. Self-management exercises intervention on text neck syndrome among university students using smartphones. Pain Management Nursing. 2023;24(6):595-602. doi:10.1016/j.pmn.2023.04.005

11. Jaroenrungsup Y, Kanchanomai S, Khruakhorn S. Effects of self-posture correction exercise in forward head posture of smartphone users. Songklanakarin Journal of Science and Technology. 2022;43(2):439-447.

12. Kim MK, Lee JC, Yoo KT. The effects of shoulder stabilization exercises and pectoralis minor stretching on balance and maximal shoulder muscle strength of healthy young adults with round shoulder posture. Journal of Physical Therapy Science. 2018;30(3):373-380. doi:10.1589/jpts.30.373

13. Roshani S, Yousefi M-R, Sokhtezari Z, Khalil Khodaparast M. The effect of a corrective exercise program on upper crossed syndrome in a blind person. Journal of Rehabilitation Sciences and Research. 2019;6(3):148-152. doi:10.30476/jrsr.2019.83417.1044

14. Letafatkar A, Rabiei P, Alamooti G, Bertozzi L, Farivar N, Afshari M. Effect of therapeutic exercise routine on pain, disability, posture, and health status in dentists with chronic neck pain: a randomized controlled trial. International Archives of Occupational and Environmental Health. 2020;93(3):281-290. doi:10.1007/s00420-019-01480-x

15. Masoumi AS, Akoochakian M. The effect of duration of smartphone use on head and shoulders posture of young adults aged 20-35 years. Iranian Journal of Ergonomics. 2019;7(2):62-71. [Persian] doi:10.30699/jergon.7.2.62

16. Shahidi B, Johnson CL, Curran-Everett D, Maluf KS. Reliability and group differences in quantitative cervicothoracic measures among individuals with and without chronic neck pain. BMC Musculoskeletal Disorders. 2012;13:215. doi:10.1186/1471-2474-13-215

17. Ghorbani F, Kamyab M, Azadinia F. Smartphone applications as a suitable alternative to crom device and inclinometers in assessing the cervical range of motion in patients with nonspecific neck pain. Journal of Chiropractic Medicine. 2020;19(1):38-48. doi:10.1016/j.jcm.2019.10.004

18. Zarei M, Davarian S, Sarrafzadeh J, Sohani SM. Comparison of cervical muscle strength between forward head posture and normal posture. The Scientific Journal of Rehabilitation Medicine. 2017;6(4):84-90. [Persian] doi:10.22037/jrm.2017.110729.1489

19. Sikka S, Sasidharan A. Association of cervical range of motion, cervical core strength and pectoralis minor tightness in car drivers. Indian Journal of Basic and Applied Medical Research. 2020;9(4):195 - 210. doi:10.36848/IJBAMR/2020/18215.56040

20. Farzana M. Influence of Neck Pain on Pectoralis Minor Muscle Length among Young Adults. Indian Journal of Forensic Medicine and Toxicology. 2022;15:2820-2827. doi:10.37506/ijfmt.v15i2.14798

21. Lee JH, Cynn HS, Yoon TL, Ko CH, Choi WJ, Choi SA, Choi BS. The effect of scapular posterior tilt exercise, pectoralis minor stretching, and shoulder brace on scapular alignment and muscles activity in subjects with round-shoulder posture. Journal of Electromyography and Kinesiology. 2015;25(1):107-114. doi:10.1016/j.jelekin.2014.10.010

22. Arshadi R, Ghasemi GA, Samadi H. Effects of an 8-week selective corrective exercises program on electromyography activity of scapular and neck muscles in persons with upper crossed syndrome: Randomized controlled trial. Physical Therapy in Sport. 2019;37:113-119. doi:10.1016/j.ptsp.2019.03.008

23. Antyesti A, Wahyuni N, Wahyuddin W, Samatra D, Sundari L, Tianing N. Effectiveness of modified scapular exercise and stretching exercise on pressure pain and neck disability in architecture students with mechanical neck pain in Denpasar. International Journal of Public Health Excellence 2023;3:169-177. doi:10.55299/ijphe.v3i1.532

24. Goodarzi F, Rahnama L, Karimi N, Baghi R, Jaberzadeh S. The effects of forward head posture on neck extensor muscle thickness: An ultrasonographic study. Journal of Manipulative and Physiological Therapeutics. 2018;41(1):34-41. doi:10.1016/j.jmpt.2017.07.012

25. Lin G, Wang W, Wilkinson T. Changes in deep neck muscle length from the neutral to forward head posture. A cadaveric study using Thiel cadavers. Clinical Anatomy. 2022;35(3):332-339. doi:10.1002/ca.23834

26. Torkamani MH, Mokhtarinia HR, Vahedi M, Gabel CP. Relationships between cervical sagittal posture, muscle endurance, joint position sense, range of motion and level of smartphone addiction. BMC Musculoskeletal Disorders. 2023;24(1):61. doi:10.1186/s12891-023-06168-5

27. Amini M, Alizadeh MH. An overview of the impact of exercise protocols on correcting forward head abnormalities. Journal of Paramedical Sciences & Rehabilitation. 2021;10(3):113-125. [Persian] doi:10.22038/jpsr.2021.58473.2266

28. Abdollahzade Z, Shadmehr A, Malmir K, Ghotbi N. Research paper: Effects of 4 week postural corrective exercise on correcting forward head posture. Journal of Modern Rehabilitation. 2017;11(2):85-92.

29. Agrawal YK, Hande D. Effect of activation of deep neck flexor muscle exercise on neck pain due to smartphone addiction. International Journal of Multidisciplinary Research and Development. 2017;4(7):489-492.

30. Lee SM, Lee CH, O'Sullivan D, Jung JH, Park JJ. Clinical effectiveness of a Pilates treatment for forward head posture. Journal of Physical Therapy Science. 2016;28(7):2009-2013. doi:10.1589/jpts.28.2009

31. Kang DY. Deep cervical flexor training with a pressure biofeedback unit is an effective method for maintaining neck mobility and muscular endurance in college students with forward head posture. Journal of Physical Therapy Science. 2015;27(10):3207-3210. doi:10.1589/jpts.27.3207

Send email to the article author

Add your comments about this article