Isometric neck exercises for adolescents with smartphone-related cervicogenic headache

A Randomized Controlled Trial Evaluating the Effects of Isometric Neck Exercises and Postural Advice on Cervicogenic Headache Symptoms , Serum Cortisol, and Brain-Derived Neurotrophic Factor Levels in Adolescents With Smartphone Addiction

This project will test whether a one-month isometric neck exercise program can reduce neck-related headaches and change cortisol and BDNF levels in adolescents with smartphone addiction.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 44 (estimated)
• Ages: 13 Years to 19 Years
• Sex: All
• Sponsor: Khyber Medical University Peshawar (other)
• Locations: 1 site (Peshawar, KPK)
• Trial ID: NCT07354776 on ClinicalTrials.gov

What this trial studies

This single-blind randomized controlled trial enrolls adolescents (13–19 years) with smartphone addiction and confirmed cervicogenic headache and randomly assigns them to a one-month supervised/home-based isometric neck exercise program or usual care. About 44 participants will be enrolled and followed for one month to measure changes from baseline. Primary symptom outcomes are the Neck Disability Index (NDI) and Headache Impact Test (HIT-6), and secondary outcomes include serum cortisol, BDNF, and sleep quality (PSQI). The protocol uses the Cervical Flexion-Rotation Test (CFRT) for diagnostic confirmation and ELISA for BDNF measurement.

Who should consider this trial

Good fit: Adolescents aged 13–19 who use a smartphone ≥4 hours per day and have a positive CFRT-confirmed cervicogenic headache, and who are medically fit for moderate exercise, are the ideal candidates.

Not a fit: Patients with other primary headache disorders, recent neck injuries, vascular cervical pathology, severe uncorrectable vision problems, or current drug addiction are unlikely to benefit or are excluded.

Why it matters

Potential benefit: If successful, the exercise program could reduce headache burden, improve sleep, and lower stress-related biomarkers in affected adolescents.

How similar studies have performed: Targeted neck and physiotherapy exercises have previously improved cervicogenic headache symptoms, but using isometric neck exercises to alter cortisol and BDNF in smartphone-addicted adolescents is relatively novel.

Eligibility criteria

Inclusion Criteria:

* Adolescents aged 13 to 19 years.
* Smartphone addiction, defined as using a smartphone for ≥4 hours per day.
* A confirmed diagnosis of Cervicogenic Headache (CGH), as determined by a positive Cervical Flexion-Rotation Test (CFRT) performed by a physical therapist.

Exclusion Criteria:

* Diagnosis of other primary headache disorders (e.g., migraine, tension-type headache, cluster headache) or sinusitis.
* Presence of fever, cranial tumors, meningitis, or subarachnoid hemorrhage.
* Known carotid or vertebral artery dysfunction.
* Significant use of other screened devices (e.g., tablets, laptops) that would confound the primary exposure.
* History of prior neck injuries or cervical fractures.
* Any medical condition that renders the individual unfit to participate in a moderate exercise program.
* Presence of photophobia or phonophobia.
* Current drug addiction.
* Extreme, uncorrectable vision issues (Snellen chart score worse than 20/200 in either eye).

Where this trial is running

Peshawar, KPK

• Institute of Basic Medical Sciences (IBMS), Khyber Medical University — Peshawar, KPK, Pakistan (RECRUITING)

Study contacts

• Principal investigator: Misbah Ali Syed — Khyber Medical University
• Study coordinator: Misbah Ali Syed, Mphil

Conditions: Cervicogenic Headache, Sleep Disturbance, Stress, Exercise Physiology, Sleep disturbance, Isometric exercises