Digital Use, 24-Hour Movement Behaviors, and Myofascial Release in University Students With Neck Pain

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.

Inclusion Criteria: * 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. Exclusion Criteria: * 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.