Effects of Strain Counter Strain With and Without Sustained Natural Aphophyseal Glide on Pain Range Of Motion ,Craniovertebral Angle and Disability in Patients With Non Specific Neck Pain
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 68
- 试验地点
- 1
- 主要终点
- Numeric pain rate scale (NPRS)
研究概览
简要总结
Non-specific neck pain is a common problem that doesn't have a specific cause like an injury or disease. It usually includes neck pain, reduced movement, poor posture like forward head position, and some level of disability that can make daily activities difficult. Physiotherapists often use hands-on techniques like Strain Counterstrain (SCS) and SNAGs (Sustained Natural Apophyseal Glides) to help reduce pain, improve movement, and correct posture. This study aims to find out if adding SNAGs (Sustained Natural Apophyseal Glides) to the usual Strain Counterstrain (SCS) treatment helps more than SCS alone in patients with neck pain. We will measure changes in pain levels, neck movement, posture (craniovertebral angle), and daily life impact (NDI) over a four-week treatment program.
详细描述
This study will be a randomized clinical trial and will take place at Ibne Sina Hospital in Multan. Patients will be chosen using convenience sampling. Those who meet the required conditions will be randomly divided into two groups using a computer program. Group A will receive the SCS and SNAG technique , while Group B will receive SCS alone . Treatment will be given three times a week for four weeks The outcomes will be measured before and after the treatment. These include: Pain (measured using the NPRS Scale ,Neck movement (measured with a goniometer), Craniovertebral angle (checked using digital photos) ,Disability level (measured using the Neck Disability Index - NDI) . The collected data will be analyzed using SPSS version 21. First, the normality of the data will be checked using the Shapiro-Wilk test. Based on the results, suitable statistical tests will be used to compare the results within and between the groups.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- ••Both Males and Females (20)
- •Age 18 and 60 years
- •pain intensity 3-6 rating on NPRS
- •Pain localized to cervical or upper trapezius
排除标准
- •• Cervical radiculopathy(20)
- •History of whiplash injury
- •History of cervical and thoracic spine surgery
- •Neck pain associated with vertigo(20)
- •History of spinal osteoporosis
- •Vertebral Fractures
- •Diagnosed psychological disorders
结局指标
主要结局
Numeric pain rate scale (NPRS)
时间窗: upto 4 weeks
Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates "no pain" and 10 indicates "worst pain".(25) NPRS shows strong construct validity and correlates well with other pain scales like the Visual Analog Scale (VAS) and McGill Pain Questionnaire. It is especially useful for tracking changes in pain over time.(13) The NPRS demonstrates excellent test-retest reliability with an intraclass correlation coefficient (ICC) of \~0.95 in patients with chronic musculoskeletal pain.(26) The MCID for NPRS is generally considered to be 2 points, meaning a change of 2 or more points is considered clinically meaningful in musculoskeletal pain patients
Neck Disability index (NDI)
时间窗: Upto 4 weeks
This questionnaire will be used to assess disability. It comprises of 10 items; 7 related to daily living activities, 2 related to pain and 1 related to concentration. Each item is scored from 0 to 5. Total score is expressed as a percentage, with higher scores related to greater disability(28) Its construct validity has been supported through correlations with pain intensity, cervical range of motion, and quality-of-life measures (13). It shows excellent test retest reliability, with an ICC of 0.89-0.98 in patients with mechanical or non-specific neck pain (26)The Minimal Detectable Change (MDC) for NDI has been reported to be 5 points, while the MCID is commonly considered to be around 7-10 points for clinical relevance in chronic musculoskeletal pain
Universal Goniometer (UG)
时间窗: Upto 4 weeks
It will measure range of motion of neck (29) A universal goniometer will be used to measure active cervical range of motion (CROM) in flexion, extension, lateral flexion, and rotation. This tool is portable, affordable, and easy to use in clinical and research settings. The validity of goniometry in measuring cervical ROM has been confirmed through comparisons with CROM devices and motion sensors, showing strong correlations (r \> 0.85) in neck mobility measurement (27). Goniometer-based cervical ROM assessments demonstrate good to excellent reliability, with ICC values ranging from 0.79 to 0.96, depending on the plane of movement and rater experience
Craniovertebral Angle (CVA)
时间窗: Upto 4 weeks
It is used to measure the degree of forward head posture, which is common in people with neck pain. A smaller CVA indicates a more forward head position, while a larger angle reflects a more neutral, healthy posture .To measure CVA, a lateral photograph is taken while the patient stands in a relaxed position. The angle is formed between a horizontal line passing through the C7 vertebra and a line connecting C7 to the tragus of the ear. This measurement is usually done using image analysis software or mobile applications like Posture Screen or ImageJ. Studies have shown that CVA measurement is a reliable and valid method for assessing head posture. It has good intra-rater and inter-rater reliability, with Intraclass Correlation Coefficients (ICC) ranging from 0.88 to 0.98 (8, 15).The Minimal Detectable Change (MDC) for CVA varies across studies but is generally estimated to be about 3-4 degrees, making it a sensitive tool for detecting postural improvements
次要结局
未报告次要终点