Effectiveness of Isometric Neck Exercises along with Myofascial Release Technique versus Dynamic Neck Exercises along with Myofascial Release Technique on the Pain, Function and Quality of Life in Case of Cervical Spondylosis: A Comparative Study

40 participants will randomly be divided into two groups. In Group A: all 20 patients will be treated by Isometric neck exercise along with myofascial release. Group B: all 20 patients will be treated with dynamic neck exercise along with myofascial release. All participants will be assessed for cervical pain, function, and quality of life. The Numeric Pain Rating Scale (NPRS) will be used to measure the intensity of pain, functional performance will be assessed using the Neck Disability Index (NDI) and quality of life will be assessed by SF-36. All variables will be measured at baseline, at the end of the second week and Fourth week of the study.

Group A: Isometric neck exercise along with MFR

Isometric Neck Flexion:

Sit or stand with a straight spine and place your hand on your forehead.  Push your forehead gently against your hand without allowing any actual movement. Hold the contraction for 5-10 seconds. Relax and repeat for 10 repetitions.

Isometric Neck Extension:

Place your hands on the back of your head. Push your head backward against your hands without allowing any actual movement. Hold the contraction for 5-10 seconds. Relax and repeat for 10 repetitions.

Isometric Lateral Neck Flexion

Place your right hand on the right side of your head.  Push your head to the right against your hand without allowing any actual movement. Hold the contraction for 5-10 seconds. Relax and repeat on the left side. Perform 10 repetitions on each side.

Isometric Neck Rotation

Place your right hand on the right side of your face.  Push your head to the right against your hand without allowing any actual movement. Hold the contraction for 5-10 seconds. Relax and repeat on the left side. Perform 10 repetitions on each side.

10 repetitions were given per session with 30 secs of rest will be given in between the session. Total 6 sessions in a week for 4 weeks

MYOFASCIAL RELEASE

Patient position: Sitting

Procedure: The therapist stand behind the patient, then with hands crossed with one hand placing on the shoulder and the other below the ear on the head of the involved side. The hands are placed along the direction of the fibres. Local myofascial stretch for 20 seconds is given slowly and repeated 3-4 times.

4 repetitions were given per session with 30 secs of rest will be given in between the session. Total 6 sessions in a week for the period of 4 weeks.

Subjects in both the groups will be receiving the above protocol along with physical modality such as TENS.

Transcutaneous electrical nerve stimulation (TENS) will be given on painful areas in both groups A and B for 6 days a week for an initial 2 weeks according to the protocol mention below:

Frequency:5Hz Intensity: high Pulse duration: 300 Micro sec. Duration: 20 minutes, Electrode placement: Area of greatest intensity of pain.

Group B: Dynamic neck exercise along with MFR

Neck Flexion and Extension:

Sit or stand with a straight spine.  Slowly lower your chin towards your chest, feeling a stretch in the back of your neck.   Return to the neutral position and then gently tilt your head backward, looking up towards the ceiling Repeat for 10 repetitions.

Neck Lateral Flexion:

Slowly tilt your head to the right, bringing your ear towards your shoulder. Return to the neutral position and then tilt your head to the left.  Repeat for 10 repetitions on each side.

Neck Rotation:

Turn your head to the right, looking over your shoulder. Return to the neutral position and then turn your head to the left.  Repeat for 10 repetitions on each side.

Shoulder Blade Squeezes:

Sit or stand with good posture. Squeeze your shoulder blades together, bringing them towards your spine. Hold for a few seconds and then release. Repeat for 10 repetitions.

10 repetitions were given per session with 30 secs of rest will be given in between the session. Total 6 sessions in a week for 4 weeks

MYOFASCIAL RELEASE

Patient position: Sitting

Procedure: The therapist stands behind the patient, with hands crossed with one hand placed on the shoulder and the other below the ear on the head of the involved side. The hands are placed along the direction of the fibers. Local myofascial stretch for 20 seconds is given slowly and repeated 3-4 times.

4 repetitions were given per session with 30 secs of rest will be given in between the session. Total 6 sessions in a week for 4 weeks. Subjects in both groups will be receiving the above protocol along with physical modalities such as TENS.

Transcutaneous electrical nerve stimulation (TENS) will be given on painful areas in both groups A and B for 6 days a week for an initial 2 weeks according to the protocol mentioned below:

Frequency:5Hz Intensity: high Pulse duration: 300 Micro sec. Duration: 20 minutes, Electrode placement: Area of greatest intensity of pain.