Comparison of the Effectiveness of Different Exercise Types in Individuals with Chronic Neck Pain
- Conditions
- Chronic Neck Pain
- Registration Number
- NCT06697457
- Lead Sponsor
- Muğla Sıtkı Koçman University
- Brief Summary
The aim of this study is to compare the effectiveness of craniocervical flexion, static and dynamic isometric exercise training applied with a conventional physiotherapy program in individuals with chronic neck pain.
- Detailed Description
Neck pain is a significant musculoskeletal problem that is frequently encountered in society. Pain that cannot be diagnosed with a specific pathology is called "nonspecific" and pain that continues for more than three months is called "chronic pain". Chronic nonspecific neck pain has negative effects on function and quality of life. The importance of the exercise approach in the treatment of neck pain is quite great. Craniocervical flexion and static isometric exercises are frequently used in individuals with chronic neck pain. However, there are very few studies that include dynamic isometric exercises. The aim of this study is to compare the effectiveness of craniocervical flexion, static and dynamic isometric exercise training applied with a conventional physiotherapy program in individuals with chronic neck pain. The intervention groups of the study are deep cervical flexion exercise training, dynamic isometric exercise training and static isometric exercise training and electrotherapy group. The craniocervical flexion exercise training group will receive deep cervical flexor muscle training with Pressure Biofeedback, the dynamic isometric exercise group will receive exercise training with Thera-band, and the static isometric exercise group will receive neck isometric exercises. The electrotherapy group will receive hotpack, tens, and ultrasound applications. At the beginning and end of the study, pain, disability, posture, muscle strength, endurance, range of motion, and body awareness will be assessed in all individuals.TENS (Transcutaneous Electrical Nerve Stimulation) will be applied to all groups for 20 minutes with a TENS device at a strength of 10-30 mA and a frequency of 80 Hz. A pair of surface electrodes will be placed on the painful area of the neck. The intensity of TENS will be adjusted according to the patient's sensory thresholds so that they are not disturbed by a numbness sensation. After TENS, continuous ultrasound will be applied to the cervical region to produce thermal effects. The intensity will be 1.5 W/cm² and the duration will be 5 minutes. Hotpack will be applied to the trapezius muscle for 10 minutes. Chin tuck exercise will be applied to the cervical region.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 48
- Being between the ages of 18 and 55,
- Scoring 15/50 or less on the Neck Disability Index,
- Having a history of chronic neck pain for at least 3 months,
- Having a pain level of 5/10 or more,
- Showing signs of cervical movement control dysfunction,
- Having cervical muscle tenderness during physical examination.
- Being diagnosed with a vascular disease,
- Being diagnosed with a vestibular disease,
- Being diagnosed with hypertension,
- Being diagnosed with fibromyalgia or rheumatoid arthritis,
- Having had spine surgery in the last 12 months,
- Having received an exercise program or standard physiotherapy program involving the cervical region in the last 12 months,
- Having congenital or acquired kyphosis, scoliosis, etc. having postural deformity,
- Having specific neck pain such as cancer,
- Having fractures, instability, inflammatory diseases, history of neck trauma, infections, neurological deficit, having spinal diseases such as radiculopathy, spondylosis.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method Pain Assesment 8 week An algometer with a 1 cm2 rounded surface area will be used for objective pain assessment. Measurements will be made on the spinous processes of C2 and c5 and the trapezius muscle. The assessor will gradually increase the pressure until pain or discomfort occurs and the patient says "yes". The average of the three measurements will be taken. A 30-second rest period will be given between each measurement.
Disability Assesment 8 week Neck Disability Index, designed to assess how neck pain affects daily living activities, will be used. The questionnaire includes 10 items that measure disability secondary to neck pain. Scores range from 0-50 and are interpreted as follows:
* 0-4 represents no disability,
* 5-14 represents mild disability,
* 15-24 represents moderate disability,
* 25-33 represents severe disability,
* 34 and above represents complete disability.
- Secondary Outcome Measures
Name Time Method Cervical Joint Range of Motion Assessment 8 week Goniometer will be used for active ROM (flexion, extension, left/right rotation, left/right lateral flexion) measurements. Maximum ROM will be measured in degrees for each test. Participants will be asked to sit against the back of the chair, look forward, and position their arms in a relaxed manner.
Cervical Postur Assesment 8 week The craniovertebral angle will be measured for forward head posture in the sagittal plane. The craniovertebral angle will be measured with the photograph method. The camera is fixed 1.5 meters away on a flat surface aligned with the humeral head of the participants. The participants are asked to perform head flexion-extension movements to find the neutral head position and the participants are told to stay in the most appropriate position. A cursor is placed on the c7 spinous process and tragus in the photograph. The participants' photographs are taken 3 times. Craniovertebral angle is measured with the photographs taken and noted in degrees. The angles are averaged. Image processing will be done with Image J software
Cervical Strength Assessment 8 week Hand Held dynamometer will be used for strength assessment. It will include 3 isometric contractions held for 3 seconds for flexion, extension, lateral flexion and rotation movements. The value greater than the maximal contractions will be recorded.
Cervical Endurance Assessment 8 week Cervical Extensor Endurance Test: For the test, patients will be asked to lie in a prone position with their head and upper body positioned on the edge of the bed and their arms next to their body. A 2 kg sandbag will be placed on the patient's cervical region. They will then be asked to lift their head to a neutral position and maintain this position. The test will end when the patient feels any pain or fatigue or when there is a 5° deterioration in head position (measured with an inclinometer). The test will be repeated twice with a 3-minute rest interval and the longest holding time in seconds will be recorded as the test result.
Cervical Endurance Assesment 8 week Cervical Flexion Endurance Test: Participants will be asked to lie in a crook-lying position. The physiotherapist will place their hand under the patient's head. They will be asked to lift their head approximately 2.5 cm off the bed and maintain this position for as long as possible. The test will end when the patient feels any pain or fatigue or when their head touches the therapist's hand. Endurance time was measured in seconds. The test will be performed twice with 3 minutes of rest between repetitions.
Neck Awareness Assesment 8 week It will be evaluated with the Fremantle Neck Awareness Questionnaire. It is a simple Likert-type questionnaire (0=Never/Never feel like this, 1= Rarely feel like this, 2= Sometimes or some of the time feel like this, 3= Often feel like this, 4= Always or most of the time feel like this) that evaluates the individual's altered perception. The questionnaire asks individuals 9 questions such as how they perceive their neck in relation to their body.
Trial Locations
- Locations (1)
Mugla Education and Research Hospital
🇹🇷Mugla, Menteşe, Turkey