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Investigation of the Effectiveness of Manual Therapy Plus Cervical Stabilization Exercise in Chronic Neck Pain

Not Applicable
Completed
Conditions
Neck Pain
Interventions
Other: Manual Therapy
Other: Cervical Stabilazation Exercise (CSE)
Registration Number
NCT04420403
Lead Sponsor
Ataturk Training and Research Hospital
Brief Summary

This study aims to investigate the effectiveness of manual therapy plus cervical stabilization exercise compared to manual therapy alone on balance, proprioception, and neck muscle morphology in chronic neck pain.

Detailed Description

Neck pain is defined as pain and/or stiffness localized to the dorsal area of the area between the condyle of the occiput and the third thoracic vertebra. Chronic neck pain (CNP), defined as persistent pain lasting three or more mounts, causes disability and a reduction in life quality. Balance disorders or postural instability, a deficit in proprioception, changes in muscle recruitment, a decrease in dimension of deep cervical muscle, and an increase in stiffness of superficial neck muscle may lead to pain in patients with CNP. Both manual therapy and exercise have favorable effects on management with CNP. According to our knowledge, no study has investigated the effects of manual therapy plus cervical stabilization exercise on balance, proprioception, and neck muscle morphology in CNP, yet.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
20
Inclusion Criteria
  • 20 to 55 years of age,
  • Having generalized neck pain for more than 3 months,
  • Being volunteer
Exclusion Criteria
  • Being pregnant,
  • Malignancy,
  • Having cervical stenosis,
  • Severe cervical spondylosis,
  • Cervical fractures and tumor,
  • Osteoporosis,
  • Positive vertebrobasilar test
  • Positive Babinski reflex
  • Neurologic deficit related to compression of the spinal root or cord,
  • Having neurologic, dermatologic, infectious, inflammatory rheumatologic and endocrine diseases,
  • Being an inability to fulfill the questionnaires,
  • Any problems that will hinder exercise (advanced cardiopulmonary or orthopedic problems), having intervention including exercise program or physiotherapy in the three months

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Manual therapy plus cervical stabilization exercise groupCervical Stabilazation Exercise (CSE)The patients diagnosed with chronic neck pain (CNP) with 18-55 years of age followed by routine controls and who were volunteered will be included in the study.
Only manual therapy groupManual TherapyThe patients diagnosed with CNP with 18-55 years of age followed by routine controls and who were volunteered will be included in the study.
Manual therapy plus cervical stabilization exercise groupManual TherapyThe patients diagnosed with chronic neck pain (CNP) with 18-55 years of age followed by routine controls and who were volunteered will be included in the study.
Primary Outcome Measures
NameTimeMethod
Balancechange from baseline at 6 weeks

The balance will be evaluated with Biodex BioSwayTM Balance Evaluation System. It reliably measures the patient's ability to balance on soft and/or hard ground.

Secondary Outcome Measures
NameTimeMethod
Disability levelchange from baseline at 6 weeks

The disability level will be measured with the Turkish version of Neck Disability Index (NDI). It consists of 10 sections which include the severity of pain, personal care, lifting, reading, headache, concentration, work-life, driving, sleeping and leisure activities. There are 6 responses for each section, scored 0 (no pain and no functional limitation) and 5 (worst pain and maximum limitation). The total score ranges from 0 to 50. Patients will be asked to select the most appropriate option for each section.

Proprioceptionchange from baseline at 6 weeks

Proprioception will be assessed with dual digital inclinometer. The feet of the inclinometers will be placed as simultaneously as possible over the head of the patients and the cervical seventh vertebra. Firstly, patients will be asked to move their heads forward as possible as from the neutral position and then they will try to find neutral position from reached position. The angle on digital display of inclinometer will be recorded as degree. Each test will be repeated 3 times and the average deviation error score will be recorded.

Muscle morphologychange from baseline at 6 weeks

The thickness and stiffness of the neck muscles will be evaluated by a specialist radiologist with real-time ultrasonography. It is a reliable, valid and, non-invasive method that provides an assessment of muscle morphology. Measurements will be made by using the Logiq S7 / Expert ultrasound device. The cross-sectional area of deep neck muscle with sonography, the stiffness of the superficial muscles with elastography were assessed.

Pain intensitychange from baseline at 6 weeks

The pain intensity will be assessed with the Visual Analog Scale, which consists of a horizontal line of 10 cm in length. For pain level assessment, "0" defines "no pain" and "10" defines "unbearable pain''. The participants will be asked to mark the intensity of their pain level.

Trial Locations

Locations (1)

Ankara Yildirim Beyazit University

🇹🇷

Ankara, Turkey

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