Comparison of Joint Mobilization vs. Strengthening Exercises for Improving Cervical Proprioception in Individuals With Nonspecific Neck Pain: A Randomized Clinical Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 26
- 试验地点
- 1
- 主要终点
- Active cervical movement sense
研究概览
简要总结
This clinical trial aims to compare the effects of cervical joint mobilization versus cervical strengthening exercises in patients with chronic neck pain. The study will assess neck proprioception, pain intensity, cervical muscle strength, range of motion, and neck disability.
The main question it aims to answer is:
Which treatment is superior, or do they have equal effects after the first session and after the 12th session?
Participants will:
Receive either cervical joint mobilization or cervical strengthening exercises for 12 sessions.
Do not perform any physical therapy treatment outside the trial. Visit the clinic three times per week for treatment.
详细描述
Neck pain refers to a type of generalized neck discomfort characterized by mechanical features. This condition is a widespread issue, causing significant levels of pain, disability, and can lead to economical strain. Patients suffering from neck pain often experience functional impairments, including weak neck muscles and impaired proprioception. Strengthening exercises and cervical joint mobilization offer effective relief of pain and improve disability. Exploring the superiority of these techniques in improving cervical proprioception to prevent recurrence is still a vague topic. Therefore, this study will investigate the effect of Maitland joint mobilization versus cervical strengthening exercises in patients with nonspecific chronic neck pain on neck proprioception, pain intensity, cervical muscles strength, range of motion and neck disability. This is a double-blinded randomized clinical trial with a parallel-group design. Twenty-six participants will be allocated randomly to one of two groups. Group one (Mobilization) will have cervical joint mobilization according to Maitland approach. Group two (Exercises) will perform craniocervical, cervical and axioscapular muscles strengthening exercises. Treatment will be provided for 12 sessions. Both groups will receive standardized care, including patient education and transcutaneous electrical nerve stimulation.
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
- Double (Care Provider, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 50 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •18 to 50 years
- •Pain ≥ 3 months
- •Neck pain on VAS ≥ 3/10
- •NDI ≥ 5/50 points
- •ZZ Errors ≥ 9 or the time to complete the task ≥ 28s
排除标准
- •Unilateral headache aggravated by neck movement.
- •Upper extremity symptoms beyond the elbow.
- •Any history of neck trauma including whiplash
- •Recent fractures (last 8 weeks)
- •Cervical surgery (last 3 months)
- •Current neck-related dizziness
- •Known or suspected ves3bular pathology
- •Internal fixation of the cervical spine
- •Physical therapy for the neck (last 3 months)
研究组 & 干预措施
Joint mobilization group
This group will receive passive cervical joint mobilization following Maitland's approach for 3 sets of 1 minute on the most painful segment with one minute rest between sets. The specific technique and most painful level will be determined during the clinical examination. The participant lies prone on a treatment bed, then the therapist uses both thumbs to apply grade III or IV based on the patient's irritability using posteroanterior pressure to the cervical spinous process or articular pillar, with a rhythm of 2 to 3 Hz per second. This intervention could be applied in different positions of the cervical spine, depending on the patient's response, in a pain-free manner.
干预措施: Cervical joint mobilization (Other)
Strengthening exercises group
The exercise program will include concentric and eccentric training of the craniocervical, cervical flexors, extensors, muscles involved in cervical spine rotation and axioscapular muscles. The strengthening exercises with high frequency - low intensity will be performed. Low frequency - high intensity will be implemented when the patient's irritability is low.
干预措施: cervical strengthening exercises (Other)
结局指标
主要结局
Active cervical movement sense
时间窗: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4
Participants will be comfortably seated upright on a chair with a backrest, positioned 1 meter away from a board displaying a zigzag pattern (ZZ). They will wear a headband with a laser pointer attached. The pattern is affixed to the board in a manner that directs the laser beam to the pattern's centre.
Active cervical movement sense
时间窗: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4
Participants will be comfortably seated upright on a chair with a backrest, positioned 1 meter away from a board displaying a zigzag pattern (ZZ). They will wear a headband with a laser pointer attached. The pattern is affixed to the board in a manner that directs the laser beam to the pattern's centre.
Cervical joint position error
时间窗: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4
Participants were comfortably seated upright on a chair with a backrest, positioned 0.9 meters away from a wall. Using a distance laser meter, for accurate measurement, the distance between the forehead of the participant and the wall was measured after the participant wore a headband with a laser pointer attached. A point on the wall was located as the patient was in a self-neutral position. A warm-up session was given as the patient with open eyes was instructed to perform flexion, extension, and rotation on both sides and return to the selected point after each movement. After that, the patient was asked to perform the movement for three trials in each movement direction with their eyes closed.
次要结局
- Cervical range of motion(Three points: 1) baseline, 2) immediately after intervention, and 3) week 4)
- Cervical muscles strength(Three points: 1) baseline, 2) immediately after intervention, and 3) week 4)
- Cervical range of motion(Three points: 1) baseline, 2) immediately after intervention, and 3) week 4)
- Visual Analogue Scale(Three points: 1) baseline, 2) immediately after intervention, and 3) week 4)
- Cervical muscles strength(Three points: 1) baseline, 2) immediately after intervention, and 3) week 4)
- Neck Disability Index(Three points: 1) baseline, 2) week 4)
研究者
Faisal Fahad Alharthi
Principal investigator
Imam Abdulrahman Bin Faisal University