“Effectiveness of Deep Cervical Fascial manipulation and Yoga postures on pain, function and oculomotor control in mechanical neck pain: A pragmatic, parallel group, randomized, controlled trialâ€

Purpose:  The pathological modifications of deep fascia are considered to be one of the sources of musculoskeletal pain. Mechanical Neck pain (MNP) is usually treated symptomatically and the involvement of the deep cervical fascia (DCF) and its continuum is often ignored which may be involved in the presence of plethora of symptoms.The associated symptoms of the upper quarter with MNP, leads to an extensive treatment without any positive treatment effect. This mandates the need for treatment, focusing on the anatomical myofascial continuum (DCF and its continuum) of the upper quarter which may help in relieving MNP. There is a dearth of literature on the anatomical continuity of deep cervical fascia and their potential implications in patients with MNP. A well-designed pragmatic study investigating the role of deep fascia and incorporating manipulation of the fascia in MNP is needed. Aim of the study: To study the effectiveness of deep cervical fascial manipulation and it’s continuum on pain, patient-specific functions, oculomotor control, and myofascial stiffness in sub-acute and chronic mechanical neck pain. Primary objective:  To study the effectiveness of fascia directed approach that includes fascial manipulation (4 sessions in 3-4 weeks) and sequential yoga poses (12 weeks) as compared to usual care.  The objective is to study effects on function, oculomotor control and pain in patients with subacute and chronic mechanical neck pain. Primary research hypothesis Secondary objectives 1. To study the effectiveness of fascia directed treatment approaches (FM & SYP), in comparison to usual care on elbow extension ROM angle during ULNT  2. To examine the modifying effects on the viscoelastic properties (tone, stiffness, elasticity) of myofascia by combining FM and SYP, compared to usual care in patients with MNP. 3. To investigate if there is any change in the patient-reported fear avoidance behavior with interventions such as FM and SYP when compared with the routine treatment of patients with MNP. The hypothesis of this study is fascia directed treatment approaches (FM and SYP) will be better to usual care (Therapeutic exercises, mobilisation, manipulation) for improving pain, functions and oculomotor control in subjects with MNP.