Core Stability Exercises Versus Scapular Stabilization Exercises on Hand Grip Strength in Patients With Chronic Myofascial Neck Pain
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Hand Grip Strength
研究概览
简要总结
Chronic myofascial neck pain (CMNP) is a painful non-articular musculoskeletal neck syndrome that is a persistent and prevalent with a high incidence of recurrence rate range 30-93%.Management of myofascial trigger points were directed at its deactivation, and prevention of its recurrence. Based on mechanical kinetic chain, the upper extremity functions as a unique system of connected segments those collaborated in a harmony in order to perform daily life activities. Core stability exercises maximize motor pathways mechanoreceptors' activities, as well scapular stabilization exercises are generally recommended based on reported benefits in terms of chronic neck pain. The relationship between chronic myofascial neck pain, and hand disability is quite strong. From mechanical point of view, core stability exercises improve trunk stability in line to enhance upper extremity efficiency that facilitates hand, and pinch grasping. In addition, scapular stabilization exercises could improve both hand, and pinch grasp strength and dexterity. Therefore, this randomized clinical trial will be conducted in line to clarify the superiority of the therapeutic effects between core stability exercises, scapular stabilization exercises, and conventional physical therapy program on hand grip strength, pinch grip strength, neck pain intensity level, pain pressure threshold, and whole upper extremity functional level in patients with chronic myofascial neck pain.
详细描述
Chronic myofascial neck pain (CMNP) is a painful non-articular musculoskeletal neck syndrome that is a persistent and prevalent with a frequently reported myofascial trigger points (MTrPs) at upper trapezius with a reported prevalence of up to 93.75%. Individuals with upper trapezius MTrPs would have an overall upper extremity muscular strength reduction that ultimately resulting in decline hand grip strength. positive relation between core endurance and hand grip strength. That finding may be explained by the fact that the core region exhibits an anatomical, and biomechanical interconnection with the extremities, characterized by a prominent muscular linkage. Both core and scapular stabilization exercises has been addressed as one of the most evidence-based modalities. core acts as a the central most part of the kinetic chain, or a double walled cylinder with abdominals in front, multifidis as back, diaphragm as a roof, pelvic floor at the bottom. Where upper extremities connect with core, and attached extremities articulations that transfer energy from torso proximally to extremities' parts distally during functional activities . Scapular stability represents a vital role in terms of whole upper extremity functioning. The research gap to answer the question; Are there any significant differences between core stability exercises, scapular stabilization exercises, and conventional physical therapy program on hand grip strength, pinch grip strength, neck pain intensity level, pain pressure threshold, and whole upper extremity functional level in patients with chronic myofascial neck pain?
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
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
盲法说明
Subjects will be included diagnosed with chronic myofascial neck pain depending on certified referral, and physical examination. Subjects will be randomly assigned into three equal groups. Each group consisted of 20 subjects. Simple randomization will be done as the following a double, blinded randomization using opaque, sealed envelopes, containing the name of one of each group (groups A, B and C). The second supervisor, who is not participating in recruiting, treating or evaluating participants selected the envelopes. After the initial assessment that conducted by the third supervisor 'who will be completely blinded regarded the participants ' distribution on the three groups', but before first therapy session, group allocation will be carried out; finally papers will be picked and assigned to three groups.
入排标准
- 年龄范围
- 25 Years 至 45 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients diagnosed with chronic myofascial neck pain depending on referral, and physical examination.
- •Sixty patients diagnosed with chronic myofascial neck pain for more than six months.
- •Patients age range will 25-45 years
- •Patients body mass index (BMI) will be 18.5-24.9 kg/m2
- •Each patient suffering from all active MTrPs in the upper trapezius muscle with painful/ tender nodule.
- •Patients have a constant neck pain with positive jump sign when palpating the upper trapezius muscle.
- •Patients have referred pain, and symptoms of ipsilateral hand muscle weakness.
- •No history of undergoing physiotherapy modalities or corticosteroid injection therapies in the past six months before the study
排除标准
- •Presence of signs of severe pathology such as malignancies, mainly of the cervical region.
- •Fracture of the cervical spine.
- •Cervical radiculopathy or myelopathy.
- •Diabetes mellitus.
- •Trauma, cognitive anomalies, and surgery around neck, shoulders, or hand.
- •Fibromyalgia or vascular syndromes such as vertebral basilar insufficiency.
- •Having undergone physical therapy within the past three months before the study.
- •Having corticosteroid injection therapies in the past 3 months before the study.
研究组 & 干预措施
Experimental Group A (Core Stability)
consists of 20 participants who receive core stability exercises, plus the traditional physical therapy program in the form of ischemic compression of upper trapezius muscle, strain-counter strain of upper trapezius muscle, and muscle energy technique of upper trapezius muscle, three sessions per week for 6 weeks.
干预措施: Traditional Physical Therapy Protocol (Other)
Experimental Group B (Scapular Stabilization)
consists of 20 participants who receive scapular stabilization exercise, plus the traditional physical therapy program, three sessions per week for 6 weeks.
干预措施: Scapular stabilization Exercise Protocol (Other)
Experimental Group B (Scapular Stabilization)
consists of 20 participants who receive scapular stabilization exercise, plus the traditional physical therapy program, three sessions per week for 6 weeks.
干预措施: Traditional Physical Therapy Protocol (Other)
Control Group C (Traditional Physical Therapy Program)
consists of 20 participants who receive the traditional physical therapy program, three sessions per week for 6 weeks, only
干预措施: Traditional Physical Therapy Protocol (Other)
Experimental Group A (Core Stability)
consists of 20 participants who receive core stability exercises, plus the traditional physical therapy program in the form of ischemic compression of upper trapezius muscle, strain-counter strain of upper trapezius muscle, and muscle energy technique of upper trapezius muscle, three sessions per week for 6 weeks.
干预措施: Core Stability Exercise Protocol (Other)
结局指标
主要结局
Hand Grip Strength
时间窗: 1. At Baseline (Pre-procedure), 2. Post-treatment ( after 6 weeks of treatment program).
Hand-held Dynamometer (SAMMONS PRESTON, INC. Bolingbrook, IL604404989) will be used to measure it. The patient will sit on a standard height chair with no armrest with his/ her forearm in a neutral position, and shoulder in adducted and neutral rotation, with elbow flexed 90 degrees (°). The patient will be requested to squeeze the ipsilateral hand on the hand grip dynamometer handle accordingly to the ordered verbs 'i.e., one, two, three, squeeze…harder, harder'. Three measures will be conducted with one minute a break in between, then the average will be recorded in value score.
Pinch Grip Strength
时间窗: 1. At Baseline (Pre-procedure), 2. Post-treatment ( after 6 weeks of treatment program).
The pinch gauge (FEI, White plains, NY 10602, USA) will be used to measure the pinch grip strength, it is a valid and reliable tool. The patient will sit on a standard height chair with no armrest with his/ her shoulder, elbow, forearm, and wrist in a neutral position. The patient will be requested to squeeze the thumb pad as firm as possible against the lateral aspect of index fingers' middle phalanx, while the examiner will hold the distal end of the pinch gauge. Three measures will be conducted with one minute a break in between, then the average will be recorded in a score value.
Hand Grip Strength
时间窗: 1. At Baseline (Pre-procedure), 2. Post-treatment (Post 6 weeks of treatment program).
Hand-held Dynamometer (SAMMONS PRESTON, INC. Bolingbrook, IL604404989) will be used to measure it. The patient will sit on a standard height chair with no armrest with his/ her forearm in a neutral position, and shoulder in adducted and neutral rotation, with elbow flexed 90 degrees (°). The patient will be requested to squeeze the ipsilateral hand on the hand grip dynamometer handle accordingly to the ordered verbs 'i.e., one, two, three, squeeze…harder, harder'. Three measures will be conducted with one minute a break in between, then the average will be recorded in value score.
Pinch Grip Strength
时间窗: 1. At Baseline (Pre-procedure), 2. Post-treatment (Post 6 weeks of treatment program).
The pinch gauge (FEI, White plains, NY 10602, USA) will be used to measure the pinch grip strength, it is a valid and reliable tool. The patient will sit on a standard height chair with no armrest with his/ her shoulder, elbow, forearm, and wrist in a neutral position. The patient will be requested to squeeze the thumb pad as firm as possible against the lateral aspect of index fingers' middle phalanx, while the examiner will hold the distal end of the pinch gauge. Three measures will be conducted with one minute a break in between, then the average will be recorded in a score value.
次要结局
- Chronic Myofascial Neck Pain Intensity assessment using Numerical Pain Rating Scale:(1. At Baseline (Pre-procedure), 2. Post-treatment ( after 6 weeks of treatment program).)
- Pressure Pain Threshold using electronic pressure algometer(1. At Baseline (Pre-procedure), 2. Post-treatment ( after 6 weeks of treatment program).)
- Whole Upper Extremity Functional Level using Arabic-Q-DASH scale(1. At Baseline (Pre-procedure), 2. Post-treatment ( after 6 weeks of treatment program).)
- Chronic Myofascial Neck Pain Intensity assessment using Numerical Pain Rating Scale:(1. At Baseline (Pre-procedure), 2. Post-treatment (Post 6 weeks of treatment program).)
- Pressure Pain Threshold using electronic pressure algometer(1. At Baseline (Pre-procedure), 2. Post-treatment (Post 6 weeks of treatment program).)
- Whole Upper Extremity Functional Level using Arabic-Q-DASH scale(1. At Baseline (Pre-procedure), 2. Post-treatment (Post 6 weeks of treatment program).)
研究者
Adnan Abdelkhalik Atwa Gharib
Physical Therapy Specialist
Cairo University