Effect of Scapular Motor Control Exercise in Patient With Chronic Mechanical Neck Pain

Chronic mechanical neck pain (CMNP) is defined as generalized neck and/ or shoulder pain for more than 3 months with symptoms provoked by neck movement, neck postures, or palpation of the cervical muscles .

regional interdependence (RI) is defined as the concept that a patient's primary musculoskeletal symptom(s) may be directly or indirectly related or influenced by impairments from various body regions and systems regardless of proximity to the primary symptom(s)'.

Changes in scapular posture and alteration of muscle activation patterns of scapulothoracic muscles are cited as potential risk factors for neck pain the structural connectivity of the cervical spine and scaopulothorathic muscles . The bones and muscles of the cervical spine and the shoulders are connected to each other mechanically, thus a continuously applied mechanical load on the shoulders directly increases the load on the cervical region, which may cause joint and ligament pain Scapular malalignment can contribute to prolonged compressive loading of the posterior cervical structures .

It has been suggested that abnormal joint stress affects the firing of cervical afferents, leading to changes in proprioceptive function. Moreover, pain leads to changes in motor control . we believe that scapular motor control exercises using PNF technique may help to restore normal alignment and reverse this vicious circle PNF Technique is based on movement patterns to facilitate and correct sensory-motor function it has been suggested that PNF correct the impaired impulses emerging from proprioceptive receptors in the muscle. Therefore, it decreases pain and desires to improve the strength of muscles. PNF position renders a greater amount of sensory input coming from the periphery than that in the neutral position .The purpose of this study is to investigate the effect of motor control training using scapular PNF exercise on neck pain, function, proprioception, and scapular muscle strength in patients with chronic mechanical neck pain.