Effect Of First Rib Mobilization Combined With Scapular Stabilization Exercises On Pain, Range And Disability In Non-specific Chronic Neck Pain: A Randomized Controlled Trial

This study aims to evaluate the effect of first rib mobilization combined with scapular stabilization exercises on pain intensity, cervical range of motion and functional disability in individuals with non specific chronic neck pain. Chronic neck pain is commonly associated with altered cervicothoracic biomechanics, first rib dysfunction and scapular muscle imbalance. Although first rib mobilization and scapular stabilization exercises have shown individual benefits, the combined effect of these interventions has not been adequately explored. In this randomized parallel group placebo controlled trial, thirty eight participants aged twenty to forty five years with non specific chronic neck pain lasting three months or more will be randomly allocated into two groups. The control group will receive conventional physiotherapy with sham first rib mobilization. The experimental group will receive first rib mobilization combined with scapular stabilization exercises along with conventional physiotherapy. The intervention will be provided four sessions per week for three weeks. Primary outcome will be pain intensity measured using Numerical Pain Rating Scale. Secondary outcomes will include cervical range of motion measured using Dual Inclinometer and functional disability measured using Neck Disability Index. Outcomes will be assessed at baseline and after completion of three weeks of intervention. The findings of this study may help establish an effective biomechanically oriented physiotherapy approach for managing chronic neck pain.