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Deep Cervical Flexor and Sensorimotor Training for Chronic Neck Pain

ConditionMechanical Neck Pain
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age20-40
SponsorAl-Neelain University

About this trial

This randomized controlled trial aims to investigate the effectiveness of deep cervical flexor muscle training combined with sensorimotor (proprioception) training in patients with chronic mechanical neck pain. The study will be conducted in outpatient clinic of the faculty of physical therapy- Cairo University, involving 60 participants aged 20-40 years with neck pain persisting for more than three months. Participants will be randomly allocated into an experimental group receiving conventional physical therapy plus deep flexor and sensorimotor training, and a control group receiving conventional treatment alone. Outcome measures will include pain intensity, craniovertebral angle (CVA), cervical range of motion (ROM), segmental mobility, neuromotor control, proprioception (head repositioning accuracy), and respiratory function (FEV1 and PEF). Assessments will be performed at baseline and after four weeks of intervention. The study seeks to provide evidence-based recommendations for physiotherapy management of mechanical neck pain, particularly addressing the gaps in literature within the regional context.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Participants aged between 20-40 years.

participant having neck pain report more than 4 in NPRS, and at least within the last three months known as chronic pain.

participant with CVA more than 45 degrees and less than 50.

Participant with poor cervical muscle endurance.

Disqualifiers

Participant with acute neck pain (less than three month).

Participant with radiated neck pain.

Participant who undergone recent surgeries within the thoracic, shoulder girdle, and cervical spine regions.

Participants who were already undergoing treatment for neck pain.

Trial design

Design model

Parallel

Treatments tested in this trial

  • Deep cervical flexors muscle training and sensorimotor training

    Other intervention

    deep cervical flexor muscle training will be performed according to the protocol of Jull and Falla using a pressure biofeedback unit. Participants will be positioned in a supine crook-lying posture with the neck in a neutral position, and the air bag of the pressure biofeedback unit will be placed beneath the cervical lordosis and inflated to a baseline of 20 mmHg. Patients will be instructed to perform a gentle nodding action, increasing the pressure by 2 mmHg increments up to 30 mmHg. Each increment will be held for ten seconds, repeated in three sets of ten repetitions, with a two-minute rest between sets. To enhance activation of the deep flexors, patients will be instructed to keep their mouth open during the exercise. Proprioception training will include head relocation practice, oculomotor exercises, and eye-head coordination exercises.

  • conventional physical therapy exercise

    Other intervention

    will include stretching exercises targeting the sternocleidomastoid, upper trapezius, levator scapulae, scalene, Rhomboids and pectoralis muscles, performed in three repetitions, holding each stretch for thirty seconds, strengthening exercises will be provided Isometrically for the cervical flexors, extensors and at sides using a prescription of three sets of ten repetitions with a ten-second hold and two minutes of rest between sets. TENS and Hot back.

Treatment groups

60 Participants
are divided into 2 treatment groups
Group A: core stability exercise and proprioception trainingExperimental treatment 1 intervention
Group B: conventional physical therapy exerciseActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Change in Pain Intensity Score on the Numeric Pain Rating Scale (NPRS) from Baseline to 4 Weeks

which will be measured using the Numeric Pain Rating Scale (NPRS), a validated 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain).

Time frame
4 weeks

Secondary outcomes

1

Change in Cervical Range of Motion (ROM) in Degrees Measured by Digital Inclinometer from Baseline to 4 Weeks

Flexion, Extension and Rotation range will be assessed using the Digital Inclinometer,

Time frame
4 weeks
2

Change in Neuromotor Control of the Deep Cervical Flexor Muscles Assessed by Craniocervical Flexion Test (CCFT) from Baseline to 4 Weeks

will be evaluated using the Craniocervical Flexion Test (CCFT) with a pressure biofeedback unit (PBU),

Time frame
4 weeks
3

Change in Craniovertebral Angle (CVA) Measured by AI Posture Evaluation and Correction System (APECS) from Baseline to 4 Weeks

will be used as a key postural assessment parameter, measured via the AI Posture Evaluation and Correction System (APECS) mobile application, which provides reliable digital posture analysis using lateral photographic images to quantify forward head posture.

Time frame
4 weeks
4

Change in Cervical Proprioceptive Function Assessed by Head Repositioning Accuracy (HRA) Test in centimetre from Baseline to 4 Weeks

will be evaluated through the Head Repositioning Accuracy (HRA) Test,

Time frame
4 weeks

Other outcomes

Locations

1

Map coordinates are unavailable for these locations. Locations are shown below instead.

Out-patient clinic- Faculty of physical therapyRecruiting12111, Cairo, Giza GovernorateEgyptEgypt

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Al-Neelain University

Lead sponsor

Source ClinicalTrials.gov
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