Chronic non-specific neck pain is a common musculoskeletal condition affecting a large proportion of the population worldwide. It is characterized by persistent neck pain lasting more than three months without a specific underlying pathology. Many patients experience ongoing symptoms such as pain, reduced range of motion, functional limitations, and psychological factors like kinesiophobia, which can negatively affect recovery and quality of life.
Conventional physiotherapy, including supervised clinic-based rehabilitation, is widely used for the management of chronic non-specific neck pain. These programs typically involve exercise therapy and patient education; however, access to regular in-clinic treatment can be limited due to factors such as travel, cost, and time constraints.
Telerehabilitation has emerged as an alternative approach that allows delivery of physiotherapy services through online platforms, improving accessibility and convenience for patients. In addition, pain neuroscience education (PNE) is an evidence-based strategy that helps patients understand pain mechanisms, reduce fear-avoidance behaviors, and improve treatment outcomes when combined with exercise therapy.
Although both telerehabilitation and supervised clinic-based rehabilitation are effective, there is limited evidence directly comparing these two approaches when combined with standardized pain neuroscience education.
Therefore, this randomized controlled trial aims to compare the effects of telerehabilitation with pain neuroscience education and supervised clinic-based rehabilitation with pain neuroscience education on pain intensity, functional disability, and kinesiophobia in individuals with chronic non-specific neck pain.
Age between 18-40 years of both male and female gender.
Currently suffering from neck pain & bilateral neck pain for at least three months.
Moderate pain intensity (30mm to 70mm) on Visual Analogue Scale .
Access & knowledge of mobile phone and internet use .
Any previous neck surgery or cervical trauma .
Fibromyalgia & Myelopathy .
Spinal deformities like thoracic hyper kyphosis or scoliosis .
Cervical radiculopathy ,vertigo, cancer & vertebral fractures.
Parallel
Telerehabilitation with Pain Neuroscience Education
Other interventionA remotely delivered physical therapy program including stretching and strengthening exercises for cervical and scapular muscles combined with pain neuroscience education, delivered via online platforms three times per week for six weeks.
Supervised Clinic Based Rehab with Pain Neuroscience Education
Other interventionA clinic-based physiotherapy program including stretching and strengthening exercises for cervical and scapular muscles combined with pain neuroscience education, delivered under direct supervision three times per week for six weeks.
Numeric Pain Rating Scale for Pain Intensity (NPRS)
Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), an 11-point self-reported scale ranging from 0 (no pain) to 10 (worst imaginable pain). The NPRS is a valid, reliable, and responsive tool commonly used to evaluate pain intensity in individuals with neck pain.
Neck Disability Index for Functional Disability (NDI)
Functional disability will be assessed using the Neck Disability Index (NDI), a self-reported questionnaire consisting of 10 items related to daily activities, including pain intensity, personal care, lifting, reading, concentration, headache, work, driving, sleeping, and recreation. Each item is scored from 0 to 5, with total scores ranging from 0 to 50. Higher scores indicate greater disability.
Tampa Scale of Kinesiophobia (TSK-11)
Kinesiophobia will be assessed using the 11-item Tampa Scale of Kinesiophobia (TSK-11). Each item is scored on a 4-point Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree), with total scores ranging from 11 to 44. Higher scores indicate greater fear of movement and reinjury.
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