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CompletedNCT03813680Updated Mar 11, 2021

Passive Vertebral Mobilization and Propriocemptive Neuromuscular Techniques in Mechanical Neck Pain

An interventional study of Passive Vertebral Mobilization and PNF exercise in Mechanical Neck Pain, sponsored by Isra University. Completed. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2021-03-11.

Sponsored by Isra University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
90
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

This study was conducted to determine the effectiveness of Passive Vertebral Mobilization (PVM) and Proprioceptive Neuromuscular Techniques (PNF) in reducing pain, disability and improving quality of life in patients with Mechanical Neck Pain.

Read the detailed description

Neck Pain is very common and is now considered a public health issue. It poses significant health and economic burden, being a frequent cause of disability. A significant proportion of direct health care costs associated with neck disorders are attributable to visits to health care providers, to sick leave, and to the related loss of productive capacity. Mechanical neck pain affects between 45-54% of people in the general population .This can result in severe pain and disability. Mechanical neck pain described as a reduction in the mobility of cervical spinal segment is often the focus of manipulative physical therapy interventions. Most neck pain is not attributed to diseases but rather caused by muscular and postural condition. The cervical pain is a mechanical problem .It is therefore sense that a mechanical treatment works better than pharmacological treatment.

Cervical spine often impairs flexibility of key muscles related to cervical spine . Stretching exercise is beneficial for increasing flexibility as well as muscle performance.

The normal function of cervical spine is complex and requires a large variety of activities to be coordinated in order for an individual to perform daily activities with the least amount of strain and potential injury. When the dysfunction develops in the cervical spine, a chain reaction may develop which can affect the whole neck and even the entire body.

Commonly used approaches to treatment include rest, therapeutic massage, application of physical agents like heat, cold, TENS, and ultrasonic various types of mobilizations, manipulations (by physical therapists, chiropractors, osteopaths and others), therapeutic exercises, postural care and off course medication and surgical interventions. However, studies of their effectiveness have generally been short-term and inconclusive. The aim of the study is to compare which treatment either Passive Vertebral Mobilization or Proprioceptive Neuromuscular Facilitation, whether itself or in combination, is more effective and beneficial in the treatment of mechanical neck pain.

Several studies have been reported to determine the effectiveness of manual therapy/ passive vertebral mobilization but with largely inconclusive results. However there are few studies if any to compare PNF exercise with PVM in terms of their effectiveness. PNF are simple and requiring low level expertise as compare to PVM.

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Conditions studied

  • Mechanical Neck Pain

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Keywords

  • Mechanical Neck Pain
  • Passive Vertebral Mobilization
  • Proprioceptive Neuromuscular Techniques (PNF)
  • Quality of Life
  • Disability
  • Pain
03

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients with mechanical neck pain having limited range of motion and muscle spasm and difficulty function between 18 to 60 years of age

Exclusion criteria

Exclusion Criteria:

  • Patients diagnosed with rheumatoid arthritis, Ankylosing spondylitis or other systemic disease
  • Patients with cancer of the cervical spine
  • Patients with history of fracture of spine
  • Patients with any congenital anomaly of Cervical spine
  • Patients having whiplash disorder with in last four weeks
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
90 participants (actual)

Study arms

  • Active comparator
    PVM group

    This group included 30 participants. Passive vertebral mobilization was given along with routine physiotherapy comprising TENS, Hotpack/IRR, Isometric neck exercise and postural care

    Other: Passive Vertebral Mobilization · Other: Routine Physiotherapy

  • Active comparator
    PNF group

    This group included 30 participants. PNF exercise in the form of diagonal pattern neck movements was along with routine physiotherapy comprising TENS, Hotpack/IRR, Isometric neck exercise and postural care

    Other: PNF exercise · Other: Routine Physiotherapy

  • Active comparator
    RPT(Routine Physiotherapy) group

    This group included 30 participants.Routine physiotherapy comprising TENS, Hotpack/IRR, Isometric neck exercise and postural care.

    Other: Routine Physiotherapy

Interventions

  • OtherPassive Vertebral Mobilization

    Posteroanterior glides was given to cervical spine using Maitland method along with routine physiotherapy comprising thermotherapy with Hot Packs 15 minutes, Transcutaneous Electrical Nerve Stimulation (TENS) 15 minutes,Isometric neck exercises,Education on precautions and postural care

    Also known as: Spinal mobilization

  • OtherPNF exercise

    The subjects was given PNF exercises comprising PNF diagonal patterns for neck along with routine physiotherapy comprising thermotherapy with Hot Packs 15 minutes, Transcutaneous Electrical Nerve Stimulation (TENS) 15 minutes,Isometric neck exercises,Education on precautions and postural care

    Also known as: Proprioceptive Neuromuscular Facilitation

  • OtherRoutine Physiotherapy

    Thermotherapy with Hot Packs 15 minutes, Transcutaneous Electrical Nerve Stimulation (TENS) 15 minutes,Isometric neck exercises,Education on precautions and postural care

    Also known as: Routine Physical therapy (RPT)

05

What researchers measure

Primary outcomes

  1. Visual Analog Scale (PAIN)

    changes from baseline. Visual Analog Scale (VAS) is a 10 cm horizontal line, with 0 presenting No pain and 10 representing Worst Pain.

    Time frame: 4 weeks

  2. ROM of Cervical spine (Flexion)

    changes from baseline

    Time frame: 4 weeks

  3. ROM of Cervical spine (Extension)

    changes from baseline.Bubble inclinometer was used to measure ROM in sitting position

    Time frame: 4 weeks

  4. ROM of Cervical spine (rotation rightward)

    changes from baseline.Bubble inclinometer was used to measure ROM in sitting position

    Time frame: 4 weeks

  5. ROM of Cervical spine (rotation leftward)

    changes from baseline. Bubble inclinometer was used to measure ROM in sitting position

    Time frame: 4 weeks

  6. ROM of Cervical spine (Side bending Right)

    changes from baseline.Bubble inclinometer was used to measure ROM in sitting position

    Time frame: 4 weeks

  7. ROM of Cervical spine (Side bending Left)

    changes from baseline.Bubble inclinometer was used to measure ROM in sitting position

    Time frame: 4 weeks

  8. Neck Flexors Muscle endurance

    changes from baseline. Neck Flexion holding time in supine lying position was measured in seconds with the help of stop watch.

    Time frame: 4 weeks

  9. NDI (neck Disability Index)

    changes from baseline NDI is self rated index to measure pain and disability due to neck pain. Neck disability index consists of 10 questions addressing functional activities. There are 6 potential responses for each item, ranging from no disability (0) to total disability (5).The NDI is scored from 0 to 50 with higher score indication greater disability.

    Time frame: 4 weeks

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Study locations

No study locations are listed for this record.

07

References and documents

Publications

  • Ashfaq M, Babur MN, Malick WH, Hussain MA, Awan WA. Comparative effectiveness of proprioceptive neuromuscular facilitation and passive vertebral mobilization for neck disability in patients with mechanical neck pain: A randomized controlled trial. J Bodyw Mov Ther. 2022 Jul;31:16-21. doi: 10.1016/j.jbmt.2022.02.009. Epub 2022 Mar 18. PubMed 35710215 ↗

Individual participant data

Plan to share: No

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Registry details

Key details

Study ID
NCT03813680
Lead sponsor
Isra University
Responsible party
Muhammad Ashfaq (Principal Investigator, Isra University) — Principal investigator
First posted
Jan 23, 2019
Start date
Sep 20, 2015
Primary completion
Sep 30, 2017
Completion
Mar 22, 2018
Last update
Mar 11, 2021

Study contacts

Muhammad Ashfaq
principal investigator · Isra University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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