An interventional study of Aerobic Exercise and Combined Exercise in Neck Pain Musculoskeletal and Work Related Musculoskeletal Disorders, sponsored by Hacettepe University. Completed at 1 site in Turkey (Türkiye). Open to participants aged 20 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-04-23.
Sponsored by Hacettepe University · Not applicable, Interventional, and Treatment
This randomized controlled trial investigated the acute effects of aerobic exercise (AE) and combined aerobic and cervical-upper extremity resistance exercise (CE) on the pressure pain threshold (PPT), pain perception, and fatigue in workers with high ergonomic risk and chronic non-specific neck pain (CNNP).
A total of 78 workers were randomly assigned to AE, CE, or control groups. The AE and CE groups completed single 40-minute sessions, while the control group received a 30-minute educational session with additional seated rest periods before and after the session. PPT was assessed bilaterally at multiple anatomical sites using a digital pressure algometer. Neck pain, overall pain perception, and fatigue were evaluated using a numerical rating scale (NRS) before, immediately after, and 20 minutes after exercise.
The study focused on exercise-induced hypoalgesia (EIH) and was intended to inform brief, workplace-compatible exercise strategies to reduce pain, fatigue, and work-related musculoskeletal risks in this population.
This randomized controlled trial investigated the acute effects of aerobic exercise and combined aerobic and cervical-upper extremity resistance exercise on pain sensitivity, pain perception, and fatigue in workers with chronic non-specific neck pain exposed to high ergonomic risk.
Participants were recruited from occupational groups with high ergonomic risk and were assessed in two sessions. The first session was conducted in the workplace and included eligibility screening, demographic data collection, and ergonomic risk assessment. Participants were then randomly assigned to aerobic exercise, combined exercise, or control groups.
The second session was conducted in a university laboratory setting. Baseline assessments were performed, followed by the intervention. Outcome measures were collected before the intervention (T0), immediately after (T1), and 20 minutes after the intervention (T2).
The aerobic exercise group performed moderate-intensity cycling using a recumbent ergometer (64-76% of maximum heart rate), consisting of a 5-minute warm-up, 30 minutes of exercise, and a 5-minute cool-down. The combined exercise group performed aerobic exercise at the same intensity, followed by cervical and upper-extremity resistance exercises focusing on motor control and scapular stabilization. This protocol included a 5-minute warm-up, 15 minutes of aerobic exercise, 15 minutes of resistance exercise, and a 5-minute cool-down. The control group received a 30-minute educational session on exercise and workplace ergonomics.
Pain sensitivity was assessed using pressure pain threshold measurements obtained with a digital algometer at the C2, C5, and upper trapezius regions. Neck pain, overall body pain perception, and fatigue were evaluated using numerical rating scales (0-10).
Sample size was calculated using G*Power (v3.1.9.6) based on a previous study (effect size = 0.165 for a three-group design), with an alpha level of 0.05 and power of 0.80, resulting in a required sample of 78 participants. Considering a 20% drop-out rate, 95 participants were targeted.
Statistical analyses were performed using SPSS. Data normality was assessed using the Shapiro-Wilk test. Baseline differences between groups were analyzed using ANOVA and chi-squared tests. The primary analysis evaluated group × time interactions using repeated-measures ANOVA (T0, T1, T2), with Bonferroni post-hoc tests applied when appropriate. Statistical significance was set at p \< 0.05.
The study focused on exercise-induced hypoalgesia (EIH) and aimed to compare the immediate and short-term responses to different exercise modalities in a working population with chronic neck pain.
Hacettepe University is the lead sponsor of 983 studies on the registry; 212 are open to participants now.
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Participants performed moderate-intensity cycling using a recumbent ergometer in a single 40-minute session, including a 5-minute warm-up, 30 minutes of aerobic exercise, and a 5-minute cool-down.
Behavioral: Aerobic Exercise
Participants performed a combination of aerobic and resistance exercises in a single 40-minute session, including a 5-minute warm-up, 15 minutes of aerobic exercise, 15 minutes of resistance training targeting cervical and upper-extremity muscles, and a 5-minute cool-down.
Behavioral: Combined Exercise
A 30-minute educational session on exercise benefits, workplace ergonomics, and postural recommendations. Participants remained seated for 5 minutes before and after the session.
Behavioral: Informed Control
Moderate-intensity aerobic exercise performed using a recumbent cycle ergometer in a single 40-minute session. The protocol included a 5-minute warm-up, 30 minutes of continuous cycling, and a 5-minute cool-down. Exercise intensity was maintained at 64-76% of maximum heart rate and adjusted individually throughout the session. No resistance or strength training exercises were included.
Participants performed a combination of aerobic and resistance exercises in a single 40-minute session. The protocol included a 5-minute warm-up, 15 minutes of moderate-intensity aerobic exercise (64-76% HRmax, Borg RPE 11-14), 15 minutes of resistance exercises targeting cervical and upper-extremity muscles, and a 5-minute cool-down. The resistance program focused on cervical motor control and scapular stabilization, including chin tuck, cervical retraction with extension, scapular retraction, vertical pulling, horizontal shoulder abduction, scapular plane abduction, and shoulder elevation. Each exercise was performed for 8-10 repetitions in two sets with 30-second rest intervals. All exercises were supervised and performed with proper postural alignment.
Participants attended a 30-minute educational session on exercise benefits, workplace ergonomics, and postural recommendations. Participants remained seated for 5 minutes before and after the session.
Pressure Pain Threshold
Pressure pain threshold is assessed using a digital algometer to evaluate pain sensitivity. The value at which the sensation of pressure first becomes painful is recorded in lbf/cm². Three consecutive measurements are obtained at each site, and the mean value is used for analysis. Measurements are obtained bilaterally at the C2 region, C5 region, and upper trapezius muscle.
Time frame: Three time points: before the intervention (T0), immediately after the intervention (T1), and 20 minutes after the intervention (T2).
Acute Neck Pain Perception
Acute neck pain intensity is assessed using a numerical rating scale (0-10), a simple and widely used tool for evaluating pain. Participants are asked to select the number that best represents their pain intensity. Zero indicates no pain, and 10 represents the worst imaginable pain.
Time frame: Assessments are performed at three time points: before the intervention (T0), immediately after the intervention (T1), and 20 minutes after the intervention (T2).
Acute Overall Body Pain Perception
Acute overall body pain perception is assessed using a numerical rating scale (0-10), a simple and widely used tool for evaluating pain. Participants are asked to select the number that best represents their pain intensity. Zero indicates no pain, and 10 represents the worst imaginable pain.
Time frame: Assessments are performed at three time points: before the intervention (T0), immediately after the intervention (T1), and 20 minutes after the intervention (T2).
Acute Fatigue
Acute fatigue is assessed using a numerical rating scale (0-10), a simple and widely used tool for evaluating fatigue. Participants are asked to select the number that best represents their fatigue intensity. Zero indicates no fatigue, and 10 represents the worst imaginable fatigue.
Time frame: Assessments are performed at three time points: before the intervention (T0), immediately after the intervention (T1), and 20 minutes after the intervention (T2).
Ergonomic Risk Level - Rapid Upper Limb Assessment (RULA)
Ergonomic risk level is assessed using the RULA method to classify participants' workplace-related ergonomic risk at baseline.
Time frame: Baseline
Functional Aerobic Capacity 6-Minute Walk Test (6MWT)
Functional aerobic capacity is assessed using the 6MWT. The total walking distance is recorded to ensure that participants have sufficient functional capacity to safely complete the study procedure.
Time frame: Baseline
Physical Activity Level (IPAQ-SF)
Physical activity level is assessed using the International Physical Activity Questionnaire Short Form (IPAQ-SF). The questionnaire evaluates the time spent in walking, moderate, and vigorous physical activities over the past 7 days. Time Frame: Baseline
Time frame: Baseline
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Hacettepe University