An interventional study of Neck Exercise Program and Diaphragmatic Myofascial Release and Diaphragm-Directed Manual Therapy in Chronic Neck Pain, sponsored by Abdelrahman Alghoul. Not yet recruiting at 1 site in Palestinian Territories. Open to participants aged 25 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-08-12.
Sponsored by Abdelrahman Alghoul · Not applicable, Interventional, and Treatment
Chronic neck pain can affect daily activities and may be associated with pain, disability, fear of movement, and fatigue. Exercise is commonly used to manage chronic neck pain, but some people continue to experience symptoms despite exercise treatment.
This study will investigate whether adding diaphragmatic myofascial release, a hands-on manual therapy directed toward the diaphragm and surrounding tissues, to a neck exercise program provides greater benefits than neck exercises alone in adults with chronic neck pain.
Sixty adults aged 25 to 60 years with chronic neck pain lasting more than three months will be randomly assigned to one of two groups. The control group will receive a supervised neck exercise program, while the intervention group will receive the same neck exercise program combined with diaphragmatic myofascial release and related diaphragmatic manual therapy. Both groups will receive treatment for six weeks, with three supervised sessions per week.
Pain, neck-related disability, fear of movement, and fatigue will be assessed before treatment, immediately after the six-week intervention, and four weeks after completion of treatment. The study will examine whether adding diaphragmatic myofascial release to neck exercises leads to greater improvements in these outcomes compared with neck exercises alone.
This study is a prospective, assessor-blinded, parallel-group randomized controlled trial that will be conducted at the outpatient Physical Therapy Clinic of Nasser Medical Complex in the Gaza Strip. The study aims to evaluate the added effect of diaphragmatic myofascial release and diaphragm-directed manual therapy when combined with a standardized neck exercise program in adults with chronic neck pain.
Participants will be randomly allocated in a 1:1 ratio to either an intervention group or a control group using a computer-generated random sequence. The control group will receive a supervised neck exercise program that includes deep cervical flexor training, cervical stabilization, stretching, postural correction, scapular strengthening, and a home exercise program. The intervention group will receive the same neck exercise program in addition to a diaphragm-focused intervention that includes manual diaphragm release, diaphragmatic myofascial release, release of accessory respiratory muscles, and breathing re-education.
The intervention period will last six weeks, with three supervised treatment sessions per week. Outcomes will be assessed at baseline, immediately after the intervention, and at a four-week follow-up. The clinical outcomes include neck-related disability measured using the Neck Disability Index (NDI), pain intensity measured using the Numeric Pain Rating Scale (NPRS), kinesiophobia measured using the Tampa Scale of Kinesiophobia (TSK-17), and fatigue measured using the Fatigue Severity Scale (FSS).
The study will compare changes over time between the intervention and control groups to determine whether adding the diaphragmatic intervention to neck exercises provides additional benefits for patients with chronic neck pain.
285 studies on the registry are indexed under Kinesiophobia; 91 are open to participants now.
This study's planned enrollment of 60 is above the median of 52 across 174 interventional studies indexed under Kinesiophobia.
Browse Kinesiophobia studies →This is the only study on the registry with Abdelrahman Alghoul as lead sponsor.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.
Cancer (malignancy)
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
COPD
Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants will receive a supervised neck exercise program consisting of deep cervical flexor training, cervical stabilization exercises, stretching exercises, postural correction, scapular strengthening, and a home exercise program. The intervention will be provided for 6 weeks with 3 supervised sessions per week.
Other: Neck Exercise Program
Participants will receive the same supervised neck exercise program as the active comparator group, combined with a diaphragm-focused intervention consisting of manual diaphragm release, diaphragmatic myofascial release, release of accessory respiratory muscles, and breathing re-education. Treatment will be provided for 6 weeks with 3 supervised sessions per week.
Other: Neck Exercise Program · Other: Diaphragmatic Myofascial Release and Diaphragm-Directed Manual Therapy
A supervised neck exercise program including deep cervical flexor training, cervical stabilization exercises, stretching of the upper trapezius, levator scapulae, pectoralis major, and sternocleidomastoid muscles, postural correction exercises, scapular strengthening, and a daily home exercise program. Participants will attend 3 supervised sessions per week for 6 weeks.
The diaphragm-focused intervention includes manual diaphragm release using gentle sustained traction under the lower costal margin during exhalation; diaphragmatic myofascial release targeting the lower ribs, xiphoid region, costal margins, and related fascial structures; manual release of accessory respiratory muscles including the sternocleidomastoid, scalenes, upper trapezius, and pectoralis minor; and diaphragmatic breathing re-education.
Change in Neck Disability Index (NDI) Score
Neck-related disability will be assessed using the Neck Disability Index (NDI), a 10-item self-reported questionnaire assessing the impact of neck pain on daily functioning. Each item is scored from 0 to 5, producing a total score from 0 to 50, which can be expressed as a percentage from 0% to 100%. Higher scores indicate greater neck-related disability.
Time frame: Baseline, immediately after the 6-week intervention, and 4 weeks after completion of the intervention
Change in Neck Disability Index (NDI) Score
Neck-related disability will be assessed using the Neck Disability Index (NDI), a 10-item self-reported questionnaire assessing the impact of neck pain on daily functioning. Each item is scored from 0 to 5, producing a total score from 0 to 50, which can be expressed as a percentage from 0% to 100%. Higher scores indicate greater neck-related disability.
Time frame: Baseline, immediately after the 6-week intervention, and 4 weeks after completion of the intervention.
Change in Tampa Scale of Kinesiophobia (TSK-17) Score
Kinesiophobia will be assessed using the 17-item Tampa Scale of Kinesiophobia (TSK-17). Each item is rated on a 4-point Likert scale, with total scores ranging from 17 to 68. Higher scores indicate greater fear of movement or reinjury.
Time frame: Baseline, immediately after the 6-week intervention, and 4 weeks after completion of the intervention.
Change in Numeric Pain Rating Scale (NPRS) Score
Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS). Participants will rate their average neck pain over the previous week on an 11-point scale from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity.
Time frame: Baseline, immediately after the 6-week intervention, and 4 weeks after completion of the intervention
Change in Fatigue Severity Scale (FSS) Score
Fatigue will be assessed using the 9-item Fatigue Severity Scale (FSS). Each item is rated from 1 to 7. The mean of the nine items will be calculated, resulting in a score from 1 to 7, with higher scores indicating greater fatigue severity.
Time frame: Baseline, immediately after the 6-week intervention, and 4 weeks after completion of the intervention.
Plan to share: Undecided
Start is estimated for Oct 2026; primary completion for Jan 2027, 3 months later.
Of 132 non-industry interventional studies with no phase under Kinesiophobia, half reached primary completion within 8 months of starting (the median), counting those still running; a quarter within 4 and three quarters within 14. This study's planned 3 months is below that.
Counting every sponsor, half of 132 studies reached it within 8 months; a quarter within 4 and three quarters within 14.
How these figures are worked out, and which studies are left out of them.
This study is not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.
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