An interventional study of Cervical Force Control Training and Conventional Exercise Training in Chronic Non-specific Neck Pain and Neck Pain, sponsored by Cairo University. Not yet recruiting at 1 site in Egypt. Open to participants aged 18 Years to 24 Years. Per ClinicalTrials.gov, last updated 2026-09-11.
Sponsored by Cairo University · Not applicable, Interventional, and Treatment
Chronic non-specific neck pain (CNSNP) is a very common issue among young adults, often linked to poor posture, prolonged screen time, and sedentary habits. This persistent pain can change how the neck muscles work and control movement. The purpose of this study is to investigate whether a specific type of rehabilitation-called "cervical force control training"-can help improve how well people can feel and control their neck muscle strength, and whether this reduces their pain and improves their daily function.
Researchers will invite young adults (18 to 24 years old) who have had neck pain for at least 3 months to participate. Participants will be randomly divided into two groups:
Force Control Training Group: Will receive a new training program that uses a handheld dynamometer with a screen to help them practice holding steady, precise neck muscle contractions with visual feedback.
Conventional Exercise Group: Will receive a standard physical therapy program consisting of neck muscle stretches and shoulder-blade strengthening exercises.
Both groups will perform their exercises 3 times a week for 8 weeks. Researchers will measure participants' neck muscle steadiness, pain levels, and neck disability before the program starts, right after the 8-week program ends, and again at a 3-month follow-up to evaluate the long-lasting effects.
Chronic non-specific neck pain (CNSNP) involves persistent cervical pain without an identifiable structural pathology. Recent evidence suggests that CNSNP is closely associated with sensorimotor control deficits, including impaired proprioception and diminished force steadiness (the neuromuscular ability to produce and sustain precise submaximal force levels with minimal fluctuations). While conventional exercises improve strength and reduce pain, they often neglect the fine-motor precision and sensorimotor integration necessary for optimal neck function.
This randomized controlled trial (RCT) is designed to investigate the effect of cervical force control training compared to conventional neck exercises on force sense, force steadiness, pain intensity, and functional disability in young adults (18-24 years) with CNSNP.
Following baseline assessments for maximum voluntary isometric contraction (MVIC), force sense, and force steadiness (quantified by the coefficient of variation) using a Handheld Dynamometer (HHD), as well as clinical measures (VAS for pain, NDI for disability), eligible participants will be randomized into two groups:
Experimental Group (Force Control Training):
Participants will undergo an 8-week targeted training program (3 sessions/week, 30-40 mins each). The protocol utilizes submaximal isometric contractions with visual feedback via an HHD device paired with an application. The program progresses systematically through three phases: Phase 1 (Calibration \& Reference at MVIC), Phase 2 (Acquisition using descending submaximal intensities 25% to 10% MVIC with continuous visual tracking), and Phase 3 (Retention \& Transfer involving faded/no feedback and complex dual-tasking, such as auditory monitoring or arithmetic).
Control Group (Conventional Exercise Training):
Participants will undergo an 8-week program (3 sessions/week, 30 mins each) consisting of standard cervical stretching (upper trapezius and levator scapulae) and scapular strengthening/stabilization exercises (e.g., side-lying external rotation, side-lying forward flexion, prone extension, and push-up plus). Resistance will be tailored based on gender and body weight.
Re-evaluations will be conducted immediately post-intervention (at 8 weeks) and at a 3-month follow-up. The study aims to establish whether integrating specific force-control tasks offers superior benefits in restoring sensorimotor function and alleviating symptoms in patients with CNSNP compared to conventional rehabilitation alone.
Exclusion Criteria:
Patients in this group will receive an 8-week cervical force control training program (3 sessions/week). The training involves submaximal isometric neck contractions using visual feedback via a Handheld Dynamometer, progressing from simple feedback-assisted holds to complex dual-task exercises.
Behavioral: Cervical Force Control Training
Patients in this group will receive an 8-week conventional exercise program (3 sessions/week). The program includes standard cervical stretching (upper trapezius and levator scapulae) and scapular strengthening and stabilization exercises.
Behavioral: Conventional Exercise Training
An 8-week program (3 sessions/week, 30-40 mins each) utilizing submaximal isometric neck contractions with visual feedback via a Handheld Dynamometer. The protocol progresses through three phases: initial calibration, acquisition using descending target intensities (25% to 10% MVIC) with continuous visual tracking, and retention/transfer using faded or no feedback combined with dual-tasking (e.g., auditory monitoring or arithmetic).
An 8-week program (3 sessions/week, 30 mins each) consisting of standard cervical stretching for the upper trapezius and levator scapulae muscles, alongside scapular strengthening and stabilization exercises (e.g., side-lying external rotation, side-lying forward flexion, prone extension, and push-up plus). Resistance is tailored based on patient gender and body weight.
Cervical Force Sense
Assessed using a Handheld Dynamometer (HHD) during force reproduction tasks. It is measured by calculating the absolute error between a target submaximal force and the reproduced force without visual feedback. Lower error values indicate better force sense and proprioception.
Time frame: Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up
Cervical Force Steadiness
Evaluated by calculating the Coefficient of Variation (CoV) of force during submaximal isometric cervical contractions using a Handheld Dynamometer (HHD). Lower CoV percentages indicate better force steadiness and neuromuscular control.
Time frame: Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up
Neck Functional Disability (Neck Disability Index - NDI)
A 10-item patient-completed questionnaire assessing how neck pain affects the ability to manage everyday life activities. Total scores range from 0 to 50, which can be expressed as a percentage (0-100%). Higher scores indicate greater patient-rated functional disability.
Time frame: Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up
Pain Intensity (Visual Analogue Scale - VAS)
Pain intensity is assessed using a 100-mm horizontal line, anchored by "no pain" at 0 mm and "worst imaginable pain" at 100 mm. Lower scores indicate a lower level of pain.
Time frame: Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up
Plan to share: No
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Cairo University