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Not yet recruitingNCT07813871Updated Sep 11, 2026

Effect of Cervical Force Control Training on Force Sense and Steadiness in Chronic Non-Specific Neck Pain

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

Phase
Not applicable
Study type
Interventional
Enrollment
32
Allocation
Randomized
Ages
18 Years to 24 Years
Sex
All
01

Study summary

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.

Read the detailed description

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.

02

Conditions studied

  • Chronic Non-specific Neck Pain
  • Neck Pain

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Keywords

  • Cervical Force Control
  • Force Steadiness
  • Force Sense
  • Sensorimotor Control
  • Proprioception
  • Handheld Dynamometer
  • Physical Therapy
03

Who can participate

Ages eligible
18 Years to 24 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients diagnosed with Chronic Non-Specific Neck Pain (CNSNP) lasting >= 3 months.
  • Body mass index (BMI) between 18.5 and 29.9 kg/m² (non-obese).
  • Pain intensity >= 30 mm on the Visual Analogue Scale (VAS).
  • Neck disability ranging from mild to moderate (10% to 48%) on the Neck Disability Index (NDI).
  • Able to perform isometric contractions with visual feedback.

Exclusion criteria

Exclusion Criteria:

  • Shoulder/upper limb fractures or replacement (\<12 months), or moderate-severe shoulder osteoarthritis (OA).
  • Cervical radiculopathy/myelopathy, peripheral neuropathy, vestibular disorders, or history of stroke/Transient Ischemic Attack (TIA).
  • Upper limb pathology (tendinopathy, capsulitis), thoracic outlet syndrome, or fibromyalgia.
  • Received neck-specific physiotherapy within the last 3 months.
  • Severe osteoporosis, uncontrolled diabetes (HbA1c >9%), or active infection/inflammation.
  • Cervical injections or surgery within the last 6 months.
  • Inability to follow 2-step instructions.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
32 participants (estimated)

Study arms

  • Experimental
    Experimental Group: Force Control Training

    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

  • Active comparator
    Active Comparator: Conventional Exercise 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

Interventions

  • BehavioralCervical Force Control 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).

  • BehavioralConventional Exercise Training

    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.

05

What researchers measure

Primary outcomes

  1. 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

  2. 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

Secondary outcomes

  1. 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

  2. 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

06

Study locations

1 site
  • Faculty of Physical Therapy
    Kafr ash Shaykh, Kafr el-Sheikh Governorate, Egypt
07

References and documents

Publications

  • Vaillancourt DE, Slifkin AB, Newell KM. Inter-digit individuation and force variability in the precision grip of young, elderly, and Parkinson's disease participants. Motor Control. 2002 Apr;6(2):113-28. doi: 10.1123/mcj.6.2.113. PubMed 12122222 ↗
  • Arvanitidis M, Falla D, Sanderson A, Martinez-Valdes E. Does pain influence control of muscle force? A systematic review and meta-analysis. Eur J Pain. 2025 Feb;29(2):e4716. doi: 10.1002/ejp.4716. Epub 2024 Aug 23. PubMed 39176440 ↗
  • Vannebo KT, Iversen VM, Fimland MS, Mork PJ. Test-retest reliability of a handheld dynamometer for measurement of isometric cervical muscle strength. J Back Musculoskelet Rehabil. 2018;31(3):557-565. doi: 10.3233/BMR-170829. PubMed 29526841 ↗
  • Zaidi, S., Khan, S. A., Zaki, S., Sundus, H., Alam, M. F., & Nuhmani, S. (2025). Effectiveness of sensorimotor training on pain, cervical joint position sense, range of motion, balance, and disability in chronic neck pain: A systematic review. Heliyon, 11(10), Article e43409.
  • Peng B, Yang L, Li Y, Liu T, Liu Y. Cervical Proprioception Impairment in Neck Pain-Pathophysiology, Clinical Evaluation, and Management: A Narrative Review. Pain Ther. 2021 Jun;10(1):143-164. doi: 10.1007/s40122-020-00230-z. Epub 2021 Jan 12. PubMed 33464539 ↗
  • Muceli S, Farina D, Kirkesola G, Katch F, Falla D. Reduced force steadiness in women with neck pain and the effect of short term vibration. J Electromyogr Kinesiol. 2011 Apr;21(2):283-90. doi: 10.1016/j.jelekin.2010.11.011. Epub 2010 Dec 30. PubMed 21195628 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT07813871
Lead sponsor
Cairo University
Responsible party
Mohamed Mahmoud Refaey (Assistant Lecturer, Kafrelsheikh University) — Principal investigator
First posted
Sep 10, 2026
Start date
Sep 2026 (estimated)
Primary completion
Dec 2026 (estimated)
Completion
Dec 2026 (estimated)
Last update
Sep 11, 2026

Study contacts

Mohamed M Refaey, M.Sc.
Contact
mohamed_salama@pt.kfs.edu.eg
00201030290667

Oversight

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

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