Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Effectiveness of a Manual Specific Approach to the Suboccipital Area on Pain, Range of Motion, Disability and Clinical Significance of Changes on Patients With Chronic Mechanical Neck Pain and Rotation Deficit of the Upper Cervical Spine
Brief Summary: There are different inhibition suboccipital techniques, usually adjuvant of physiotherapy, for treatment of patients with chronic neck pain. In our clinical practice, a favorable effect is observed on patients with chronic neck pain, but there are no published studies evaluating the results of this techniques on pain, mobility and disability.

The objective of this trial is to evaluate if the suboccipital manual techniques, provides further improvement in pain intensity, neck disability, range of motion, on patients with chronic mechanical neck pain and rotation deficit of the upper cervical spine, being treated with physiotherapy. For this purpose, investigators conduct a double-blind (patient and evaluator) randomized controlled trial, in a Public Primary Care Center.

Seventy four subjects will be randomized (computer application) into three groups: Mobilization Group, Maintained pressure Group and Control Group. All the three groups receive the same protocolized physiotherapeutic treatment during three weeks and, additionally, the Mobilization Group receives six sessions (two sessions in a week during three weeks) of translational dorsal glide mobilization technique grade III of the atlanto-occipital joint and the Maintained pressure Group receives six sessions (two sessions in a week during three weeks) of pressure maintained suboccipital Inhibition technique. The Control Group receives the protocolized physiotherapeutic treatment only.

Pain intensity (VAS), Neck Disability Index (NDI), Range of motion (CROM), will be measured at baseline, after treatment period, and three months after discharge from treatment. After discharge for treatment the patient subjective opinion about their evolution will be collected through a Global Rating of Change (GROC) scale, and evaluation of headache disability (HIT-6).


Options:
A: Arm Label: Exercise and connective tissue massage; Type: EXPERIMENTAL; Interventions: Behavioral: "Exercise" and "connective tissue massage" | Arm Label: Exercise; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: "Exercise" | Intervention Type: BEHAVIORAL; Name: "Exercise" and "connective tissue massage"; Assigned to Arm(s): Exercise and connective tissue massage | Intervention Type: BEHAVIORAL; Name: "Exercise"; Assigned to Arm(s): Exercise
B: Arm Label: Mobilization Group; Type: EXPERIMENTAL; Interventions: Other: translational dorsal glide mobilization technique grade III, Other: Control Group | Arm Label: Maintained pressure Group; Type: EXPERIMENTAL; Interventions: Other: pressure maintained suboccipital Inhibition technique, Other: Control Group | Arm Label: Control Group; Type: OTHER; Interventions: Other: Control Group | Intervention Type: OTHER; Name: translational dorsal glide mobilization technique grade III; Assigned to Arm(s): Mobilization Group | Intervention Type: OTHER; Name: pressure maintained suboccipital Inhibition technique; Assigned to Arm(s): Maintained pressure Group | Intervention Type: OTHER; Name: Control Group; Assigned to Arm(s): Control Group, Maintained pressure Group, Mobilization Group
C: Arm Label: cupping massage; Type: EXPERIMENTAL; Interventions: Procedure: cupping massage | Arm Label: control group; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Progressive muscle relaxation | Intervention Type: PROCEDURE; Name: cupping massage; Assigned to Arm(s): cupping massage | Intervention Type: PROCEDURE; Name: Progressive muscle relaxation; Assigned to Arm(s): control group
D: Arm Label: High dose spinal manipulation; Type: EXPERIMENTAL; Interventions: Other: Spinal Manipulation | Arm Label: Moderate dose spinal manipulation; Type: EXPERIMENTAL; Interventions: Other: Spinal Manipulation, Other: Light Massage | Arm Label: Low dose spinal manipulation; Type: EXPERIMENTAL; Interventions: Other: Spinal Manipulation, Other: Light Massage | Arm Label: High dose massage; Type: OTHER; Interventions: Other: Light Massage | Intervention Type: OTHER; Name: Spinal Manipulation; Assigned to Arm(s): High dose spinal manipulation, Low dose spinal manipulation, Moderate dose spinal manipulation | Intervention Type: OTHER; Name: Light Massage; Assigned to Arm(s): High dose massage, Low dose spinal manipulation, Moderate dose spinal manipulation

Answer: B