Effects of Autogenic and Reciprocal Inhibition, Muscle Energy Techniques in the Management of Mechanical Neck Pain
Condition: Neck Pain
MeSH terms: Neck Pain
Study type: Interventional

Summary: 
      Neck pain is among the most common musculoskeletal disorders worldwide and is an important
      public health issue in terms of personal wellbeing. Prevalence of neck pain show excessive
      variations, with a point prevalence varying between 6% and 22%, and one year prevalence
      ranging between 1.5-75%. Neck pain like all other mechanical disorders leads to pain,
      disability and decreased range of motion (ROM). Stretching is a very common exercise
      performed by sportsmen, elderly, in physical therapy and rehabilitation patients, thus
      practiced in all sorts of fitness programs. The major types of stretching included in the
      literature are static, dynamic and pre-contraction stretching; of which static stretching is
      the conventional type of stretching. The different types of pre-contraction stretching
      include Proprioceptive Neuromuscular Facilitation (PNF) stretching, Post Isometric Relaxation
      (PIR), Post Facilitation stretch (PFS) and Active Isolated Stretch (AIS). Pre-contraction
      stretching is also considered a part of Muscle Energy Technique (MET). Recently MET and
      pre-contraction stretching have been shown to have significant superiority over conventional
      stretching in management of mechanical neck pain, but the evidence is currently lacking
      regarding which of the two pre-contraction stretching protocols, namely autogenic and
      reciprocal inhibition is more effective than the other. A RCT will be conducted in order to
      find and compare the effectiveness of conventional stretching and pre-contraction stretching
      (autogenic inhibition and reciprocal inhibition). One Control group (conventional group) and
      two Experimental groups (Experimental Group A - Autogenic Inhibition & Experimental Group B -
      Reciprocal Inhibition) will be formed. The participants will be recruited in the study if
      they meet the inclusion criteria using consecutive sampling from Fauji Foundation Hospital
      and randomized into the three respective groups. All the groups will receive the gold
      standard treatment for chronic neck pain including mobilization and modalities. In addition
      to the gold standard treatment the participants will receive specific stretching protocol
      based on their interventional group
    


Intervention name(s): Group A (Control Group - Static Stretching + Standard Treatment); Group B (Autogenic Inhibition - PIR + Standard treatment); Group C (Reciprocal Inhibition - RI + Standard treatment)
Intervention type(s): Other; Other; Other
Intervention description(s): o Conventional Gold Standard treatment (Manual Therapy + Modalities) Conventional Static Stretching 15-30 seconds hold 3-5 repetitions (Page P, 2012) for Ant/Middle/Posterior Scaleni, Sternocleidomastoid, Levator Scapulae and Upper Trapezius Muscles.; o Conventional Gold Standard treatment (Manual Therapy + Modalities) Post Isometric Relaxation MET (3-5 reps) for Ant/Middle/Posterior Scaleni, Sternocleidomastoid, Levator Scapulae and Upper Trapezius Muscles. (Chaitow L, 2006); o Conventional Gold Standard treatment (Manual Therapy + Modalities) Reciprocal Inhibition MET (3-5 reps) for Ant/Middle/Posterior Scaleni, Sternocleidomastoid,Levator Scapulae and Upper Trapezius Muscles (Chaitow L, 2006)
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A randomized Controlled trial will be conducted in order to find and compare the effectiveness of conventional stretching and MET stretching (autogenic inhibition and reciprocal inhibition). One Control group (conventional group) and two Experimental groups (Experimental Group A - Autogenic Inhibition & Experimental Group B - Reciprocal Inhibition) will be formed. The participants will be recruited in the study if they meet the inclusion criteria using consecutive sampling from Fauji Foundation Hospital and randomized into the three respective groups. All the groups will receive the gold standard treatment for chronic neck pain including mobilization and modalities. In addition to the gold standard treatment the participants will receive specific stretching protocol based on their interventional group.
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Muscle Energy Techniques; Autogenic Inhibition; Reciprocal Inhibition; Stretching; Range of Motion; Muscle Strength; VAS; Neck Disability Index; NDI