Muscle Energy Techniques and Self-Stretching in Nonspecific Neck Pain
Condition: Nonspecific Neck Pain; Exercise
MeSH terms: Neck Pain
Study type: Interventional

Summary: 
      Non-specific neck pain (NSNP) is defined as pain not associated with neurological and
      specific pathologies in the posterior and lateral part of the neck between the superior
      nuchal line and the first thoracic vertebra. Many conservative treatment modalities including
      different exercise techniques are used in the treatment of NSNP. Therefore, the aim of our
      study was to investigate the effect of these techniques.
    

Detailed description: 
      Non-specific neck pain (NSNP) is defined as pain not associated with neurological and
      specific pathologies (infection, fracture, inflammation, etc.) in the posterior and lateral
      part of the neck between the superior nuchal line and the first thoracic vertebra. Neglecting
      this pain can lead to muscle spasms, stiffness, and many other serious complications. Most
      neck pain is caused by trigger points in the cervicothoracic muscles. Trigger points cause
      the muscles to weaken, and neck pain with weak cervical muscles has a negative impact on a
      person's quality of life.

      The estimated incidence of neck pain ranges from 10.4% to 21.3% each year and is affecting an
      increasing number of computer and office workers. Pain intensity is low in most new cases,
      but disabling neck pain develops in 0.6% of the population. Therefore, it is important to
      investigate which treatment modality is more effective in reducing neck pain and its
      symptoms. Some recent studies report evidence in favor of a particular type of exercise,
      while others report that there is no superior type or dose of exercise.

      Neck pain recurs and develops within one to five years in 20% of patients and the rate of
      complete recovery in these cases is very low. Neck pain is the most frequently investigated
      musculoskeletal problem after low back pain. It is defined as non-specific neck pain due to
      multifactorial etiology. Many conservative treatment modalities are used in the treatment of
      NSNP. These include clinical exercises, medical treatments, neural therapy, manual therapy
      methods, massage, acupuncture, and various physical therapy modalities. Muscle energy
      techniques (MET) are manual therapy methods that involve soft tissue manipulation using
      precise and controlled, patient-initiated, isometric, and/or isotonic contractions to improve
      musculoskeletal function and reduce pain. MET can be used to mobilize a joint with a limited
      range of motion, lengthen a spastic or shortened muscle, reduce local edema, and strengthen a
      physiologically weak muscle or muscle group.

      Post-isometric relaxation (PIR) is defined as a reduction in the tone of the agonist muscle
      after an isometric contraction. This technique aims to reduce muscle tension by regulating
      muscle function and is used to mobilize the restricted joint, reduce edema, and lengthen and
      strengthen muscles in both subacute and chronic conditions. Studies have also used PIR for
      neck pain.

      The muscle spindle is one of the sensory receptors in skeletal muscle. Its function is to
      provide proprioceptive information to the cerebral cortex. As the muscle lengthens, the
      muscle spindle is activated, and a reflex contraction of the agonist muscle and relaxation of
      the antagonist muscle occurs. This process is known as reciprocal inhibition (RI). Studies
      using the RI technique in people with neck pain were found. However, no studies were found in
      people with non-specific neck pain.

      Stretching is a general term describing a therapeutic maneuver used to increase the
      extensibility of soft tissues. Self-stretching (SS) is the self-application of this
      technique. Studies comparing the effects of MET with different treatment modalities in people
      with non-specific neck pain were identified in the literature. These trials found similar
      effects and varying degrees of superiority in reducing pain intensity and increasing range of
      motion (ROM). In the literature, studies have compared stretching with MET in people with
      neck pain or compared MET with different treatment methods and examined their effects on
      variables such as pain and ROM. However, no study was found that compared different METs and
      self-training in individuals with NSNP and investigated the immediate effect of EMG.
      Therefore, the aim of our study was to investigate the effect of these techniques. It was
      thought that the information obtained as a result of the study would guide the creation and
      development of rehabilitation programs.

      The hypotheses of the study are as follows:

      Hypothesis 1: The PIR technique applied to individuals with NSNP has a positive effect on
      pain intensity, pressure pain threshold, range of motion, and muscle activation.

      Hypothesis 2: The RI technique applied to individuals with NSNP has a positive effect on pain
      intensity, pressure pain threshold, range of motion, and muscle activation.

      Hypothesis 3: SS technique applied to individuals with NSNP has a positive effect on pain
      intensity, pressure pain threshold, range of motion, and muscle activation.

      Hypothesis 4: Muscle energy techniques applied to individuals with NSNP have more positive
      effects on pain intensity, pressure pain threshold, range of motion and muscle activation
      than SS technique.
    

Intervention name(s): Self-Streching Exercises; Post-Isometric Relaxation Exercises; Reciprocal-Inhibiton Exercises
Intervention type(s): Other; Other; Other
Intervention description(s): The participants in the SSE group; received 1 session SSE with 10 repetitions, about 30 min. The assessments were applied before and after the session.; The participants in the PIRE group; received 1 session PIRE with 10 repetitions, about 30 min. The assessments were applied before and after the session.; The participants in the RIE group; received 1 session RIE with 10 repetitions, about 30 min. The assessments were applied before and after the session.
Other intervention name(s): SSE; PIRE; RIE
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Neck Pain; Muscle Stretching Exercise; Electromyography; Range of Motion; Pain Threshold