Effects of Scapulothoracic Stabilization Exercises on Pain and Neck Function in Patients With Chronic Neck Pain

Neck pain is a common musculoskeletal disorder, involving discomfort and pain around the neck region, which results in limited neck function. Due to chronic neck pain, patient's neck function, cervical proprioception, ROM and cervical muscle strength is affected. Exercise is considered as one of the evidence-based modality to decrease pain, prevent further injury, increase muscle strength, endurance and flexibility, improve proprioception, and contribute and sustain normal life activities. In addition, recent studies suggest that exercises including not only neck but also scapulothoracic region might be more beneficial for the management of patients with chronic neck pain.Scapulothoracic stabilization exercises in addition to cervical stabilization exercises have the potential of improving this cervical sensorimotor control, however evidence is deficient Hence, this study was designed to evaluate the effectiveness of adding scapula-thoracic stabilization training to conventional physical therapy on pain and neck function in the patients with chronic neck pain.

The prevalence of neck pain has increased among general population due to several factors like wroking conditions, postural abnormalitites, sedentary lifestyle, previous trauma to neck region, and altered neuromuscular control of cervical muscles, which are the main risk factors as stated in the literature. Neck pain is the second most prevalent musculoskeletal disorder and ranked 21st on global burden of disease. According to literature, it causes 30% level of restriction in performance of daily life tasks. Sleeping, driving, recreational activities and absence from work are the daily life tasks in which they face difficulty.Due to work absenties and loss of productivity can lead to reduction of quality of life of individual as well as social and ecnomical loss.

Over time, several treatment approaches have been developed to treat neck pain but the most important thing is the correction of faulty biomechanics. One such technique is scapulothoracic stabilization exercise for patients of neck pain. There are findings that support the scapular stabilization exercises for reducing neck pain and disability level.Literature reviewed regarding assessment and treatment of chronic neck pain patients revolve around pain, neck function and range of motion, however limited evidance is available on cervical proprioception and deep cervical flexors strength This research presents comparison between conventional (including TENS,hot pack and cervial focused exercises) and scapulothoracic stabilization exercises in addition to conventional treatment for chronic neck pain. It will expand current understanding of importance of scapulothoracic stabilization exercises for chronic neck pain patients in improving pain,neck function,range of motion, cervical proprioception and deep cervical flexors strength.

The main objective of this study is to compare the conventional treatment and scapulothoracic stabilization exercises along with conventional treatment in chronic neck pain patients.

The participants meeting the eligibility criteria will be recruited, followed by random allocation to 2 groups,Group A (conventional) and Group B (scapulothoracic stabilization exercises plus conventional), respectively.Both groups will recieve standard treatment protocol which conjsist of hot pack, TENS, stretchings,post isometric relaxation and home exercise plan.Twelve treatment sessions will be performed on altervative days. Pretreatment and post treatment measurements of pain, neck function, neck range of motion, cervical proprioception and deep cervical flexors strength will be noted for each participant.

Eligibility Criteria:
Inclusion Criteria:

* Patients with Chronic neck pain greather than 3 months
* Adults aged 18-45 years
* Both Male and Female
* Subjects with non-specific neck pain without specific identifiable etiology (infection, inflammatory disease etc)

Exclusion Criteria:

* Patients with history of previous neck/ shoulder surgery
* History of cervical spine injury or surgery
* History of any psychological disorder.
* Pregnant females.
* Patient suffering from neck pain secondary to other conditions (neoplasm,neurological or vascular disease)
* Patient experiencing neck pain due to other causes such as tumors, fractures, radiculopathy etc.
* Patients who have received physiotherapy for neck pain from last 1 month