Effect of Combined Kendell and McKenzie on Brachial Plexus Mechanosensitivity in Chronic Non-Specific Neck Pain

this study will apply a modified cervical exercise that combined McKenzie's and Kendall's exercises, consisted of neck extension exercises and stretching of the pectoralis muscles at the same time. Although they only required a short time to complete, the exercises proved being effective in improving forward head posture.

Nowadays, neck pain is predictable among people of all ages, whether it is a golden-ager, juvenile, or a schoolchild. In any stage of life, a person may experience neck pain because of the poor posture and prolonged use of electronic devices. Students spend about 80% of their daily life in college and performing various activities in their college, like slouching over computers and laptops for long periods for their college projects, backpacks over one shoulder (laptop bag), and squeezing into chairs or desk, etc. All are posture ruining activities that every student perform daily

When there is no traumatic injury, poor posture is the main root of neck pain. Bad posture results with the functional deviation from the normal aligned posture without any structural changes in the spine or lower extremities (Saxton, 1993). In reflection, muscle weakness and muscular imbalance of the musculoskeletal system leads to the postural deformities that coincide with muscle findings. Continuous load on the neck leads to disc collapse or degenerative changes in the future.

Several studies reported the effect of cervical postural correction exercises on pain, ROM and cranio-cervical angle in patients with chronic non-specific neck pain. Few studies have been concerned with measuring mechanosensitivity as an indicator technique of the effect of different modalities on chronic non-specific neck pain. With the proposal of the combined Kendall and McKenzie exercise program for patients with chronic non-specific neck pain secondary to forward head posture deviations recently, it is important to document how could this new combined technique impact neck posture as well as neural tissue sensitivity and function.

The outcome of this study will provide necessary information to clarify the effect of combined Kendall and McKenzie exercise program on mechanosensitivity and peripheral nerve excitability, pain intensity and cervical range of motion. This study may help and add to the physiotherapists exercise protocol for patient with chronic non-specific neck pain.

Eligibility Criteria:
Inclusion Criteria:

1. Sixty subjects of both genders will be recruited in the study.
2. The age of the recruited subjects will be ranging from 25 to 50 years old
3. Subjects having neck pain symptoms provoked by neck postures, neck movement, or palpation of the cervical musculature, for at least the last 3 months )
4. Subjects with a craniovertebral angle (CVA) of less than 54º
5. Subjects with a BMI between 25-30 )

Exclusion Criteria:

1. History of previous injury of the neck
2. History of surgical intervention at the neck
3. History of inflammatory joint disease affecting facet joints
4. Neurological disorders such as cervical spondylosis, spondylolythesis or disc prolapse
5. Rheumatic diseases.
6. Cancer patients.
7. Patients who received pain medication or physical therapy for their neck pain during the last 3 months
8. Patients who are unable to perform the exercises.