## 7 Discussion
Therefore, both the scapula stabilizing exercises group and the thoracic exercises group performed strengthening exercises for the LT and SA muscles and noted improved neck pain. Only the UT muscle was different between groups. It is speculated that these results may be because both groups performed the same SCM muscle stretching and neck flexor strengthening exercises, but the CSG performed more UT muscle stretching exercises. Stretching exercises can promote muscle relaxation, improve flexibility, and reduce myofasical tightness, which may explain the superior effects observed in the UT muscle. Scapular stabilization exercises have a greater impact on strengthening the LT and SA muscles and reducing the hyperactivity of the UT muscle [24]. These adaptations likely resulted in the greater pain reduction observed in the CSG group. In this study, the cervical ROM for extension, flexion, right rotation, and left rotation had statistically significant differences in both the CSG and CTG before and after the intervention. However, there was no statistical significance between groups. The ROM of the cervical spine is restricted in cervical extension [4], and previous studies have found that this limited ROM is related to imbalance in the neck muscles, such as a weakening of the DCF and shortening of superficial extensor muscles like the UT and SCM muscles [5; 61]. Stretching exercises can contribute to the normalization of muscle length by elongating the shortened muscle, thereby enhancing the ROM [62], and strengthening the weak DCF can improve muscle imbalance and increase the ROM of the cervical spine [63]. According to [PERSON], [PERSON] et al., neck pain can lead to a reduction in cervical ROM [64]; therefore, strengthening weak DCF muscles and stretching shortened UT and SCM muscles can reduce neck pain and increase the ROM of the cervical spine [61; 63]. Both groups performed cervical spine exercises, such as stretching exercises and deep cervical flexor strengthening exercises; thus, the ROM was significantly improved in both groups. Research has found that, because of the mechanical relationship between the cervical and thoracic spines, improving the thoracic spine can also increase the ROM of the cervical spine [63]. Both scapular exercises and thoracic exercises are muscle strengthening exercises used to improve scapulothoracic dysfunction, thoracic spine alignment, and the ROM of the cervical spine [21]. There was no difference between the two groups. This may be because both scapular stabilization exercises and thoracic exercises improve spinal alignment and thus improve the ROM. Moreover, the ROM limitations experienced by the subjects were not severe, and so they were improved to average levels after exercise. In summary, cervical stabilization exercises, in combination with either scapular stabilization or thoracic exercises, improve the mechanical properties of cervical muscles, reduce pain, and enhance the cervical ROM. These findings suggest that combining cervical stabilization exercises with scapular or thoracic exercises may be an effective treatment for cervical extension disorders. This noninvasive approach may help reduce pain, improve mobility, and enhance daily functioning, offering a cost-effective alternative to more invasive treatments such as surgery or medications. It offers a valuable option for treating neck pain and improving patients' quality of life.