Effects of Cervical Extension Traction With & Without Modified Cervical and Shoulder Retraction Exercises in Neck Pain

Study Overview
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Brief Summary
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The study aims to explore whether the modified cervical and shoulder retraction exercise program restores cervical sagittal alignment and reduces neck pain in patients with non-specific neck pain.

Detailed Description
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Neck pain is a musculoskeletal system disorder that causes social and economic loss by reducing the quality of life (QOL) of the individual, and its prevalence varies from 16.7 to 75.1% in the adult population. Non-specific neck pain (NNP) is a symptom related to a postural or mechanical cause. NNP is also associated with loss of cervical curvature. In healthy spines, the axial load along the cervical spine is supported along the ventral column of the spine. However, in spines with the loss of lordosis, the load moves more anteriorly, which causes neck pain. Cervical exercise has been shown to be an effective treatment for neck pain and cervical alignment, but there is still a need for more clinical trials evaluating the effectiveness of the exercise approach. It seems reasonable to assume that naturally good neck muscle strength and range of motion are likely to be protective factors against neck pain. As per previous research, the effects of exercise therapy on non-specific neck pain have been examined but there is limited literature available for use of cervical and shoulder retraction exercises in patients with nonspecific neck pain. Most of the studies have been done with neck isometrics, manual mobilization, and deep cervical flexors training and there is less scope of practicing cervical extension traction in contrast with modified cervical and shoulder retraction exercises. Previous research is limited by no use of a control group in a modified retraction exercise regime. To fill this literature gap this study is proposed which will focus on the clinical significance of modified cervical and shoulder retraction exercises on pain, disability, and Cobb's angle in the management of non-specific neck pain.

Official Title
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Comparative Effects of Cervical Extension Traction Exercises With and Without Modified Cervical and Shoulder Retraction Exercises on Pain, Disability and Cobb's Angle in Patients With Non-specific Neck Pain

Conditions
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Neck Pain

Intervention / Treatment
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* Other: Modified Cervical and Shoulder Retraction exercises
* Other: Cervical Extension Traction exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Neck pain history Patients with Lateral Cervical Radiograph Patients who agreed for a follow up of 6 weeks Exclusion Criteria: Congenital abnormalities e.g. torticollis Past surgical history of cervical spine Positive VBI sign Patients with inflammatory or rheumatic diseases Already undergoing physiotherapy treatment

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Modified Cervical and Shoulder Retraction exercises<br>Cervical extension traction protocol will be added as standard treatment. Then, patients either sit or stand in an upright position while pushing their chin backward and simultaneously raising their head within the pain-free range, then, in a seated or standing position, patients will maintain an upright posture and try to pull back their shoulders and extend their neck within the pain-free range. | Other: Modified Cervical and Shoulder Retraction exercises<br>* 11 patients will receive cervical traction and modified cervical and shoulder retraction exercises (10 to 12 repetitions). The total treatment session will be of 20-25 minutes with a total intervention period of 6 weeks with 3 sessions per week on alternative days.<br>|
| Active Comparator: Cervical Extension Traction exercises<br>Here, patients will receive Cervical Extension Traction exercises as standard treatment. Cervical extension traction includes a protocol in which traction will be applied within the extension range of the cervical region in full spine position. | Other: Cervical Extension Traction exercises<br>* 11 patients will receive cervical traction force for 10 seconds and extend the cervical spine. The total treatment session will be of 20-25 minutes with a total intervention period of 6 weeks with 3 sessions per week on alternative days<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| NPRS for pain | The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an eleven-point numerical scale. The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain). | 6th week | 
| NDI for disability | The neck disability index (NDI) has become a standard instrument for measuring self-rated disability due to neck pain. Each of the 10 items scores from 0 to 5. The maximum score is 50 | 6th week | 
| Lateral cervical radiograph for Cobb's angle | Radiography of a patient provides important spine/posture data, such as segmental and total angles of curvature and sagittal balance. Cobb's angle measurement taken by Lateral Cervical Radiograph. | 6th week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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neck pain, retraction, disability, cervical traction