Cervical Stabilization Exercises on Respiratory Strength in Chronic Neck Pain

Study Overview
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Brief Summary
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This project was a Randomized control trial conducted to check the effects of Cervical Stabilization Exercises on Respiratory Strength in Chronic Neck Pain Patients with Forward Head Posture, duration of study was of 6 months, convenient sampling was done, subject following eligibility criteria from Jinnah Hospital Lahore, were randomly allocated in two groups via lottery method, baseline assessment was done, Group A participants were given baseline treatment protocol for 4 weeks which included 3 sessions per week. Heating Pad applied for 15 min and TENS (Transcutaneous Electric Nerve Stimulation) for 10 min. After that Cervical isometric exercises performed in sitting (10sec hold, 10 to 15 reps). Group B was experimental group and participants were given baseline treatment in addition to Cervical Stabilization exercises for 4 weeks which included 3 sessions per week. The baseline measurement was taken on day one for Numeric Pain Rating Scale (NRPS) and Neck Disability Index (NDI). Forward head posture assessed by measuring Cranio Vertebral Angle (CVA). Respiratory muscle strengths measured by Spirometer and SBC (single breath count). All the measurements repeated at the end of fourth week. Data was analyzed by using SPSS version 20.

Detailed Description
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Extensive usage of electronic gadgets in today's life leads to the musculoskeletal problems among which neck pain is the most common problem reported to physicians, orthopedics and physical therapists. Even before reporting to clinics there is long history of using over the counter pain killers. Pain avoidance behaviors let the cervical spine stiff so much that a clinician help is sought. There is huge literature regarding the management of chronic neck pain and yet after the decades of research there are gaps in treatment options. In modern age of health care, it is common goal of every healthcare to make patient self-sufficient as early as possible. The self-care models have tremendous advantages. The current study has compared the effects of cervical stabilization exercises and isometric exercises. The current study was novel in a way that there is limited literature about treating Chronic Neck Pain Patients with effects of physiotherapy on respiratory strength in improving forward head posture. All the methods were employed to see if they improve ranges along with accompanying pain and disability.

Official Title
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Effects of Cervical Stabilization Exercises on Respiratory Strength in Chronic Neck Pain Patients With Forward Head Posture

Conditions
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Neck Pain

Intervention / Treatment
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* Other: baseline physical therapy treatment
* Other: Cervical Stabilization exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with chronic neck pain for more than 3 months. Mild neck disability (NDI score 5-15) Exclusion Criteria: Neck pain secondary to trauma Deformities of thoracic region or vertebral column History of any thoracic or vertebral column surgery. History of smoking Patients with any other serious pathology/red flags

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: baseline physical therapy treatment<br>baseline physical therapy treatment ,Control group- Group A | Other: baseline physical therapy treatment<br>* Group A was control group and the patients received Conventional treatment protocol for 4 weeks which included 3 sessions per week. Patients received hot pack for 15 min and TENS (Transcutaneous Electric Nerve Stimulation) for 10 min. After that Cervical isometric exercises will be performed in sitting (10sec hold,10 to 15 reps)<br>|
| Experimental: Cervical Stabilization exercises<br>baseline physical therapy treatment along with Cervical Stabilization exercises- Experimental Group- Group B | Other: Cervical Stabilization exercises<br>* Group B was experimental group and received baseline physiotherapy treatment in addition to Cervical Stabilization exercises. Pillow was placed beneath cervical spine in supine position and guided patients to nod head as though they said 'yes' and asked them to hold for 10 seconds. 10 repetitions were done before progressing to the next target level. 4 weeks (3 sessions per week) Hot pack: 10 min TENS: 10 min Cervical isometric exercises in sitting (10sec hold,10 to 15 reps) Cervical Stabilization exercises (10 sec hold, 10 reps) On eligible participants baseline assessment was taken on day 1, post intervention assessment was taken at the end of 4th week.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numeric Pain rating scale | The NPRS is the segmented numeric version of visual analog scale (VAS) in which a respondent selects a whole number (0-10 integers) that best reflects the intensity of pain. The common format is a horizontal bar or line. Similar to VAS, the NPRS is anchored by terms describing pain severity extremes. | 4th week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neck disability Index | Methods of assessment for such disability, especially those targeted at activities of daily living which are most affected by neck pain, questionnaire 10-item scaled entitled the Neck Disability Index (NDI) | 4th Week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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NDI, NPRS, CVA, SBC