Efficacy of Deep Cervical Flexor Muscles Training on Neck Pain, Functional Disability and Muscle Endurance in School Teachers

Study Overview
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Brief Summary
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Neck pain (NP) is a common work related disorder. Teaching is one profession in which its prevalence is high. The Daily job of a school teacher involves head down posture while reading, writing, etc., exposing them to risk of developing NP. Deep cervical flexor (DCF) muscles have been shown to have lower endurance in patients with cervical impairment which has been associated with disability. There is limited evidence that reports efficacy of DCF muscles training in occupational NP. This study was done to see the effect of DCF muscles training using pressure biofeedback on pain, muscle endurance and functional disability in school teachers with NP.

Detailed Description
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Neck pain (NP) is a common work related disorder. Teaching is one profession in which its prevalence is high. The Daily job of a school teacher involves head down posture while reading, writing, etc., exposing them to risk of developing NP. Deep cervical flexor (DCF) muscles have been shown to have lower endurance in patients with cervical impairment which has been associated with disability. There is limited evidence that reports efficacy of DCF muscles training in occupational NP. This study was done to see the effect of DCF muscles training using pressure biofeedback on pain, muscle endurance and functional disability in school teachers with NP. 65 teachers, aged between 25 to 45 years with experience of more than 5 years were agreed to participate in this study. Subjects were randomly divided into two groups, experimental (EG) and control group (CG). In EG, subjects received DCF muscles training using pressure biofeedback in addition to conventional exercises for neck pain while in CG subjects received only conventional exercises. Pain, muscle endurance and disability measured at day 0 (before treatment), day 14 and day 42 after treatment. Endurance of DCF muscles was measured by CCF test using pressure biofeedback instrument, Pain intensity was measured using NPRS and Functional disability was assessed using NDI questionnaire.

Official Title
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Efficacy of Deep Cervical Flexor Muscles Training on Neck Pain, Functional Disability and Muscle Endurance in School Teachers

Conditions
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Neck Pain

Intervention / Treatment
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* Behavioral: DCF muscles training using pressure biofeedback in addition to conventional exercises
* Behavioral: conventional exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: experience of more than 5 years neck pain score of more than 5 on numeric pain rating scale (NPRS), mild to moderate disability score on neck disability index (NDI) and poor cranio-cervical flexion (CCF) test Exclusion Criteria: any neurological sign or symptom, history of spinal surgery or if they were taking any treatment for their pain.

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 45 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 |
| --- | --- |
| Experimental: experimental group<br> | Behavioral: DCF muscles training using pressure biofeedback in addition to conventional exercises<br>* DCF muscles training using pressure biofeedback in addition to conventional exercises<br>|
| Active Comparator: control group<br> | Behavioral: conventional exercises<br>* conventional exercises<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Pain at day 42, day 14 after intervention from baseline | Numeric pain rating scale (NPRS): NPRS. Subjects had to rate their pain on the 0-10 rating scale, where 0 means no pain while 10 is the worst possible pain. | at day 0 (before treatment), day 14 and day 42 after treatment | 
| Change in muscle endurance at day 42, day 14 after intervention from baseline | Craniocervical flexion test (CCF) test using pressure biofeedback instrument | at day 0 (before treatment), day 14 and day 42 after treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| disability | Functional disability was assessed using Neck disability index (NDI) questionnaire. Subjects had to answer the multiple choice questions and their score was interpreted on range from 0 to 50, 0 being no disability and 50 indicating complete disability. | at day 0 (before treatment), day 14 and day 42 after treatment |