Effects of Manual Therapy Versus Stretching Exercise Versus Routine Physical Therapy on Work-related Pain, Among Chefs

Study Overview
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Brief Summary
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The aim of this research is to analyze the effect of Mulligan technique versus stretching techniques and versus routine physical therapy on pain, range of motion and functional disability among restaurant chefs presenting with non-specific chronic pain.

Detailed Description
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A Randomized Control Trail study will be conducted, at Riphah International University Faisalabad after the approval of synopsis. Purposive sampling will be used to enroll the patients. Patients will be selected according to the pre-defined inclusion and exclusion criteria. The patients who will meet the inclusion criteria are allocated into three groups. The patients of group A will receive Routine physical therapy only. Group B will receive manual therapy and routine physical therapy while Group C will receive stretching exercises and routine physical therapy. The outcomes will be measured by the Neck Disability Index, visual analogue scale and bubble inclinometer. The data of patients will be recorded pre-treatment and post-treatment. The comparison between pre-treatment and post-treatment data will be done after 3 months. Informed consent will be taken from each patient. Data entry and analysis will be done with Statistical Package of Social Sciences Version 20 software.

Official Title
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The Effects of Manual Therapy Versus Stretching Exercise Versus Routine Physical Therapy on Work-related Pain, Among Patients With Non-specific Chronic Neck Pain Working as Chefs: A Randomised Controlled Trial

Conditions
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Neck Pain

Intervention / Treatment
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* Other: Routine Physical Therapy
* Other: Manual Therapy And Routine Physical Therapy
* Other: Stretching Exercises And Routine Physical Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: For at least 3 months, you've been suffering from neck pain Any Neurological problems For the previous three months, the patient has taken some analgesic drug for neck pain. Rheumatological issues Non-specific neck pain Age 18-60 years Exclusion Criteria: Neck pain due to, Tumors Ankylosing Spondylitis Fracture Dislocation Cord compression Insufficiency of the vertebrobasilar artery Osteoprosis Anticoagulant or corticosteroid therapy for a long period of time Pain due to any congenital deformity, inflammation or any infection Carcinoma

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 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: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Routine Physical Therapy<br>Electrotherapy Exercises. Electrotherapy Hot pack Patients will be in prone position and for relaxation pillow will place beneath the abdomen. Then to reduce muscle spasm and to induce vasodilation hot pack will use for 15 minutes. Treatment with hot pack helps in improving and relaxing the muscle spasm and soft tissue elasticity. TENS TENS will be of 50 Hz, duration of pulse will be<150 microseconds, for 15 minutes to reduce pain. TENS and Hot Pack will use at the same time for 15 minutes. Ultrasound Ultrasound's gel will be applied on outer surface of skin with 2-3 mm thickness. Then ultrasound which frequency will be 1MHz applied for 5 min. • Exercises Passive Range of Motion exercises for 10 minutes Neck Flexion Neck Side bending Neck Rotation Isometric neck flexion Isometric neck extension Isometric neck side bending These exercises will repeat 3 times within the treatment program. | Other: Routine Physical Therapy<br>* Routine Physical Therapy treatment with hot pack, TENS, and ultrasound helps in improving and relaxing the muscle spasm and soft tissue elasticity along pain reduction.<br>|
| Experimental: Manual Therapy And Routine Physical Therapy<br>The routine physical therapy will be applied first, in which electrotherapy will applied for 20 mins, TENS and hot pack for 15 mins, ultrasound for 5 mins. Manual therapy Natural Apophyseal Glides The natural apophyseal glides, which will be applied between C2 and C7, will be the Manual Muscle Testings first action. Patients may request to sit and lean on a chair. The oscillatory motions will reapply the mobilization. Sustained Natural Apophyseal Glides Sustained Natural Apophyseal Glides will be a mixture of mobilization and active gestures/movements. 5 repetitions for 10 minutes of each. | Other: Manual Therapy And Routine Physical Therapy<br>* Mulligan is consider one of the most effective technique of mobilization.it is also important treatment for neck pain so that many physiotherapist used mulligan by including several methods such as Natural Apophyseal Glides or Sustained Natural Apophyseal Glides.<br>|
| Experimental: Stretching Exercises And Routine Physical Therapy<br>The routine physical therapy will be applied first, in which electrotherapy will applied for 20 minutes, TENS and hot pack is applied for 15 minutes at the same time, then ultrasound will applied for 5 minutes. Stretching exercises will be done in the following order; For trapezius: Stretching into lateral flexion for the upper part, For scalene: rotation and ipsilateral flexion For the extensor muscles: flexion will be performed. Performing each action for 30 seconds with 5 repetitions for 10 minutes Finally, by retruding the jaw, a neck straightening exercise can be performed. | Other: Stretching Exercises And Routine Physical Therapy<br>* Regular stretching helps increase your range of motion in the joints, improves blood circulation and posture and alleviates muscular tension throughout the body.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual analog scale | A Visual Analogue Scale is a measurement instrument that tries to measure a characteristic or attitude that is believed to range across a continuum of values and cannot easily be directly measured. | 12th Week | 
| Neck disability index | The Neck Disability Index is a 10-item questionnaire that measures a patient's self-reported neck pain related disability. A higher Neck Disability Index score means the greater a patient's perceived disability due to neck pain | 12th Week | 
| Bubble inclinometer | The Bubble Inclinometer precisely measures, tests and evaluates the ranges of motion of neck. While using, place the Inclinometer near the joint to be measured. | 12th Week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Manual Therapy, Stretching Exercises, Routine Physical Therapy, Non Specific Chronic Neck Pain, Restaurant Chefs