Cervicothoracic Junction Mobilization Versus Eccentric Muscle Energy Technique in Mechanical Cervical Pain

Study Overview
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Brief Summary
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To compare the effectiveness of the cervicothoracic junction mobilization and eccentric muscle energy technique on mechanical cervical pain. To compare the effectiveness of the cervicothoracic junction mobilization and eccentric muscle energy technique on cervical disability. To compare the effectiveness of the cervicothoracic junction mobilization and eccentric muscle energy technique on cervical ROM.

Official Title
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Effects of Cervicothoracic Junction Mobilization Versus Eccentric Muscle Energy Technique in the Treatment of Mechanical Cervical Pain

Conditions
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Neck Pain

Intervention / Treatment
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* Other: Cervicothoracic Junction Mobilization Technique
* Other: Eccentric Muscle Energy Technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants falling in this category would be recruited into the study. Females Age between 18-45 years. Diagnosed with mechanical cervical pain. Exclusion Criteria: Participant failing to fall in this category would be excluded of the study. Pregnant Females Any previous history of trauma or surgery Diagnosed with mechanical cervical pain due to disc herniation, radiculopathy or any other cervical malignancy.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Female

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: Cervicothoracic Junction Mobilization Technique<br>It is a part of manual therapy technique. Maitland mobilization to the C7- T1 level, according to their primary movement restriction (for flexion-extension restriction- central PA glide, for rotation restrictions unilateral PA glide) is given.For central PA glide, a central pressure angled towards the participant's head was given with overlapping thumbs of the therapist placed on the spinous process of C7. Dosage: Glide would be given according to the nature, intensity and severity of the patient's pain. 30 sec bouts with 3 sets &amp; 2 reps. Total 2-3 min duration. 2 sessions per week for 3 weeks. | Other: Cervicothoracic Junction Mobilization Technique<br>* It is a part of manual therapy technique. Patient would be in prone position with his forehead in the palm of the therapist. Maitland mobilization to the C7- T1 level, according to their primary movement restriction (for flexion-extension restriction- central PA glide, for rotation restrictions unilateral PA glide) is given. For central PA glide, a central pressure angled towards the participant's head was given with overlapping thumbs of the therapist placed on the spinous process of C7. The therapist's thumbs were placed on the posterior surface of the articular process to be mobilized (C7 on the side of restriction), and anteriorly directed oscillatory pressure was applied for unilateral PA mobilization.<br>|
| Experimental: Eccentric Muscle Energy Technique<br>Eccentric muscle energy technique would be applied to the patient's cervical spine. The cervical spine would be brought to the barrier of motion in each plane i.e. flexion/extension, lateral bending and rotation. Then patient would be asked to push their heads into the direction opposite that of the barrier. Dosage: The therapist provided isometric resistance for 3- 5 seconds, after which the subjects relaxed their muscles completely and the therapist applied stretch. This is applied for generalized cervical movements in each plane like Flexion, Extension, Side Bending &amp; Rotation. 3-5 repetitions with 2-3 sets were performed. Total duration: 3-5 min 2 sessions per week for 3 weeks. | Other: Eccentric Muscle Energy Technique<br>* Eccentric muscle energy technique would be applied to the patient's cervical spine. The cervical spine would be brought to the barrier of motion in each plane i.e. flexion/extension, lateral bending and rotation. Then patient would be asked to push their heads into the direction opposite that of the barrier.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual Analogue Scale | A Visual Analogue Scale (VAS) 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. It is often used in epidemiologic and clinical research to measure the intensity or frequency of various symptoms. It is a straight horizontal line of fixed length, usually 100 mm. The ends are defined as the extreme limits of the parameter to be measured (symptom, pain, health) orientated from the left (worst) to the right (best). Test-retest reliability has been shown to be good, but higher among literate (r= 0.94) | 3 Weeks | 
| Neck Disability Index (NDI) | This questionnaire has been designed to give us information as to how your neck pain has affected your ability to manage in everyday life. Patient-completed, condition-specific, functional status questionnaire with 10 items including pain, personal care, lifting, reading, headaches, concentration, work, driving, sleeping and recreation. Each section is scored on a 0 to 5 rating scale, in which zero means no pain and 5 means Worst imaginable pain. It has highest score of 50. | 3 Weeks | 
| Cervical Goniometer | A goniometer is an instrument which measures the available range of motion atjoint. Goniometer have different types; the most use is the universal standard goniometer, which is either made with plastic or metal tool. It consists of a stationary arm, a movable arm and a fulcrum. | 3 Weeks |