Effect of Exercise and Manuel Therapy Methods on Pain, Posture, Daily Living in People With Cervical Pathologies

Study Overview
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Brief Summary
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The aim of the study is to determine the effect of exercise and two different manual therapy methods on pain, quality of life and posture in people with neck pain.

Detailed Description
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Deep friction massage will use on cervical regions in first group, muscle energy technic will use second group and cervical stabilization exercise will use as an third group. For all groups, pain intensity, Quality of life and posture will assess.

Official Title
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Servikal bölge Patolojisi Olan Bireylerde Egzersiz ve Manuel Terapi yöntemlerinin ağrı, postür ve yaşam Kalitesi üzerindeki etkinliğinin Belirlenmesi

Conditions
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Musculoskeletal Disorder of the Neck

Intervention / Treatment
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* Procedure: Muscle Energy Technic
* Procedure: Deep Friction Massage
* Procedure: Exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: clinical diagnosis of cervical disorder (for example; chronic neck pain, cervical disc herniation) must have pain at least three months. Exclusion Criteria: History of structural scoliosis History of surgery History of metabolic, neurologic and metastatic diseases.

Ages Eligible for Study
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Minimum Age: 25 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: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Muscle energy technic<br>post isometric relaxation technics were used as muscle energy technics. | Procedure: Muscle Energy Technic<br>* post isometric relaxation technics were applied to levator scapulae, trapezius, pectoralis muscles three sessions per week, totally six weeks.<br>Procedure: Exercise<br>* spinal stabilization exercise were applied three sessions in a week totally six weeks.<br>|
| Active Comparator: Deep Friction Massage<br>Painful areas palpated and deep friction massage was applied. | Procedure: Deep Friction Massage<br>* deep friction massage was applied to cervical region included tendons, muscles and soft tissue.<br>Procedure: Exercise<br>* spinal stabilization exercise were applied three sessions in a week totally six weeks.<br>|
| Active Comparator: exercise<br>Physiotherapist guided Spinal stabilization exercises were applied. | Procedure: Exercise<br>* spinal stabilization exercise were applied three sessions in a week totally six weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in pain sensitivity | pressure pain threshold (PPT) was measured with digital algometer. Pressure pain threshold which identifies minimum levels increasing mechanical stimulus is gold standard method for measuring pain sensitivity. PPT was measured from cervical vertebrae's spinous process and muscle belly's. Algometer range was set 0 kgF to 12kgF. Higher values represent increased pressure sensation. | change from baseline PPT at six weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in Light touch sensation | Semmes weinstein monofilaments were used to determine light touch sensation. It has twenty different evaluator size. Evaluator size was started 2.83 point and higher values represent worse outcome. Upper extremity dermatomes were tested. | change from baseline light touch sensation at six weeks | 
| change in upper extremity disability | The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used.The questionnaire has 34 item which each item scored 1 to 5 points. All responses summed and averaged.This value is then transformed to a score out of 100 by subtracting one and multiplying by 25. This transformation is done to make the score easier to compare to other measures scaled on a 100 scale. Minimum score is 0 and total score is 100. higher values represent a worse outcome. | Change from baseline disability at six weeks . | 
| change in posture | Posture was assessed with global postural system. This computer generated system has two cameras and lets three different plane postural assessment. the assessments and postural deviation calculate with computer programme. | change from baseline posture at six weeks | 
| change in perceived life quality | perceived quality of life was assessed with nottingham health profile. the questionnaire has 38 questions in 6 subareas, with each question assigned a weighted value; the sum of all weighted values in a given subarea adds up to 100. higher values represent better life quality. | change from baseline life quality at six weeks | 
| change in functional disability | Neck Disability Index (NDI) was used.NDI total scores ranged from 0 (no disability) to 50 (severe disability) which have ten items assessing perceived neck pain during daily living activities such as lifting, reading, driving, sleeping and recreational activities. | change from baseline functional disability at six weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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neck pain, physiotherapy, rehabilitation