Manual Therapy on Head-repositioning Accuracy and Static Postural Balance in Neck Pain Patients

Study Overview
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Brief Summary
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To investigate the effect of cervical manual mobilization on head repositioning accuracy and postural balance in patients with chronic mechanical neck pain in a randomized controlled trial. Hypothesis: There is no difference between the intervention group (manual mobilization) and control group head repositioning accuracy and postural balance.

Detailed Description
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The aim of the study is to investigate the effectiveness of manual therapy to standing balance and head-neck proprioception sense in patients with chronic neck pain. The study will recruit 120 chronic neck pain patients and randomize the into 2 groups of 60. Group 1 will receive a course of manual therapy and infrared radiation for 15 minutes (twice weekly for 12 sessions). The other group (control) will receive infrared radiation therapy only. Manual therapy will be provided by experienced physiotherapists and assessed by a separate assessor. All outcome measures will be assessed at the beginning of study, upon completion of intervention, 3-month and 6-month after the completion of study. All measurements collected will be analysed by computerized statistical software in order to calculate the effectiveness of manual therapy and relationship among those outcome measurements.

Official Title
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To Investigate the Effectiveness of Manual Therapy on Head-repositioning Accuracy and Static Postural Balance in Patients With Non-traumatic Chronic Mechanical Neck Pain.

Conditions
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Neck Pain

Intervention / Treatment
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* Procedure: Manual mobilization on cervical spine
* Procedure: Infra-red therapy with self exercise pamphlet


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 18 to 65 years Presented with a complaint of neck pain (defined as pain in the region from the upper thoracic spine to the occiput and the surrounding musculature) for more than 7 weeks. Had not received neck pain treatment in the past 1 month Exclusion Criteria: Onset of presenting neck pain episode after trauma (eg, whiplash) History of cervical injury of trauma since the onset of presenting neck pain episode History of cervical injury or trauma Neck pain due to fracture, tumor, infection, severe spondyloarthropathy, or other non-mechanical cause such as inflammatory arthritis; Progressive neurological deficit, myelopathy, herniated nucleus pulpous, or severe incapacitating pain; Being treated by electrical devices; Blood coagulation disorder or were using corticosteroids or anticoagulant medications; History of stroke or transient ischemic attacks; Vertebrobasilar artery insufficiency; Neurologic disease (eg, multiple sclerosis, Parkinson's disease, syringomyelia); Congenital anomalies involving the C-spine; Systemic disease (eg, diabetes mellitus); Pain involving third-party liability or Workers' Compensation.

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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Manual mobilization on cervical spine<br>Manual mobilization given on cervical spine with infra-red therapy and self exercise and advice pamphlet. | Procedure: Manual mobilization on cervical spine<br>* Manual mobilization provided on selected cervical spine in patients with chronic mechanical neck apin<br>|
| Active Comparator: Infra-red radiation therapy<br>Infra-red radiation therapy with self exercise pamphlet given to patients with chronic mechanical neck pain. | Procedure: Infra-red therapy with self exercise pamphlet<br>* Infra-red radiation therapy on cervical spine with self exercise pamphlet given to patients with chronic mechanical neck pain.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Head repositioning accuracy | Head re-positioning accuracy by using laser-pointer mounted in a cyclist helmet. | up to 6 month post intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postural balance | Standing postural sway using computerized validated equipment. | up to 6 month post intervention | 
| Northwick Park Questionnaire | Neck disability questionnaire | up to 6 month post intervention | 
| Active neck range of motion | Active neck range of motion using 3-dimensional goniometer. | up to 6 month post intervention | 
| Numeric Pain Rating Scale | Subjective numeric pain rating scale from 0 - 10. | up to 6 month post intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Musculoskeletal manipulations, Proprioception, Postural balance