Cervicothoracic Junction Mobilization Versus Muscle Energy Technique in Chronic Neck Pain

Study Overview
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Brief Summary
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This study will be conducted to identify the difference between the effect of of cervicothoracic junction mobilization and autogenic Muscle Energy Technique. on neck pain, cervical range of motion, cervical proprioception and neck disability in mechanical neck pain patients with cervicothoracic junction hypomobility.

Official Title
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Cervicothoracic Junction Mobilization Versus Autogenic Muscle Energy Technique in Patients With Chronic Mechanical Neck Pain

Conditions
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Chronic Mechanical Neck Pain

Intervention / Treatment
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* Other: cervicothoracic junction mobilization in form of Maitland mobilization
* Other: autogenic muscle Energy Technique
* Other: conventional physical therapy


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Patients with a primary complaint of chronic neck pain (assessed by VAS )for more than 3 months Subjects with pain provocation and reduced mobility at the CT junction segment (assessed by passive accessory intervertebral movements (PAIVMs) and reduced mobility at cervical spine (assessed by CROM device. patients with age range from 18 to 45 years old. patients with body mass index less than 30 kg/m2. Exclusion Criteria: previous spine surgery pregnancy. Diabetic patients Hypertensive patients Patients were excluded if neck pain was associated with cervical radiculopathy whiplash injuries or severe headaches cervical spine fracture vertebro-basilar insufficiency. red flags suggesting of cancer, infection, vascular insufficiency Rheumatologic condition as mild systemic lupus erythematosus, poly-articular osteoarthritis, rheumatoid arthritis and advanced cervical spine degenerative diseases.

Ages Eligible for Study
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Minimum Age: 18 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
Interventional Model Description: mobilization and conventional physical therapy autogenic muscle Energy Technique and conventional physical therapy conventional physical therapy only
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group A:cervicothoracic junction mobilization<br>Group A: patients will receive cervicothoracic junction mobilization and conventional physical therapy program for 3 sessions/week over 4 weeks periods | Other: cervicothoracic junction mobilization in form of Maitland mobilization<br>* Group A: will receive cervicothoracic junction mobilization mobilization in form of 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) for 3 sessions/week over 4 weeks periods.<br>Other: conventional physical therapy<br>* conventional physical therapy only in form of: (superficial heat using hot pack for 10 minutes , Isometric Neck Exercises and Dynamic Neck Exercises)) for 3 sessions/week over 4 weeks periods<br>|
| Experimental: Group B:autogenic muscle Energy Technique<br>Group B: will receive autogenic muscle Energy Technique and conventional physical therapy program for 3 sessions/week over 4 weeks periods. | Other: autogenic muscle Energy Technique<br>* the technique will applied to neck muscles that are prone to get short including anterior, middle and posterior Scaleni, Sternocleidomastoid, Levator Scapulae and upper fibers of the Trapezius muscle. The AI MET group will given 3-5 repetitions of post isometric relaxation (PIR) (30-50% isometric contraction of the muscle to be stretched for 7-10 seconds, followed by rest period of 5 seconds and then a stretch of 10-60 seconds hold<br>Other: conventional physical therapy<br>* conventional physical therapy only in form of: (superficial heat using hot pack for 10 minutes , Isometric Neck Exercises and Dynamic Neck Exercises)) for 3 sessions/week over 4 weeks periods<br>|
| Active Comparator: Group C:conventional physical therapy<br>Group C: will receive conventional physical therapy only in form of: (superficial heat using hot pack for 10 minutes , Isometric Neck Exercises and Dynamic Neck Exercises)) for 3 sessions/week over 4 weeks periods. | Other: conventional physical therapy<br>* conventional physical therapy only in form of: (superficial heat using hot pack for 10 minutes , Isometric Neck Exercises and Dynamic Neck Exercises)) for 3 sessions/week over 4 weeks periods<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in neck pain | change in neck pain will be measured by Visual analog scale for the 3 groups pre- and post treatment | Evaluation Will be performed prior to the first treatment session; as a baseline measure, and at last treatment session(after 4 weeks) as a post-treatment measure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cervical ROM and cervical prorprioception | cervical ROM and cervical prorprioception will be measured by cervical ROM device pre treatment and post treatment | Evaluation Will be performed prior to the first treatment session; as a baseline measure, and at last treatment session(after 4 weeks) as a post-treatment measure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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chronic mechanical neck pain, cervicothoracic junction mobilization, autogenic muscle energy technique, cervicothoracic junction hypomobility