Effects of Core Stability Versus Swiss Ball Exercise in Patients With Chronic Neck Pain

Study Overview
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Brief Summary
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The study will be a randomized clinical trial to determine the effects of core stability versus swiss ball exercises on pain, range of motion and function in patients with chronic neck pain. A sample of 42 patients having neck pain since last 3 months will be taken from physical therapy department of Bahawalpur medical & dental hospital and will be divided into two groups each with 21 patients. Patient of any gender(male or female) with no history of neck surgery or any systemic disease will be considered. Group A will receive core stability exercises along with conventional physical therapy while group B will receive swiss ball exercises along with the conventional physical therapy protocol. The conventional physical therapy protocol will include a hot pack, and cervical stretches. The session will be around 30-45 minutes for each patient with three sessions per week on alternate days. A total of four-week treatment regime will be given to the patients and an assessment of patient's pain, range of motion, and function with NPRS (numeric pain rating scale), goniometry, and NDI (neck disability index) will be done at the baseline and after 4 weeks of treatment, data will be analyzed by using SPSS version 21, after the completion of treatment at four weeks.

Detailed Description
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Chronic neck pain is one of the pains with the highest prevalence these days due to the imprecise daily life routine of people including students & office workers etc. It is generally declared that pain and stiffness in neck occur due to faulty posture for prolonged periods of time against the gravity. Deep layered muscles e.g longus capitus, longus Colli, rectus capitus anterior & rectus capitus lateralis provides the stability to neck if they are targeted it is believed that the observed problem can be cured. This study is aimed to compare two methods for stability of neck i.e. core stability exercises & swiss ball exercises. Until now many treatment options have been used for chronic neck pain e.g stretching, isometrics, fascia release, mobilization techniques etc, and in recent literature, it is seen that stability of neck muscles are emerging to alleviate chronic neck pain. This study is aiming to compare the effects of core stability exercises and swiss ball exercises.So, the latest , effective and economical options for treatment can be used by the physical therapists and can be guided to the patients in order to gain long-lasting effects.

Official Title
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Effects of Core Stability Versus Swiss Ball Exercise Program on Pain, Range of Motion and Function in Patients With Chronic Neck Pain

Conditions
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Neck Pain

Intervention / Treatment
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* Other: Core stability exercises along with conventional physical therapy
* Other: Swiss ball exercises along with the conventional physical therapy protocol


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: • Both genders (male & female) Age group 20-40 years History of neck pain for more than 3 months Exclusion Criteria: History of any neck surgery Neoplasms Any systemic disease Bony disorders

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 40 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: Core stability exercises along with conventional physical therapy<br>Core stability exercises | Other: Core stability exercises along with conventional physical therapy<br>* Core stability exercises included neck isometric exercises(flexion, extension, lateral flexion, rotation), chin tuck, chin tuck into towel, cervical extension + 10 minutes hot pack+ 10 minutes stretching (cervical flexors, extensors, rotators), session will be of 30-40 minutes, three times a week, for 4 weeks duration. Chin Tuck: In standing subject pulls back the chin( as if trying to make a double chin) while keeping the eyes level. This will be done for 15 repetitions. Cervical extension: In a standing position, the subject grasps the base of the neck, with both hands while extending the neck as far as possible. This will be done for 15 repetitions<br>|
| Experimental: Swiss ball exercises along with the conventional physical therapy protocol<br>Swiss ball exercises | Other: Swiss ball exercises along with the conventional physical therapy protocol<br>* Swiss ball exercise will be executed in the following order, assume supine posture on the treatment bed by fully extending their legs and putting them back on the bed in the most comfortable posture with hands on the abdomen. Second, while in the supine posture, support the head with one hand and insert a small Swiss ball near the back of the head with the other hand. Third, after having contacted the ball to the area below the back of the head, slowly turn the head and neck in the shape of the number '8'. Fourth, after having set 3 repetitions of rotating the head and neck for 10 seconds and then taking 10 seconds of general resting as 1 set of exercise, a total of 3 sets of exercise were executed with 1 minute of general resting taken between each set of exercise. Then perform neck flexion, extension, side bending, and rotation, hold each movement for 10 seconds + Hot pack (10 minutes) + 10 minutes of cervical stretching. Perform the exercise three times a week for 4 weeks duration.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| NPRS | Changes from base Line Numeric Pain rating scale is a scale for pain starting from 0-10. where 0 indicate no pain and 10 indicate severe pain. | 4th week | 
| NDI | The NDI has become a standard instrument for measuring self-rated disability due to neck pain. Each of the 10 items scores from 0 to 5. The maximum score is 50 | 4th week | 
| Goniometric measurement of neck ROM | A goniometer is an instrument which measures the available range of motion at a joint. | 4th Week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Neck pain, Posture, Range of motion, Core Stability