Comparing the Effects of Neck Stabilization Exercises Verses Dynamic Exercises Among Patients Having Nonspecific Neck Pain With Forward Head Posture

Study Overview
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Brief Summary
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the objective of this randomized clinical trial is to compare the effectiveness of neck stabilization exercises versus neck dynamic exercises in patients having non specific neck pain with forward head posture for pain intensity, correction of forward head posture, increasing Range of movement and decrease functional disability. the study is being conducted at physiotherapy department of institute of physical medicine and rehabilitation (Dow university of health sciences) total 60 patients with non specific neck pain with forward head posture recruited by non-probability sampling technique initially screening done by consultant physicians who is blinded to the treatment given to patients. patient are included in study who fulfill inclusion criteria and sign the consent form. patients then randomly allocated to both treatment groups using computer generated randomization sheet. baseline assessment is taken at first session after providing 9 treatment of stabilizing exercises to group1 and dynamic exercises to group 2 session post assessment will be done on goniometry, NDI, VAS and plumb line at last session at third week.

Official Title
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Comparing the Effects of Neck Stabilization Exercises Verses Dynamic Exercises Among Patients Having Nonspecific Neck Pain With Forward Head Posture- A Randomized Clinical Trial

Conditions
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Non-specific Neck Pain

Intervention / Treatment
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* Other: Stabilization exercises
* Other: Dynamic exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with nonspecific neck pain more than 3 weeks less than 6 months. Patients with forward head posture on plumb line assessment. Pain on VAS moderate 4-7 NDI score with moderate; 50-64%. Age ranges from 18-40. Exclusion Criteria: Previous history of any accident (whiplash), fracture, tumor etc. Patients not willing to participate.

Ages Eligible for Study
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Minimum Age: 18 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
Interventional Model Description: it is a randomized clinical trial. total 60 patients will be recruited 30 in each group. both groups are treatment group. treatment of group 1 is stabilization exercises and group 2 is dynamic exercises. patients are allocated randomly randomization is done by computer generated software sheet
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Treatment group 1: stabilization exercises<br>stabilization exercises Chin tuck Cervical extension Shoulder shrugs Shoulder rolls Scapular retraction (15 repetitions 1 set) with TENS(10 mins before each session for 10 min at the back of the neck), stretching of trapezius, Pectorals minor, sternocleidomastoid, levator scapulae (5 rep 10 sec hold 1 set in both sides ) and cold pack (10 min at the back of neck at the end of each session) | Other: Stabilization exercises<br>* The activation of deep cervical muscle to reduce the activity of surface muscles is known as stabilization exercises<br>|
| Active Comparator: Treatment group 2: dynamic exercises<br>dynamic exercises Cervical extension-dynamic isometric. Cervical Flexion-Dynamic isometric. Chest flies exercises (15 repetitions 1 set) with TENS(10 mins before each session for 10 min at the back of the neck), stretching of trapezius, Pectorals minor, sternocleidomastoid, levator scapulae (5 rep 10 sec hold 1 set in both sides ) and cold pack (10 min at the back of neck at the end of each session) | Other: Dynamic exercises<br>* The exercises in which muscle tension remains constant but muscle length changes is known as dynamic exercises<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in pain intensity with Visual analog scale (VAS) in cm | VAS will be used for assessment of pain intensity on 10 cm straight line with marking from 0 to 10 (0 means no pain and 10 means worst pain possible) patients pain is recorded at baseline at the start of 1st session than change in pain intensity (decrease) will be assessed at the end of 9th session at week 3. | Baseline and 3 weeks | 
| Change in disability with Neck disability index questionnaire (NDI) scores | NDI will be used for the assessment of disability due to neck pain. NDI is a ten item questionnaire each question has 6 responses from 0 no disability to 5 complete disability (score of less than 4 indicates no disability, 5-14 mild disability, 15-24 moderate disability, 25-34 severe disability, and scores greater than 35 complete disability) used to assess disability associated with neck pain and whiplash injury. patients disability is recorded at baseline at the start of 1st session than change in disability (decrease) will be assessed at the end of 9th session at week 3. | Baseline and 3 weeks | 
| Change in neck range of motions with goniometer in degrees | Goniometry will be used for the assessment of change in available range of motion of around neck joint in degrees. the therapist assess the range of motion using goniometer in flexion, extension, lateral flexion(right), lateral flexion(left), rotation(right), rotation(left). patients ROM is recorded at baseline at the start of 1st session than change in ROM (increase) will be assessed at the end of 9th session at week 3. | Baseline and 3 weeks | 
| Change in ear position with reference to shoulder Plumb line measurement in inches | Plumb line measurement will be used for the assessment of forward head posture using body landmarks such as ear lobe or mastoid process and shoulder alignment in inches. patients forward head is recorded at baseline at the start of 1st session than change in forward head (postural correction) will be assessed at the end of 9th session at week 3. | Baseline and 3 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Neck Aches, Isotonic Contractions, Muscle Strength, Rehabilitation Exercises, Treatment