Comparison Of Mackenzie Exercise Program Versus Routine Physical Therapy Management in Chronic Mechanical Neck Pain

Study Overview
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Brief Summary
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Study will be a Randomized clinical trial to check comparison of mckenzie exercise program versus routine physical therapy management on pain, range of motion and function in patients with chronic neck pain so that we can devise a treatment protocol.Total fifty subjects will be included in this study .Out of total 25 will be randomly allocated via lottery method in group 1 and 25 will be allocated in group 2. Group 1 will receive mckenzie exercise program and routine physical therapy(Joint mobilization, hot pack for 15 minutes and home exercise program) while Group 2 will receive only routine physical therapy (Joint mobilization , hot pack for 15 min and home exercise program). All patients will be treated for 12 sessions, two sessions per week for 6 weeks. Neck pain and disability index consist of two parts, part one which assesses pain severity and part two which assesses functional disability. Study setting will be services hospital. Assesment will be done at 0 week, 4week, 8week and 12weeks. Data was analysed by using SPSS version 26.

Detailed Description
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Neck pain is a key public health issue that affects the human beings with reduction productivity and quality of life and produced significant socioeconomic burden on society.The purpose of this study to determine the effectiveness of Mckenzie exercise program and routine physical therapy management on pain range of motion and function in patient with chronic mechanical neck pain. Patients of both gender, neck pain for at least 3 months and age 25-55 years will be included. Patients having history of trauma, vertebral fracture, congenital disorder, ankylosing spondylitis, tumour, pott's disease and any bony or soft tissue systematic disease will be excluded. The main objective of this study is to evaluate pain level and effect of Mackenzie protocol for individuals suffering from chronic neck pain. The tools used will be Neck disability index score (NDI), Numeric Pain Rating Scale (NPRS) and Goniometer for outcome measure pain, range of motion and function. Study will be conducted into 2 groups, each group will have 12 patients and comparisons of two groups will be evaluated. One group will receive Mckenzie exercise program and Routine physical therapy (Joint Mobilization, Hot pack and home exercise program) for 12 weeks and 2 days a week for 40 min each session and other group will receive Routine physical therapy (Joint mobilization, Hot pack and home exercise plan) for 12 weeks and 2 days a week for 30 min each session. Assessment will be done at 0 weeks, 4 week, 8 week and 12 week.Both groups received hot packs for 15 minutes for warming up.

Official Title
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Title Comparison Of Mackenzie Exercise Program Versus Routine Physical Therapy Management On Pain , Range Of Motion And Function in Patient With Chronic Mechanical Neck Pain

Conditions
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Neck Pain

Intervention / Treatment
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* Other: Mckenzie exercise program
* Other: Conventional Physical therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Both Gender Neck pain for at least 3 months Age 25-55 years old Exclusion Criteria: • History of trauma Vertebral Fracture Congenital disorder Ankylosing spondylitis Tumour Pott's Spine Any bony or soft tissue systemic disease

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 55 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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mckenzie exercise program<br>Group A Week 0 : Hot pack for 15 minutes, mackenzie extension exercise program for cervical regions and mobilization with movement at cervical regions for improving flexion, extension, side flexion and rotation. 3 sets of painless glides of 10 repetitions were given, with 1 minute rest between sets. Week 2 & 4: Hot pack for 15 minutes, mckenzie exercise program at cervical region with the progression in repetition and MWM at cervical regions and then we will add progression.5 sets of painless glides of 10 repetitions were given, with 3 minute rest between sets. Week 3 & 6: Hot pack for 15 minutes, mckenzie exercise program for cervical region and MWM at cervical region . 5 sets of painless glides for 10 repetitions were given. Progression can be introduced by increasing number of repetitions performed exercises for 3 weeks. | Other: Mckenzie exercise program<br>* MacKenzie extension exercise program for cervical spine<br>|
| Active Comparator: conventional physical therapy<br>A routine physical therapy(joint mobilization,hot pack and home exercise program) treatment and hot pack for 15 minutes. | Other: Conventional Physical therapy<br>* hot pack for 15 minutes will be given followed by joint mobilization,and home exercise program.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numerical Rating Scale (NRS) | Patients are asked to circle the number on a Numerical Rating Scale (NRS) that best describes their level of discomfort between 0 and 10, 0 and 20, or 0 and 100. The lower limit often denotes the least amount of suffering , whereas zero typically denotes no pain at all. | up to 12 weeks | 
| Universal Goniometer for range of motion measurement | The most popular and reliable approach for determining shoulder range of motion (ROM) is by utilizing a goniometer. A goniometer is a straightforward instrument that has two arms joined at a hinge. The goniometer's second arm would be used to measure the joint angle while the physiotherapist placed one arm of the patient against the patient's body | up to 12 weeks | 
| Neck disability index (NDI) | The Neck Disability Index (modification of the oswestry low back pain disability index) scale scores range from 0 to 5 and the total score is the sum of the item scores possible range 0 no pain to 100 maximal pain | up to 12 weeks |