Comparison of Conservative Treatment and Graston and Cup Applications in Patients With Cervical Disc Herniation

Study Overview
=================
Brief Summary
-----------------
The aim of the study is to examine the effects of graston and dry cupping techniques applied in addition to the conservative treatment program on neck awareness, grip strength, balance and sleep quality in patients with cervical disc herniation between the ages of 18-65.

Detailed Description
-----------------
The research will be carried out on 50 cases diagnosed with cervical disc herniation between the ages of 18-65. The patients will be divided into 2 groups as control and experimental groups by simple randomization method. While the conservative physical therapy program is applied to the control group, the patients in the experimental group will be applied 1 day graston and 1 day dry cup technique in addition to the ones in the experimental group. All patients will be treated for 20 sessions, 5 days / 4 weeks. Fremantle Neck Awareness Questionnaire to assess neck awareness, hand dynamometer to assess grip strength, Berg Balance Scale to assess balance and Jenkins Sleep Scale to assess sleep quality will be used. All tests will be measured at the start of treatment and after 4 weeks of intervention. Pre- and post-intervention data were statistically analyzed and compared.

Official Title
-----------------
Comparison of Conservative Treatment and Graston and Cup Applications in Patients With Cervical Disc Herniation

Conditions
-----------------
Neck Pain, Cervical Disc Herniation

Intervention / Treatment
-----------------
* Other: conventional
* Other: traditional and complementary medicine methods


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Being between the ages of 18-65 Being diagnosed with cervical disc herniation Being diagnosed with cervical disc herniation at the level of bulging or protrusion according to MRI results Exclusion Criteria: Presence of cervical spine surgery history Presence of primary or spinal metastatic malignancy Having vascular problems Individuals with sleep apnea Those who use psychiatric drugs Presence of various pathologies in the upper extremity (fracture, ganglion cyst, etc.)

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: conservative and traditional physiotherapy
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: conventional physiotherapy<br>traditional and complementary medicine methods will not be used. | Other: conventional<br>* hot application electrotherapy ultrasound mobilization joint range of motion exercises stretching exercises balance exercises posture exercises<br>|
| Experimental: cupping therapy and graston<br>Complementary methods will be used alongside conventional physiotherapy. | Other: conventional<br>* hot application electrotherapy ultrasound mobilization joint range of motion exercises stretching exercises balance exercises posture exercises<br>Other: traditional and complementary medicine methods<br>* The Graston Technique is a form of manual therapy known as instrument assisted soft tissue mobilization. Graston massage is performed using titanium-coated metal rods specially designed for different parts of the body. Cupping therapy is a treatment method that creates a regional vacuum to increase the blood circulation of the person and provide healing.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Fremantle Neck Awareness Questionnaire | It is a 9-question questionnaire that evaluates the way people perceive the communication between their neck and their body, and the way they perceive their body position. Evaluates the perception that differs according to the individual. It is a Likert-type questionnaire (0 = Never/Never feel this way, 1= I rarely feel this way, 2 = Sometimes, or sometimes I feel this way, 3 = I feel this way often, 4 = I feel this way all or most of the time) | 6 weeks | 
| Berg Balance Scale | The Berg Balance Scale is a scale developed for the assessment of postural control in adults and is easily used in many areas of rehabilitation. It consists of 14 items in total. Scoring evaluates whether the patient can safely perform a task in a given amount of time. High fall risk and balance disorder between 0-20 points; A score of 21-40 indicates moderate risk of falling and an acceptable balance; A score of 41 and above indicates good balance and minimal risk of falling. | 6 weeks | 
| Jenkins Sleep Scale | The Jenkins Sleep Scale is used in clinical studies to evaluate the sleep problems of patients. Patients are asked 4 questions about sleep problems in the last month and are asked to answer them. 0 (hardly), 1 (1-3 days per month), 2 (4-7 days per month), 3 (8-14 days per month), 4 (15-21 days per month), 5 (23-31 days per month) | 6 weeks | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
graston technique, cupping therapy