Comparison of Different Manual Therapy Approaches in Patients With Chronic Neck Pain

Study Overview
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Brief Summary
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The aim of the study was to compare the effects of different manual therapy approaches on pain, cervical range of motion, balance, functional status and life quality in patients with chronic neck pain.

Detailed Description
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Various physiotherapy and rehabilitation methods are applied in the treatment of patients with chronic neck pain. Clinical practice guidelines for individuals with chronic neck pain recommend both manual therapy and exercise therapy among conservative treatments. Manual therapy are methods that can be safely applied to soft tissues and joints. Both manual therapy and exercise applications have been shown to have positive effects on neck pain and function. Some studies in the literature have also shown that manual therapy methods have positive effects on balance. However, no study examining the effects of different manual therapy (classical massage, connective tissue massage, manual joint techniques) approaches applied to individuals with chronic neck pain on pain, cervical range of motion, balance, functional status and quality of life was found in the literature.

Official Title
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Comparison of Different Manual Therapy Approaches in Patients With Chronic Neck Pain

Conditions
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Neck Pain

Intervention / Treatment
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* Other: Massage group
* Other: Connective tissue massage group
* Other: Mobilization group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: To be between the ages of 18-65. To participate in the study voluntarily. Having a complaint of neck pain for at least 3 months. Exclusion Criteria: To have undergone cervical spine surgery Having cervical fracture and/or joint subluxation/dislocation Severe degenerative arthritis Having a neurological disease (Parkinson's disease, poliomyelitis, etc.) or an -inflammatory rheumatic disease (ankylosing spondylitis, rheumatoid arthritis, etc.) Presence of malignancy Having cord compression and signs Severe radiculopathy or myelopathy Positive vertebrobasilar artery test, Pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 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: Massage group<br>Massage group will be applied classic massage+cervical stabilisation exercises | Other: Massage group<br>* Massage group will be applied classic massage and cervical stabilisation exercises 3 days a week for 4 weeks<br>|
| Experimental: Connective tissue massage group<br>Connective tissue group will be applied connective tissue massage+cervical stabilisation exercises | Other: Connective tissue massage group<br>* Connective tissue massage group will be applied connective tissue massage and cervical stabilisation exercises 3 days a week for 4 weeks<br>|
| Experimental: Mobilization group<br>Mobilization group will be applied cervical mobilization techniques+cervical stabilisation exercises | Other: Mobilization group<br>* Mobilization group will be applied cervical mobilization techniques and cervical stabilisation exercises 3 days a week for 4 weeks<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain Intensity | Pain intensity will be assessed with the Visual Analogue Scale (a 100 mm long horizontal line). Patient will be asked to score the pain he/she feels out of 10. The beginning of the figure is 0 no pain, ending in 10 there is unbearable pain. | change from baseline at 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pressure Pain Threshold | Pressure Pain Threshold will be assessed with a digital algometer device. The device that objectively measures the pain threshold will be used for the evaluation. The probe of the device will be pressed on the trapezius muscle. The first pain threshold felt will be recorded. | change from baseline at 4 weeks | 
| Cervical Range of Motion | Cervical range of motion will be evaluated with a goniometer in the sitting position. Neck flexion, extension, right-left lateral flexion and right-left rotation ranges of motion will be recorded | change from baseline at 4 weeks | 
| Balance | Balance will be evaluated with the Biodex Balance System Device. The individual is placed on a platform of the device that evaluates the ability to keep the centre of gravity on the support surface. Changes in the centre of gravity of the individual standing on this platform will be recorded with this device in static and dynamic, with eyes open and closed. | change from baseline at 4 weeks | 
| Functional Status | Functional Status will be assessed with Neck Disability Index. This index consists of 10 items. Each item was scored from 0 (no disability) to 5 (complete disability). The total score ranged from 0 (no disability) to 50 (total disability). As the score increased, disability increased and as the score decreased, disability decreased. | change from baseline at 4 weeks | 
| Life quality | Life quality will be assessed with Short Form-36 questionnaire. The questionnaire consists of 36 items. Scoring is done over 100 points and the scores are between 0 and 100 points for each sub-parameter. 0 is calculated as the worst value and 100 as the best value. | change from baseline at 4 weeks |