Clinical trial NCT06108882: Effects of Manual IC With and Without SCS on SCM Tightness With FHP
Official title: Effects of Manual Ischemic Compression With and Without Strain Counter Strain Technique on Sternocleidomastoid Tightness With Forward Head Posture
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Neck Pain
Keywords: Disability
Forward head posture
Pain
ROM
Sternocleidomastoid
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2023-10-31
Enrollment: 42
Sex: ALL
Minimum age (years): 25
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The aim of this study is to compare the effects of Manual Ischemic Compression with and without Strain Counterstrain technique on CVA, ROM, pain and disability among FHP individuals with SCM tightness.

Detailed description: Forward head posture is defined by excessive extension at upper cervical spine(C1-C3) and flexion at lower cervical spine (C4-C7) that increases cranial rotation angle and decreases craniovertebral angle (CVA) because of the altered relative position of the head with respect to the line of gravity. The bubble inclinometer is a gravity-based tool used to measure the cervical range of motion and to assess SCM muscle length. FHP also leads to muscles imbalance and SCM tightness as well. The Numerical Pain Rating Scale (NPRS) are most frequently used to quantify pain intensity and NDI for neck disability.

A RCT study compare the effects of IC and SCS in patients with upper trapezius trigger points. For four weeks, the therapy was given three days a week. As an outcome indicator, the NPRS, NDI, and cervical lateral flexion were used. The outcome measures were evaluated at baseline, after the second week, and after the fourth week: The ischemic compression and strain counterstrain intervention, which lasted for four weeks, significantly improved cervical range of motion, reduced pain intensity, and reduced cervical disability. However, the intergroup comparison revealed that both interventions were equally effective, and none of them outperformed the others.

Most of the studies compared digital ischemic compression as a common treatment with dry needling or other soft tissue mobilizations specially to treat trapezius trigger points but there are few studies specifically investigating comparative effects of Manual Ischemic Compression with and without Strain Counterstrain for management purpose of muscle tightness in individuals with FHP. While various treatment options exist for FHP, limited research directly compares the comparative outcomes of Strain Counterstrain and Ischemic Compression techniques. Due to lack of comparative evidence regarding the efficacy of these specific interventions, there is a need to bridge this gap by investigating and comparing the effectiveness of these interventions by using highly reliable and valid outcome measures in order to provide healthcare professionals and individuals with evidence-based guidance for optimal FHP management and SCM tightness.

Eligibility criteria: Inclusion Criteria:

* Neck pain (Numeric Pain Rating Scale \>3)
* Craniovertebral angle (CVA) less than 51
* Shortened SCM muscle

Exclusion Criteria:

* Neck pain with whiplash or headache, neurological disorder
* History of previous head, neck, cervical spine or shoulder surgery
* Infection or inflammatory arthritis in the cervical spine
* History of cervical radiculopathy

  * Diagnosed fibromyalgia and myopathy
  * History of cancer

Primary outcomes:
measure: Numeric pain rating scale (NPRS)
timeFrame: 6 weeks
measure: Neck disability index (NDI)
timeFrame: 6 weeks
measure: The bubble inclinometer
timeFrame: 6 weeks
measure: Craniovertebral angle (CVA)
timeFrame: 6 weeks
measure: Modified goniometer
timeFrame: 6 weeks
measure: Neck ROM
timeFrame: 6 weeks
Secondary outcomes:
Other outcomes:
Locations:
city: Lahore
country: Pakistan
facility: Amina Physiotherapy and Rehab Center, Nusrat Rashid Medical Complex
state: Punjab
Study officials:
affiliation: Riphah International University
name: Saba Rafique, Masters
role: PRINCIPAL_INVESTIGATOR
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