Clinical trial NCT07026019: Exercise and Chronic Mechanical Neck Pain
Official title: Effects Of Tele-Based Multimodal Versus Bruegger's Relief Exercise Program In Electronic Gadget Users With Chronic Mechanical Neck Pain
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Neck Pain Chronic
Keywords: Neck pain
Telehealth
Range of motion
Photogrammetry
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2025-06-18
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Maximum age (years): 45
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This Randomized Clinical Trial will be conducted at Riphah Rehabilitation and Research Center and spans 4 weeks. Non-probability Convenient sampling will be used to collect the data. A sample size of 40 subjects with age group between 18-45 years will be taken. Data will be collected from patients who use electronic gadgets and have present complaints of mechanical neck pain. Outcome measures will be taken using the Numeric pain rating scale (NPRS) for pain, Neck Disability Index (NDI) for disability, Goniometer for Range of motion, and Kinovea software for shoulder, eye, and craniovertebral angle measurement. Subjects will be selected based on inclusion and exclusion criteria and will be equally divided into two groups by random number generator table. The first assessment will be conducted physically and after that, both groups will receive treatment via MS teams under the supervision of a physiotherapist. Both the Groups will receive Hot Pack, and baseline treatment (neck isometrics, upper trapezius and scalene stretches), while Group A will receive multimodal exercises (chin tucks, bilateral pectoral stretching, scapular region strengthening exercises, and Wand exercises) and Group B will receive Bruegger's relief exercise. Outcome measures will be measured at baseline and after 4 weeks. Data analysis will be done by SPSS version 25.

Detailed description: Neck pain is defined as "activity-limiting neck pain with or without radiation to the upper limbs lasting for at least 24 hours" is a major public health concern globally due to significant direct and indirect individual and societal costs, and the negative impact on overall health, function, well-being and quality of life. Mechanical neck pain (MNP), also known as chronic non-specific neck pain, is a common musculoskeletal chronic disease . When the duration of symptoms is greater than 12 weeks of evolution, it acquires the value of chronicity, being denominated non-specific chronic neck pain . Neck pain is a prevalent medical condition affecting a vast number of individuals worldwide. Neck pain can significantly impede daily activities and even progress into a debilitating physical disability . The annual prevalence of musculoskeletal disorders in office workers is 63% and the most common sites for musculoskeletal disorders are neck (42%) and low back (34%). Between 20% and 70% of people will experience neck pain in their lifetime .

Several epidemiological studies have reported a high prevalence of neck and shoulder pain among worldwide users of handheld devices. For example, a study of 140 handheld device users at a Canadian university showed that 68% of users had neck pain, while 46% and 52% had pain in their left and right shoulders, respectively. Also, a study of 774 smartphone users at Khon Kaen University reported that 48.4% of users had shoulder pain, and 43.1% of users had neck pain. Interestingly, regarding posture when using a smartphone, it was found that 91% of 859 subjects had a flexed neck position, in which the head is bent down to look at the smartphone screen, and the head is tilted in a forward position for a long time, which causes fatigue and contributes to the development of pain in the neck. The duration of smartphone use in a poor posture for 20 minutes can induce muscle fatigue in the cervical muscles, such as the upper trapezius and cervical erector spinae muscles.

International guidelines recommend that in the absence of sinister 'red flag' pathology (e.g. fracture, neoplasm), first-line interventions for the majority of musculoskeletal conditions should involve simple non-surgical management, where interventions are tailored to the individual's needs and clinical presentation. Despite these recommendations, the timely, affordable and equitable access to such healthcare services can be severely limited for some. This has demanded organizations to rethink how traditional healthcare services can be delivered with many services rapidly adopting telehealth service delivery methods. Telerehabilitation interventions can include any type of treatment - such as treatment based on education, exercise prescription, and self-management - that can be offered at a distance. The most common ways to deliver telerehabilitation interventions are through websites, smartphone apps, videoconferences, over the telephone, and text messages.

With the growing reliance on electronic devices in daily life, understanding the most effective exercise program for managing neck pain in gadget users is essential for healthcare practitioners and individuals seeking relief. This study aims to fill a gap in current knowledge by evaluating the comparative effectiveness of tele based multimodal and Bruegger's relief exercise program, ultimately guiding healthcare professionals in recommending the most suitable exercise regimen for electronic gadget users with chronic neck pain.

Eligibility criteria: Inclusion Criteria:

* Age group between 18-45 years (10).
* Both gender
* Neck pain associated with degenerative changes and myofascial pain syndromes
* Individuals having localized pain or stiffness in the cervical spine (C3-C7) without upper limb radiculopathy
* People with a disability and therefore cannot come to the clinic
* People living in highly populated cities where the healthcare system is overcrowded
* People who use electronic gadgets i.e. computers, and smartphones for more than 4 hours

Exclusion Criteria:

* Tuberculosis, carcinoma, heart disease, and osteoporosis
* Previous surgery related to the cervical spine
* Having radical symptoms such as paresis, tingling, or numbness
* Any trauma or localized infection in the neck region
* Having inflammatory rheumatologic diseases, or structural deformity
* Ongoing radiotherapy, chemotherapy, steroid therapy, or anticoagulants
* Positive Spurling's test, traction test, upper limb tension test, and shoulder abduction test

Primary outcomes:
measure: Numerical Pain Rating Scale
timeFrame: Baseline, 4th Week
measure: Neck Disability Index
timeFrame: Baseline, 4th Week
measure: Cervical Range of Motion
timeFrame: Baseline, 4th Week
Secondary outcomes:
Other outcomes:
Locations:
city: Lahore
country: Pakistan
facility: Riphah Rehabilitation Clinic
state: Punjab
Study officials:
affiliation: Riphah International University
name: Syed Shakil ur Rehman, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Waongenngarm P, van der Beek AJ, Akkarakittichoke N, Janwantanakul P. Perceived musculoskeletal discomfort and its association with postural shifts during 4-h prolonged sitting in office workers. Appl Ergon. 2020 Nov;89:103225. doi: 10.1016/j.apergo.2020.103225. Epub 2020 Aug 2.
citation: Bernal-Utrera C, Gonzalez-Gerez JJ, Anarte-Lazo E, Rodriguez-Blanco C. Manual therapy versus therapeutic exercise in non-specific chronic neck pain: a randomized controlled trial. Trials. 2020 Jul 28;21(1):682. doi: 10.1186/s13063-020-04610-w.