Clinical trial NCT05618951: Effects of Transverse Thoracic Mobilization With and Without Lower Trapezius Strengthening Exercises
Official title: Effects of Transverse Thoracic Mobilization With and Without Lower Trapezius Strengthening Exercises on Pain, Disability and Range of Motion in Patients With Mechanical Neck Pain
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Mechanical Neck Pain
Keywords: Neck Pain
Trapezius muscle
Muscle strength
Range of Motion
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2022-11-16
Enrollment: 42
Sex: ALL
Minimum age (years): 18
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: Mechanical neck pain is a common musculoskeletal problem, worldwide. Patients with neck pain often have subjective complaints of muscle stiffness, tension, or tightness in addition to their pain located between the occiput and the third thoracic vertebra Approximately 68% of the total population has experienced neck pain at least once in their lifetime, and it easily transforms into a chronic state (that persists for more than 3 months). In today's society, this is conspicuous in many laborers due to the increased use of computers, where the neck and shoulders are maintained in static abnormal postures to look at the computer screens and become vulnerable to cause neck pain. The aim of the study is to determine the comparative effects of transverse thoracic mobilization with and without lower trapezius strengthening exercises on pain, disability and range of motion in patients with mechanical neck pain.

Detailed description: A Randomized controlled trial will be conducted in physiotherapy outpatient department of Syed Medical Complex and Islam Hospital, Sialkot. Non-probability consecutive sampling will be used to collect the data. Sample size of 20 subjects with age group between 18 to 40 years will be taken. Data will be collected by using tools Numeric Pain Rate Scale (NPRS) for pain, Neck Disability Index (NDI) for disability and Universal Goniometer (UG) for range of motion of neck. An informed consent will be taken. A total of 20 subjects will be selected by following inclusion and exclusion criteria and will equally divided in to two groups by random number generator table. Both groups will come thrice per week for a total of 4 weeks. The data will be analyzed using SPSS software version 25. After assessing normality of data by Shapiro-Wilk test, it will be decided either parametric or non-parametric test will be used within a group or between two groups

Eligibility criteria: Inclusion Criteria:

* Males and females between the age range of 18-40 years with mechanical neck pain for at least 3months.
* Examination- Symptoms provoked by neck movement and/or palpation of neck musculature.
* Trapezius Strength Test -To assess lower trapezius muscle strength, patient in prone with shoulder 120 degree abducted and resist the shoulder extension diagonally.

Exclusion Criteria:

* Osteoporosis
* Tumors
* Vertebral fractures
* Diagnosed psychological disorders
* Neck pain associated with vertigo
* History of cervical and thoracic spine injury
* Cervical radiculopathy
* Traumatic neck injury
* Shoulder surgery

Primary outcomes:
measure: Numeric Pain Rate Scale (NPRS)
timeFrame: follow up at 4th week
measure: Universal Goniometer (UG)
timeFrame: follow up at 4th week
measure: Neck Disability Index (NDI)
timeFrame: follow up at 4th week
Secondary outcomes:
Other outcomes:
Locations:
city: Sialkot
country: Pakistan
facility: Syed Medical Complex and Islam Hospital
state: Punjab
Study officials:
affiliation: Riphah International University,Lahore
name: Samrood Akram, Mphil
role: PRINCIPAL_INVESTIGATOR
References:
citation: Lee KW, Kim WH. Effect of thoracic manipulation and deep craniocervical flexor training on pain, mobility, strength, and disability of the neck of patients with chronic nonspecific neck pain: a randomized clinical trial. J Phys Ther Sci. 2016 Jan;28(1):175-80. doi: 10.1589/jpts.28.175. Epub 2016 Jan 30.
citation: Rodriguez-Sanz J, Malo-Urries M, Lucha-Lopez MO, Lopez-de-Celis C, Perez-Bellmunt A, Corral-de-Toro J, Hidalgo-Garcia C. Comparison of an exercise program with and without manual therapy for patients with chronic neck pain and upper cervical rotation restriction. Randomized controlled trial. PeerJ. 2021 Nov 24;9:e12546. doi: 10.7717/peerj.12546. eCollection 2021.
citation: Wan-Hee Lee I-KC, Hye-Kang Park. The Effectiveness of Selective Lower Trapezius Strengthening Exercises on Pain, Muscle Function, and Scapular Position in Patients with Rounded Shoulder and Chronic Neck Pain. Physical Therapy Rehabilitation Science. 2021;10:503-11.
citation: Twinkle Y Dabholkar SY, Abichandani Deepa. Comparison of the efficacy of Maitland Thoracic Mobilization and Deep Neck Flexor Endurance Training Versus Only Deep Neck Flexor Endurance Training in Patients with Mechanical Neck Pain. Indian Journal of Physiotherapy and Occupational Therapy. 2014;8(3):6.
citation: Lee KS, Lee JH. Effect of maitland mobilization in cervical and thoracic spine and therapeutic exercise on functional impairment in individuals with chronic neck pain. J Phys Ther Sci. 2017 Mar;29(3):531-535. doi: 10.1589/jpts.29.531. Epub 2017 Mar 22.
citation: Howell ER. The association between neck pain, the Neck Disability Index and cervical ranges of motion: a narrative review. J Can Chiropr Assoc. 2011 Sep;55(3):211-21.
citation: Park SH, Lee MM. Effects of Lower Trapezius Strengthening Exercises on Pain, Dysfunction, Posture Alignment, Muscle Thickness and Contraction Rate in Patients with Neck Pain; Randomized Controlled Trial. Med Sci Monit. 2020 Mar 23;26:e920208. doi: 10.12659/MSM.920208.
citation: Cunha AC, Burke TN, Franca FJ, Marques AP. Effect of global posture reeducation and of static stretching on pain, range of motion, and quality of life in women with chronic neck pain: a randomized clinical trial. Clinics (Sao Paulo). 2008 Dec;63(6):763-70. doi: 10.1590/s1807-59322008000600010.
citation: Sowmya. Isometric Neck Exercises versus Dynamic Neck Exercises in Chronic Neck Pain. ournal of Nursing and Health Science. 2014;3(2):32-43.
citation: Behnoush B, Tavakoli N, Bazmi E, Nateghi Fard F, Pourgharib Shahi MH, Okazi A, Mokhtari T. Smartphone and Universal Goniometer for Measurement of Elbow Joint Motions: A Comparative Study. Asian J Sports Med. 2016 Jun 11;7(2):e30668. doi: 10.5812/asjsm.30668. eCollection 2016 Jun.