Clinical trial NCT03447977: The Effect of Manual Treatment on Respiratory Parameters, Pain, Posture and Quality of Life in Chronic Neck Pain
Official title: The Effect of Manual Treatment on Respiratory Parameters, Pain, Posture and Quality of Life in Chronic Neck Pain Individuals
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Neck Pain
Keywords: neck pain
manual therapy
respiratory function
Lead sponsor: Hacettepe University
Sponsor class: OTHER
First posted: 2018-02-27
Enrollment: 46
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Neck pain which is common musculoskeletal system problem in all populations, negatively affects functional status and quality of life. Muscle spasms, postural problems in cervical and thoracic regions and impairment on respiratory parameters (respiratory functions and respiratory muscle strength) is seen with neck pain. Manual therapy and exercise are widely preferred in the treatment of neck pain for improve pain, posture, muscle strength, range of motion, functional status and quality of life.

There are some studies showing that manual therapy improves respiratory parameters in pulmonary diseases but studies are lacking for neck pain. Our aim is to indicate that effects of manual therapy, manual therapy for different regions (cervical and/or thoracal region) and exercises for pain, posture, quality of life and also respiratory parameters in patients with chronic neck pain.

Detailed description: Manual therapy and exercises are evidence-based methods for improving pain, muscle strength, range of motion, function and quality of life in individuals with neck pain. These physiotherapy approaches have been shown to improve respiratory functions in patients with neck pain and also in pulmonary diseases such as cystic fibrosis and chronic obstructive pulmonary diseases.

Studies show that to improve respiratory parameters in patients for chronic neck pain, mobilization of thoracic region and exercises for endurance of deep neck muscles are beneficial. Despite the proposal given in this study, there are few studies evaluating the relationship between respiratory functions and the strength of respiratory muscles in patients with neck pain in detail, and also the effectiveness of different physiotherapy-rehabilitation methods on respiratory functions on neck pain. In a single study on this subject, thoracic region manual therapy, stretching exercise program and both of these applications were applied for the subjects. At the end of the treatment, respiratory functions developed in all three groups; but both applications group have been shown to more effective than thoracic manual therapy group for increasing respiratory functions.Exercises and manual therapy for cervical and/or thoracic region frequently used for chronic neck pain but there are no studies that compare manual therapy for different region on respiratory parameters. Therefore, our aim is to determine the effects of exercises with manual therapy methods for cervical and/or thoracic region in chronic neck pain patients on pain, posture, quality of life, as well as on respiratory parameters.

Eligibility criteria: Inclusion Criteria:

* Individuals who have pain for at least 3 month with mechanical neck pain
* Individuals voluntarily participating to the study

Exclusion Criteria:

* Individuals who have undergone cervical, spinal, thoracic, or abdominal region surgeries or pathology; whiplash injury; neurological deficit; osteoporosis; rheumatological disease; pulmonary disease; pharmacological treatment; or malignancy; or have a body mass index (BMI) \>40 or were smokers

Primary outcomes:
measure: respiratory function(forced vital capacity,peak expiratory flow,maximum voluntary ventilation,forced expiratory flow at 1sn)
timeFrame: change from baseline respiratory parameters at six weeks
measure: respiratory muscle strength
timeFrame: change from baseline respiratory muscle strength at six weeks
Secondary outcomes:
measure: pain position
timeFrame: change from baseline pain at six weeks
measure: posture
timeFrame: change from baseline posture at six weeks
measure: range of motion
timeFrame: change from baseline range of motion at six weeks
measure: neck functional status
timeFrame: change from baseline functional status at six weeks
measure: quality of life status
timeFrame: change from baseline quality of life at six weeks
measure: anxiety level
timeFrame: change from baseline anxiety level at six weeks
measure: depression level
timeFrame: change from baseline depression level at six weeks
measure: physical activity level
timeFrame: change from baseline physical activity level at six weeks
measure: kinesiophobia
timeFrame: change from baseline kinesiophobia at six weeks
measure: neck muscle endurance
timeFrame: change from muscle endurance baseline at six weeks
measure: neck and upper limb strengths test
timeFrame: change from baseline strength at six weeks
measure: pressure pain
timeFrame: change from baseline strength at six weeks
measure: Thoracal expansion
timeFrame: change from baseline expansion strength at six weeks
Other outcomes:
Locations:
city: Ankara
country: Turkey
facility: Seval Tamer
Study officials:
affiliation: Hacettepe University Physiotherapy and Rehabilitation
name: Seval Tamer, Mcs
role: PRINCIPAL_INVESTIGATOR
References:
citation: Hwangbo PN, Hwangbo G, Park J, Lee S. The Effect of Thoracic Joint Mobilization and Self-stretching Exercise on Pulmonary Functions of Patients with Chronic Neck Pain. J Phys Ther Sci. 2014 Nov;26(11):1783-6. doi: 10.1589/jpts.26.1783. Epub 2014 Nov 13.
citation: Wirth B, Amstalden M, Perk M, Boutellier U, Humphreys BK. Respiratory dysfunction in patients with chronic neck pain - influence of thoracic spine and chest mobility. Man Ther. 2014 Oct;19(5):440-4. doi: 10.1016/j.math.2014.04.011. Epub 2014 Apr 30.
citation: Kapreli E, Vourazanis E, Strimpakos N. Neck pain causes respiratory dysfunction. Med Hypotheses. 2008;70(5):1009-13. doi: 10.1016/j.mehy.2007.07.050. Epub 2007 Oct 23.