None listed
Conditions
Brief summary
This study aims to investigate how two different types of manual therapy—specifically spinal manipulation on either the neck (cervical) or the upper back (thoracic)—affect the endurance of the deep muscles that support the neck. These muscles, known as "deep neck flexors," often become weak in individuals suffering from persistent neck pain.
Interventions
The intervention consists of high-velocity, low-amplitude (HVLA) spinal manipulation techniques. The Cervical Manipulation group receives a thrust technique directed at the dysfunctional cervical segments (C3-C7) using lateral glides or rotary thrust. The Thoracic Manipulation group receives a thrust technique at the upper thoracic segments (T1-T4) in a supine position using a "pistol grip" or "butterfly" technique. Both interventions aim to evaluate the immediate neurophysiological effect on mu
The intervention consists of high-velocity, low-amplitude (HVLA) spinal manipulation techniques. The Cervical Manipulation group receives a thrust technique directed at the dysfunctional cervical segments (C3-C7) using lateral glides or rotary thrust. The Thoracic Manipulation group receives a thrust technique at the upper thoracic segments (T1-T4) in a supine position using a "pistol grip" or "butterfly" technique. Both interventions aim to evaluate the immediate neurophysiological effect on muscle endurance and pain. The intervention is delivered by a professional physiotherapist with specialized expertise in musculoskeletal health. The clinician holds a "Certified Orthopaedic Manual Therapist" (COMT) credential and has over 10 years of clinical and academic experience in spinal manual therapy, ensuring the techniques are applied with high precision and adherence to safety protocols. The intervention is delivered face-to-face in a one-on-one individual session. This ensures the clinician can perform accurate manual screening and precisely apply the thrust manipulation in a controlled clinical environment. This study investigates the immediate effects of a single session. Participants receive one session of the allocated manipulation technique. The session lasts approximately 10–15 minutes, which includes patient positioning, the application of the thrust, and a brief rest period before the immediate post-test measurement. The intervention is delivered in a clinical physiotherapy setting (university-based physiotherapy clinic). The facility is equipped with specialized manual therapy plinths and measurement tools, specifically the Pressure Biofeedback Unit (PBU) for the craniocervical flexion test. As this is a single-session intervention with immediate pre- and post-test measurements conducted on the same day, participant adherence is 100%. The researcher directly monitors and administers every step of the protocol. No long-term follow-up or reminders were required for this specific study design.
Sponsors
Firmansyah Purwanto, Muhammadiyah University of Surakarta
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
Participants aged 18–60 years, experiencing non-specific neck pain for more than 3 months, reporting a Numeric Pain Rating Scale (NPRS) score greater than or equal to 5 out of 10, and willing to complete all study procedures by providing informed consent.
Exclusion criteria
Exclusion criteria included a history of fracture or surgery in the cervical or thoracic regions, whiplash injury, spinal stenosis, cervical radiculopathy or myelopathy, neurological deficits, or any contraindication to spinal manipulation. All potential participants underwent screening with the Spurling’s test, vertebrobasilar insufficiency test, and neurodynamic tests, and were considered eligible only if all assessments yielded negative results.
Outcome results
None listed