Non-specific Chronic Neck Pain
Conditions
Keywords
chronic non-specific neck pain, Kendall exercises, Scapulothoracic exercises, Brachial Plexus mechanoreceptors
Brief summary
The purpose of the clinical trial is to investigate the effect of the combined Kendall and scapulothoracic exercises program on mechanosensitivity of brachial plexus, cervical range of motion, neck functional ability, and craniovertebral angle in patients with chronic non-specific neck pain. we have 3 groups to compare between traditional treatment, scapulothoracic and kendall exercises in treatment of chronic non-specific neck pain.
Detailed description
Non-specific neck pain is a generalized pain in the neck and/or shoulder that has mechanical characteristics, such as symptoms brought on by holding a certain neck position, moving the neck, or palpating the cervical muscles (Fernández-de-las-Penas et al., 2007). Minor injuries to the neck caused by poor posture and abrupt muscle contractions might further cause the muscles that are not frequently utilized to shrink, which can result in mechanical dysfunction and chronic pain (Boyd-Clark et al., 2002). Kendall exercise is generally used as physical therapy for forward head posture and induces proper neck alignment generally using strengthening methods for two muscles (deep cervical flexors and retractors of the scapula) and stretching methods for two muscles (neck extensor muscles and pectoralis) to help with forward head posture, which is a state of imbalance of muscles) (Kendall et al., 2005). Scapulothoracic strength training may have positive impacts across subjective and objective parameters including pain, and sequentially, activities of daily living, neck range of motion, and strength (Anna-Maria et al., 2020) PURPOSE: The purpose of study is to investigate the effect of the combined Kendall and scapulothoracic exercises program on mechanosensitivity of brachial plexus, cervical range of motion, neck functional ability, and craniovertebral angle in patients with chronic non-specific neck pain. * The mechanosensitivity of brachial plexus will be measured with strength duration curve * CROM will be used to measure cervical range of motion * Neck disability index will be used to evaluate and document neck functional ability in patients with neck pain. * Kinovea software program will be used to measure the craniovertebral angle of the cervical spine by still photography The subjects will receive treatment for four weeks all variables wil be measured pre-treatment and post treatment
Interventions
Ultrasound, hot packs, cervical postural stretching and strengthening exercise will be done for all groups. Stretching Exercises Posture correction exercises training will include stretching of tight muscles such as Pectoralis major, levator scapulae, upper trapezius, suboccipital muscles and, sternocleidomastoid. Strengthening Exercises Exercises will include Chin Tucks exercise and Neck isometric exercises
OTHERScapulothoracic exercises
Scapulothoracic exercises It is a strengthening exercises of the serratus anterior muscle, as well as the middle and inferior fibres of the trapezius muscle
OTHERKendall exercises
The exercise techniques used by Kendell were as follows: 1\. Stretching of the Cervical Extensors: By sitting with the head down and putting both hands across the occipital area, the cervical extensors can be stretched by adopting a flex neck position 2- Strengthening of the Deep Cervical Flexors Positioning supine with the chin tucked in and lifting the head for 2 to 8 s 3- Strengthening the Shoulder Retraction Maintaining an upright posture, keep the resistance band circling with strong support and stretching it with the upper limbs of both sides so that there is full retraction of the scapula 4-Stretching the Pectorals muscle Assigning both hands on the occipital area and pulling the elbows back up (bilateral) and performance arm abduction and external rotation (unilateral).
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
25 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* Sixty patients of both genders were recruited in the study. * The age of the recruited subjects were ranging from 25 to 50 years old * Patients having neck pain symptoms provoked by neck postures, neck movement, or palpation of the cervical musculature, for at least the last 3 months * Patients with a craniovertebral angle of less than 54º * Subjects with a BMI 25-30
Exclusion criteria
* History of previous injury of the neck * History of surgical intervention at the neck * History of inflammatory joint disease affecting facet joints * Neurological disorders such as cervical spondylosis, spondylolisthesis or disc prolapse (Kim et al., 2012). * Rheumatic diseases. * Cancer patients * Patients who received pain medication or physical therapy for their neck pain during the last 3 months * Patients who are unable to perform the exercises.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The strength-duration curve to assess the change in mechanosensitivity of brachial plexus | at first week and after 4 weeks of treatment | The mechanosensitivity of brachial plexus will be measured with strength duration curve by EMG. Assessment will be before and after treatment |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Cervical range of motion | at first week and after 4 weeks of treatment | Cervical range of motion will assessed by Cervical Range of Motion (CROM) device . Assessment will be before and after treatment |
| Change in Functional performance will be measured by Neck disability index | at first week and after 4 weeks of treatment | Neck functional ability assessed by Neck disability index. Assessment will be before and after treatment |
| Change in Craniovertebral angle | at first week and after 4 weeks of treatment | Craniovertebral angle assessd by Kinovea software program. Assessment will be before and after treatment |
Countries
Egypt
Contacts
Primary ContactDoaa Rafat Assistant professor of physical therapy - Cairo university, Assistant professor
Backup ContactRania Reda Assistant professor of physical therapy - Cairo university, Assistant professor
Outcome results
None listed