Neck Pain
Conditions
Keywords
pain, range of motion, craniovertebral angle, function
Brief summary
Cervical Extension Syndrome (CES) is a form of postural dysfunction under the Movement System Impairment (MSI) classification. It has more prevalence among adults due to prolonged poor posture and sedentary lifestyles. This condition involves a forward head position,, increased thoracic curve, and altered movement patterns. This resulting in neck pain and impaired function. The Sahrmann's approach is a biomechanical principle that puts emphasizes on muscle activation, correction of postural impairments, and restoration of movement control through targeted exercises. The objective of the study will be to compare the effects of Sahrmann's Approach on Pain, ROM, craniovertebral angle and function in patients with Cervical Extension Syndrome.
Detailed description
This randomized controlled trial will investigate the effects of Sahrmann's corrective exercises on pain, range of motion, craniovertebral angle, thoracic curve and function in individuals with CFS. Total sample size 54 is calculated by GPower and participants aged 20-40 years will be recruited from Femwell Physio Clinic, Sir Ganga Ram Hospital and University of Lahore Teaching Hospital Lahore using non- probability consecutive sampling. Subjects will be randomly assigned to either Group A (conventional physiotherapy) or Group B (Sahrmann's approach) through sealed opaque envelopes. Group A will follow a standard treatment, while Group B will perform Sahrmann's corrective exercises for cervical extension syndrome. Numeric Pain Rating Scale (NPRS) for pain, Universal Goniometer (UG) for craniovertebral angle, Inclinometer for thoracic kyphosis and cervical range of motion and Neck Disability Index (NDI) for function will be assessed at baseline and after 6 weeks. Data will be analyzed using SPSS v25 to determine the comparative effects of both interventions.
Interventions
OTHERSahrmann's Exercises
capital flexion, capital flexion with and without head tilt, Shoulder flexion, Abduction And Lateral Rotation, Cervical Extensors Muscle strengthening along with baseline treatment moist heat pack and TENS.
OTHERconventional physiotherapy
this group will receive conventional physiotherapy. receive muscle stretching of trapezius, pectoralis and levator scapulae. and Active ROM as retractions of scapula and neck. along with baseline treatment moist heat pack and TENS.
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Adults between 20-40 years, NPRS score 4-6 , positive tests cervical flexion, extension, protraction and retraction and Cervical Nodding Against Wall
Exclusion criteria
Scoliosis, Pregnant females, Any active infection or disese
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Numerical Pain Rating Scale (NPRS) | upto 4 weeks | he NPRS is an 11-point self-reported scale used to assess the intensity of neck pain. Participants rate their average pain over the previous 24 hours on a scale from 0 to 10. Scoring: 0 = No pain 1-3 = Mild pain 4-6 = Moderate pain 7-10 = Severe pain Direction of Improvement: Lower scores indicate less pain and improvement. |
| Craniovertebral Angle (CVA) - Forward Head Posture | upto 4 weeks | Description: The CVA is used to quantify forward head posture. It is measured as the angle formed between: A horizontal line passing through the spinous process of C7. A line connecting C7 to the tragus of the ear. Scoring: Smaller angle = Greater forward head posture. Larger angle = Better head-neck alignment. Typical values: \<48° = Forward head posture ≥50° = More normal alignment Direction of Improvement: Increase in CVA indicates improvement. |
| Neck Disability Index (NDI) - Functional Disability | upto 4 weeks | Description: The NDI is a self-administered questionnaire consisting of 10 items assessing the impact of neck pain on daily activities.Scoring: Each item scored from 0-5. Total score: 0-50 points Interpretation: 0-4 = No disability 5-14 = Mild disability 15-24 = Moderate disability 25-34 = Severe disability ≥35 = Complete disability Direction of Improvement: Lower scores indicate reduced disability and better function. |
| Cervical Range of Motion (CROM) | upto 4 weeks | Description: Cervical ROM will be measured in: Flexion Extension Right lateral flexion Left lateral flexion Right rotation Left rotation The participant performs active cervical movements while the examiner records the maximum range in degrees. Units: Degrees (°) Typical Normal Values: Flexion: 45-50° Extension: 60-70° Lateral flexion: 45° Rotation: 70-90° Direction of Improvement: Greater ROM values indicate improvement. |
| Thoracic Kyphosis Angle | upto 4 weeks | Description: Thoracic kyphosis will be measured in standing using a dual inclinometer technique. One inclinometer is placed over the spinous process of T1-T2 and the second over T12-L1. The difference between the two readings represents the thoracic kyphosis angle. Units: Degrees (°) Interpretation: Increased angle = Greater thoracic kyphosis Reduced angle = Improved thoracic posture Typical values: Approximately 20-40° in healthy adults Direction of Improvement: Reduction toward normal values indicates improvement. |
Countries
Pakistan
Contacts
CONTACTSamrood Akram, PhD*
PRINCIPAL_INVESTIGATORKomal Qayyum, MSPT*
Riphah International University
Outcome results
None listed