Effects of Autogenic and Reciprocal Inhibition, Muscle Energy Techniques in the Management of Mechanical Neck Pain

NCT ID: NCT03136250

Last Updated: 2018-02-08

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 78 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2017-04-11
• Study Completion Date: 2017-12-30

Brief Summary

Neck pain is among the most common musculoskeletal disorders worldwide and is an important public health issue in terms of personal wellbeing. Prevalence of neck pain show excessive variations, with a point prevalence varying between 6% and 22%, and one year prevalence ranging between 1.5-75%. Neck pain like all other mechanical disorders leads to pain, disability and decreased range of motion (ROM). Stretching is a very common exercise performed by sportsmen, elderly, in physical therapy and rehabilitation patients, thus practiced in all sorts of fitness programs. The major types of stretching included in the literature are static, dynamic and pre-contraction stretching; of which static stretching is the conventional type of stretching. The different types of pre-contraction stretching include Proprioceptive Neuromuscular Facilitation (PNF) stretching, Post Isometric Relaxation (PIR), Post Facilitation stretch (PFS) and Active Isolated Stretch (AIS). Pre-contraction stretching is also considered a part of Muscle Energy Technique (MET). Recently MET and pre-contraction stretching have been shown to have significant superiority over conventional stretching in management of mechanical neck pain, but the evidence is currently lacking regarding which of the two pre-contraction stretching protocols, namely autogenic and reciprocal inhibition is more effective than the other. A RCT will be conducted in order to find and compare the effectiveness of conventional stretching and pre-contraction stretching (autogenic inhibition and reciprocal inhibition). One Control group (conventional group) and two Experimental groups (Experimental Group A - Autogenic Inhibition & Experimental Group B - Reciprocal Inhibition) will be formed. The participants will be recruited in the study if they meet the inclusion criteria using consecutive sampling from Fauji Foundation Hospital and randomized into the three respective groups. All the groups will receive the gold standard treatment for chronic neck pain including mobilization and modalities. In addition to the gold standard treatment the participants will receive specific stretching protocol based on their interventional group

Conditions

Neck Pain

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: TRIPLE

Study Groups

Group A (Control Group - Static Stretching)

(Control Group - Static Stretching + Standard Treatment)

Group Type: ACTIVE_COMPARATOR

Group A (Control Group - Static Stretching + Standard Treatment)

Intervention Type: OTHER

o Conventional Gold Standard treatment (Manual Therapy + Modalities) Conventional Static Stretching 15-30 seconds hold 3-5 repetitions (Page P, 2012) for Ant/Middle/Posterior Scaleni, Sternocleidomastoid, Levator Scapulae and Upper Trapezius Muscles.

Group B (Autogenic Inhibition MET)

(Autogenic Inhibition - PIR + Standard treatment)

Group Type: EXPERIMENTAL

Group B (Autogenic Inhibition - PIR + Standard treatment)

Intervention Type: OTHER

o Conventional Gold Standard treatment (Manual Therapy + Modalities) Post Isometric Relaxation MET (3-5 reps) for Ant/Middle/Posterior Scaleni, Sternocleidomastoid, Levator Scapulae and Upper Trapezius Muscles. (Chaitow L, 2006)

Group C (Reciprocal Inhibition MET)

(Reciprocal Inhibition - RI + Standard treatment)

Group Type: EXPERIMENTAL

Group C (Reciprocal Inhibition - RI + Standard treatment)

Intervention Type: OTHER

o Conventional Gold Standard treatment (Manual Therapy + Modalities) Reciprocal Inhibition MET (3-5 reps) for Ant/Middle/Posterior Scaleni, Sternocleidomastoid,Levator Scapulae and Upper Trapezius Muscles (Chaitow L, 2006)

Interventions

Group A (Control Group - Static Stretching + Standard Treatment)

o Conventional Gold Standard treatment (Manual Therapy + Modalities) Conventional Static Stretching 15-30 seconds hold 3-5 repetitions (Page P, 2012) for Ant/Middle/Posterior Scaleni, Sternocleidomastoid, Levator Scapulae and Upper Trapezius Muscles.

Intervention Type: OTHER

Group B (Autogenic Inhibition - PIR + Standard treatment)

o Conventional Gold Standard treatment (Manual Therapy + Modalities) Post Isometric Relaxation MET (3-5 reps) for Ant/Middle/Posterior Scaleni, Sternocleidomastoid, Levator Scapulae and Upper Trapezius Muscles. (Chaitow L, 2006)

Intervention Type: OTHER

Group C (Reciprocal Inhibition - RI + Standard treatment)

o Conventional Gold Standard treatment (Manual Therapy + Modalities) Reciprocal Inhibition MET (3-5 reps) for Ant/Middle/Posterior Scaleni, Sternocleidomastoid,Levator Scapulae and Upper Trapezius Muscles (Chaitow L, 2006)

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

1. Age 18 to 70 years;

2. Neck pain on NPRS 4 to 8 (moderate cases);

3. Subacute or chronic cases (4 to 12 weeks).

4. Decreased or painful Cervical range of motion (CROM)

Exclusion Criteria

1. Signs of serious pathology (e.g., malignancy, inflammatory disorder, infection);

2. History of cervical spine surgery in previous 12 months;

3. History of trauma or fractures in cervical spine;

4. Signs of cervical radiculopathy or myelopathy; and

5. Vascular syndromes such as VBI

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 70 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Foundation University Islamabad

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Muhammad Osama, DPT, MS-OMPT, CHPE

Role: PRINCIPAL_INVESTIGATOR

Foundation University Islamabad

Locations

Foundation University Institute of Rehabilitation Sciences

Islamabad, , Pakistan

Countries

Pakistan

Other Identifiers

FUI/CTR/2017/1

Identifier Type: -

Identifier Source: org_study_id