Trial Outcomes & Findings for Benefit of Adding Stretching to Standard Intervention For Patients With Nonspecific Mechanical Neck Pain (NCT NCT03194490)

NCT ID: NCT03194490

Last Updated: 2019-10-31

Results Overview

The cervical range of motion device (CROM) will be used to assess the changes in active range of motion for cervical rotation, flexion and extension when comparing baseline,week two, four and eight.

• Recruitment status: COMPLETED
• Study phase: NA
• Target enrollment: 43 participants
• Primary outcome timeframe: Participants ROM measurement at baselines
• Results posted on: 2019-10-31

Participant Flow

Participant milestones

Measure	Combined Intervention Group The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Overall Study STARTED	20	23
Overall Study COMPLETED	18	20
Overall Study NOT COMPLETED	2	3

Reasons for withdrawal

Measure	Combined Intervention Group The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Overall Study Lost to Follow-up	1	3
Overall Study participant developed specific neck pain	1	0

Baseline Characteristics

Benefit of Adding Stretching to Standard Intervention For Patients With Nonspecific Mechanical Neck Pain

Baseline characteristics by cohort

Measure	The Combined Intervention Group n=18 Participants The combined intervention group: The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention: The standard intervention group received cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.	Total n=38 Participants Total of all reporting groups
Sex: Female, Male Female	12 Participants n=5 Participants	12 Participants n=7 Participants	24 Participants n=5 Participants
Sex: Female, Male Male	6 Participants n=5 Participants	8 Participants n=7 Participants	14 Participants n=5 Participants
Age, Categorical <=18 years	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Age, Categorical Between 18 and 65 years	18 Participants n=5 Participants	20 Participants n=7 Participants	38 Participants n=5 Participants
Age, Categorical >=65 years	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Age, Continuous	31.4 years STANDARD_DEVIATION 9.0 • n=5 Participants	30.6 years STANDARD_DEVIATION 7.8 • n=7 Participants	31 years STANDARD_DEVIATION 8.3 • n=5 Participants
Race (NIH/OMB) American Indian or Alaska Native	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) Asian	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) Black or African American	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) White	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) More than one race	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) Unknown or Not Reported	18 Participants n=5 Participants	20 Participants n=7 Participants	38 Participants n=5 Participants
Region of Enrollment United States	18 participants n=5 Participants	20 participants n=7 Participants	38 participants n=5 Participants

PRIMARY outcome

Timeframe: Participants ROM measurement at baselines

The cervical range of motion device (CROM) will be used to assess the changes in active range of motion for cervical rotation, flexion and extension when comparing baseline,week two, four and eight.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Cervical Range of Motion Right Rotation	65.9 Degree Standard Error 3.0	66.1 Degree Standard Error 2.5
Cervical Range of Motion Left Rotation	60.1 Degree Standard Error 3.8	62.7 Degree Standard Error 2.1
Cervical Range of Motion Right Lateral Flexion	41.8 Degree Standard Error 2.5	39.9 Degree Standard Error 1.9
Cervical Range of Motion Left Lateral Flexion	43.9 Degree Standard Error 1.9	42.2 Degree Standard Error 1.4
Cervical Range of Motion Flexion	46.2 Degree Standard Error 2.6	46.1 Degree Standard Error 2.2
Cervical Range of Motion Extesion	71.2 Degree Standard Error 3.4	68.5 Degree Standard Error 2.4

PRIMARY outcome

Timeframe: Participants ROM measurement at week 2

The cervical range of motion device (CROM) will be used to assess the changes in active range of motion for cervical rotation, flexion and extension when comparing baseline, week two, four and eight.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Cervical Range of Motion Flexion	52.3 Degree Standard Error 2.4	49.7 Degree Standard Error 2.3
Cervical Range of Motion Extesion	77.5 Degree Standard Error 2.7	71.1 Degree Standard Error 3.7
Cervical Range of Motion Right Rotation	71.9 Degree Standard Error 3.1	68.6 Degree Standard Error 2.4
Cervical Range of Motion Left Rotation	66.8 Degree Standard Error 2.6	67.8 Degree Standard Error 2.1
Cervical Range of Motion Right Lateral Flexion	46.3 Degree Standard Error 1.7	41.3 Degree Standard Error 2.0
Cervical Range of Motion Left Lateral Flexion	48.4 Degree Standard Error 1.6	44.3 Degree Standard Error 1.3

PRIMARY outcome

Timeframe: Participants measurement at week four

The cervical range of motion device (CROM) will be used to assess the changes in active range of motion for cervical rotation, flexion and extension when comparing baseline, week two, four and eight.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Cervical Range of Motion Right Rotation	74.0 Degree Standard Error 3.4	74.3 Degree Standard Error 2.5
Cervical Range of Motion Flexion	54.9 Degree Standard Error 2.5	55.0 Degree Standard Error 2.3
Cervical Range of Motion Extesion	82.9 Degree Standard Error 3.1	70.3 Degree Standard Error 3.1
Cervical Range of Motion Left Rotation	73.0 Degree Standard Error 2.2	70.6 Degree Standard Error 2.3
Cervical Range of Motion Right Lateral Flexion	50.0 Degree Standard Error 2.1	43.6 Degree Standard Error 1.8
Cervical Range of Motion Left Lateral Flexion	51.6 Degree Standard Error 2.1	45.3 Degree Standard Error 1.6

PRIMARY outcome

Timeframe: Participants ROM measurement at week 8

The cervical range of motion device (CROM) will be used to assess the changes in active range of motion for cervical rotation, flexion and extension when comparing baseline,week two, four and eight.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Cervical Range of Motion Flexion	53.9 Degree Standard Error 2.5	53.2 Degree Standard Error 2.6
Cervical Range of Motion Extesion	79.2 Degree Standard Error 2.8	74.5 Degree Standard Error 4.0
Cervical Range of Motion Right Rotation	78.5 Degree Standard Error 2.5	71.5 Degree Standard Error 2.8
Cervical Range of Motion Left Rotation	72.9 Degree Standard Error 2.4	71.3 Degree Standard Error 2.1
Cervical Range of Motion Right Lateral Flexion	51.2 Degree Standard Error 2.4	47.3 Degree Standard Error 1.9
Cervical Range of Motion Left Lateral Flexion	55.3 Degree Standard Error 2.6	74.4 Degree Standard Error 1.9

SECONDARY outcome

Timeframe: NPRS score at baseline

Numeric pain rating scale (NPRS) is a liner outcome measurement used to determine the level of the participant's pain when comparing baseline, week two, four and eight. It consists of a straight 10 cm line that is scored from 0 to 10 with 10 mm intervals. The zero represents no pain while a 10 represents very severe pain that participant cannot stand. The standard error is correct as stated.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Numeric Pain Rating Scale	5.2 Cm Standard Error 0.4	4.3 Cm Standard Error 0.4

SECONDARY outcome

Timeframe: NPRS score at week two

Numeric pain rating scale (NPRS) is a liner outcome measurement used to determine the level of the participant's pain when comparing baseline, week two, four and eight. It consists of a straight 10 cm line that is scored from 0 to 10 with 10 mm intervals. The zero represents no pain while a 10 represents very severe pain that participant cannot stand.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Numeric Pain Rating Scale	3.6 Cm Standard Error 0.4	3.0 Cm Standard Error 0.4

SECONDARY outcome

Timeframe: NPRS score at week four

Numeric pain rating scale (NPRS) is a liner outcome measurement used to determine the level of the participant's pain when comparing baseline, week two, four and eight. It consists of a straight 10 cm line that is scored from 0 to 10 with 10 mm intervals. The zero represents no pain while a 10 represents very severe pain that participant cannot stand.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Numeric Pain Rating Scale	1.7 Cm Standard Error 0.4	1.8 Cm Standard Error 0.4

SECONDARY outcome

Timeframe: NPRS score at week eight

Numeric pain rating scale (NPRS) is a liner outcome measurement used to determine the level of the participant's pain when comparing baseline, week two, four and eight. It consists of a straight 10 cm line that is scored from 0 to 10 with 10 mm intervals. The zero represents no pain while a 10 represents very severe pain that participant cannot stand.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Numeric Pain Rating Scale	1.5 Cm Standard Error 0.5	1.8 Cm Standard Error 0.6

SECONDARY outcome

Timeframe: NDI score at baseline

Neck disability index measuring the level of neck disability when comparing baseline, week two, four, and eight. It consists of ten items each item is scored from 0 to 5 with a minimum score 0 and highest score 50. A score of zero (0) represents no disability while a score of 50 represents severe, full disability.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Neck Disability Index	12.2 points Standard Error 1.1	10.6 points Standard Error 1.1

SECONDARY outcome

Timeframe: NDI score at week two

Neck disability index measuring the level of neck disability when comparing baseline, week two, four, and eight. It consists of ten items each item is scored from 0 to 5 with a minimum score 0 and highest score 50. A score of zero (0) represents no disability while a score of 50 represents severe, full disability.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Neck Disability Index	7.2 points Standard Error 1.0	8.1 points Standard Error 0.9

SECONDARY outcome

Timeframe: NDI score at week four

Neck disability index measuring the level of neck disability when comparing baseline, week two, four, and eight. It consists of ten items each item is scored from 0 to 5 with a minimum score 0 and highest score 50. A score of zero (0) represents no disability while a score of 50 represents severe, full disability.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Neck Disability Index	3.8 points Standard Error 1.2	5.1 points Standard Error 1.1

SECONDARY outcome

Timeframe: NDI score at week eight

Neck disability index measuring the level of neck disability when comparing baseline, week two, four, and eight. It consists of ten items each item is scored from 0 to 5 with a minimum score 0 and highest score 50. A score of zero (0) represents no disability while a score of 50 represents severe, full disability.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Neck Disability Index	3.7 points Standard Error 1.0	6.5 points Standard Error 2.6

SECONDARY outcome

Timeframe: GROC score at week two

The Global rating of change (GROC) is used to measure the amount of improvement that the patient achieves from the intervention or rehabilitation program when comparing baseline, week two, four, and eight. The score ranges from -7 to 0 to 7 in which -/+3 to -/+ 1 represents a small change, -/+ 4 to -/+5 represents moderate change and -/+6 to -/+7 means a large change. The negative and positive means the patient condition worsens or improves respectively. The points are scores on a scale (-7-0-+7 = 15 point scale).

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Global Rating of Change	2.6 points Standard Error 0.5	2.1 points Standard Error 0.5

SECONDARY outcome

Timeframe: GROC score at week four

The Global rating of change (GROC) is used to measure the amount of improvement that the patient achieves from the intervention or rehabilitation program when comparing baseline, week two, four and eight. The score ranges from -7 to 0 to 7 in which -/+3 to -/+ 1 represents a small change, -/+ 4 to -/+5 represents moderate change and -/+6 to -/+7 means a large change. The negative and positive means the patient condition worsens or improves respectively.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Global Rating of Change	4.9 points Standard Error 0.5	4.5 points Standard Error 0.5

SECONDARY outcome

Timeframe: GROC score at week eight

The Global rating of change (GROC) is used to measure the amount of improvement that the patient achieves from the intervention or rehabilitation program when comparing baseline, week two, four and right. The score ranges from -7 to 0 to 7 in which -/+3 to -/+ 1 represents a small change, -/+ 4 to -/+5 represents moderate change and -/+6 to -/+7 means a large change. The negative and positive means the patient condition worsens or improves respectively.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Global Rating of Change	4.9 points Standard Error 0.6	3.3 points Standard Error 1.0

SECONDARY outcome

Timeframe: Pressure Pain Threshold score at baseline

Pressure pain threshold is an electronic device used to measure the amount of force that is required to produce pain when comparing baseline, week two, four, and eight.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Pressure Pain Threshold Right Pressure Pain Threshold	4.5 pound per centimeter square Standard Error 0.4	5.0 pound per centimeter square Standard Error 0.5
Pressure Pain Threshold Left Pressure Pain Threshold	4.3 pound per centimeter square Standard Error 0.4	4.7 pound per centimeter square Standard Error 0.4

SECONDARY outcome

Timeframe: Pressure Pain Threshold score at week two

Pressure pain threshold is an electronic device used to measure the amount of force that is required to produce pain when comparing baseline, week two, four and eight.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Pressure Pain Threshold Right Pressure Pain Threshold	4.7 pound per centimeter square Standard Error 0.3	4.6 pound per centimeter square Standard Error 0.4
Pressure Pain Threshold Left Pressure Pain Threshold	4.5 pound per centimeter square Standard Error 0.3	4.5 pound per centimeter square Standard Error 0.4

SECONDARY outcome

Timeframe: Pressure Pain Threshold score at week four

Pressure pain threshold is an electronic device used to measure the amount of force that is required to produce pain when comparing baseline, week two, four and eight.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Pressure Pain Threshold Right Pressure Pain Threshold	5.6 pound per centimeter square Standard Error 0.5	5.3 pound per centimeter square Standard Error 0.5
Pressure Pain Threshold Left Pressure Pain Threshold	5.8 pound per centimeter square Standard Error 0.6	5.6 pound per centimeter square Standard Error 0.5

SECONDARY outcome

Timeframe: Pressure Pain Threshold score at week eight

Pressure pain threshold is an electronic device used to measure the amount of force that is required to produce pain when comparing baseline, week two, four and eight.

Outcome measures

Measure	Combined Intervention Group n=18 Participants The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: anterior, middle and posterior scalene, upper fibers of trapezius, pectoralis minor muscles and interspinous muscles.	The Standard Intervention n=20 Participants The standard intervention group will receive cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as far as possible and return to neutral.
Pressure Pain Threshold Right Pressure Pain Threshold	5.8 pound per centimeter square Standard Error 0.6	4.9 pound per centimeter square Standard Error 0.4
Pressure Pain Threshold Left Pressure Pain Threshold	5.5 pound per centimeter square Standard Error 0.7	5.4 pound per centimeter square Standard Error 0.6

Adverse Events

The Combined Intervention Group

Serious events: 0 serious events

Other events: 1 other events

Deaths: 0 deaths

The Standard Intervention

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Measure	The Combined Intervention Group n=20 participants at risk The combined intervention group: The combined intervention group received the cervical passive mobilization, stretching, and home program (Stretching and ROM exercise). Stretching, cervical passive mobilization, and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques were selected by the physical therapist based on the participant's condition. Stretching exercise will be given to the participants by the physical therapist. Stretching techniques were performed in the combined intervention group for 30 seconds and repeated 3 times twice a week in the following order on the following muscles: an	The Standard Intervention n=22 participants at risk The standard intervention: The standard intervention group received cervical mobilization and home program (ROM exercises). Cervical mobilization and range of motion: The manual therapy was conducted by a physical therapist who has experience in manual therapy and is licensed from the California Board of Physical Therapy. The manual therapy intervention will consist of Passive Accessory Intervertebral Movements (PAIVMs). The nature of PAIVMs techniques was selected by the physical therapist based on the participant's condition. Active Cervical Range of Motion Exercises (ACROM) were performed 10 repetitions 3-4 times daily. Subjects were advised to maintain their usual activity within the limits of pain. The ACROM exercise consisted of the subject placing fingers over the manubrium bone and placing chin on the fingers. The subject was then instructed to rotate to one side as f
Musculoskeletal and connective tissue disorders Developed specific neck pain	5.0% 1/20 • Number of events 1 • In the combined intervention group, one participant was excluded from the study at week two from base line measurement (second visit). Adverse events in each subject was monitored from baseline through the study completion (e.g., 8-weeks). In the combined intervention group, one participant reported a specific neck pain at week two of the study which required the patient to be excluded from the study.	0.00% 0/22 • In the combined intervention group, one participant was excluded from the study at week two from base line measurement (second visit). Adverse events in each subject was monitored from baseline through the study completion (e.g., 8-weeks). In the combined intervention group, one participant reported a specific neck pain at week two of the study which required the patient to be excluded from the study.

Additional Information

Dr. Everett Lohman III

Loma Linda University

Phone: (909) 558-4632

Email: elohman@llu.edu

Results disclosure agreements

• Principal investigator is a sponsor employee
• Publication restrictions are in place