Effect of Cervical Stabilization and Oculomotor Exercises on Position Sense With Chronic Neck Pain

NCT ID: NCT05083858

Last Updated: 2021-10-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

72 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-08-01

Study Completion Date

2022-07-31

Brief Summary

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The aim of this study is to compare the effectiveness of Cervical Stabilization and Oculomotor Exercises in addition to the classical physiotherapy on pain severity, cervical joint position sense, posture, cervical joint range of motion, strength and endurance of deep cervical flexor muscles, static and dynamic balance, neck awareness, functional disability and patient satisfaction in individuals with chronic neck pain. When the literature is examined, there is no study comparing the effectiveness of cervical stabilization and oculomotor exercises in individuals with chronic neck pain. However, it has also attracted our attention that a progressive and dynamic program was not followed in studies stating the oculomotor exercise program. In this sense, The study is important in terms of both comparing the effects of these 3 treatments and presenting a progressive and dynamic exercise protocol to the literature.

Detailed Description

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The Participants included in the study will be divided into 3 groups. Participants in Group 1 will receive cervical stabilization exercises in addition to the classical physiotherapy program, individuals in Group 2 will receive oculomotor exercises in addition to the classical physiotherapy program, and only the classical physiotherapy program will be applied to group 3.

Transcutaneous Electrical Nerve Stimulation, hotpack, classical massage and stretching/posture exercises will be given to participants within the scope of the Classical Physiotherapy program. In addition to the classical physiotherapy program, the participants in the 1st and 2nd groups will be given exercises that gradually increase in difficulty level, 3 days a week, for a total of 8 weeks, under the control of a physiotherapist. Participants in the 3rd group will be given only classical physiotherapy. At the same time, stretching and posture exercises will be performed under the control of a physiotherapist.

Conditions

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Chronic Neck Pain Exercise Addiction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Classical Physiotherapy Program + Cervical Stabilization Exercises

In addition to classical physiotherapy, Cervical Stabilization Exercises will be applied to the individuals in the 1st group.

Group Type EXPERIMENTAL

Classical Physiotherapy Program + Cervical Stabilization Exercises

Intervention Type OTHER

First of all, patients will be taught correct craniocervical flexion movement without activation of superficial muscles in different positions (supine, prone, crawling, sitting, standing). The program will be continued by asking to maintain the cranio-cervical flexion position during all movements. In order to gain dynamic stabilization, unilateral, bilateral, contralateral, ipsilateral and reciprocal extremity movements will be added to the program together with craniocervical flexion movement. Resistance will be added to the exercises as control of the movement is achieved. The exercises will progress from static to dynamic, from stationary floors to moving floors, from simple movements to complex movements.

Classical Physiotherapy Program + Oculomotor Exercises

In addition to classical physiotherapy, Oculomotor Exercises will be applied to the individuals in the 2nd group.

Group Type EXPERIMENTAL

Classical Physiotherapy Program + Oculomotor Exercises

Intervention Type OTHER

Oculomotor Exercises is a program consisting of exercises that support proprioception in the cervical region. It consists of 4 main contents; Sacadic Eye movements, Gaze stability, Head/eye coordination, Head repositioning exercise.

Classical Physiotherapy Program

Only the classical physiotherapy program will be applied to the individuals in 3rd group.

Group Type ACTIVE_COMPARATOR

Classical Physiotherapy Program

Intervention Type OTHER

Conventional TENS will be applied to apply analgesic current. TENS application will be made to the cervical paravertebral region, using four 5 x 5 cm adhesive surface electrodes, at 80 Hz frequency for 20 minutes, 100 msec.

All participants will be asked to lie in a prone position. The neck will be in a neutral position. The hot pack will be applied to the cervical region for 20 minutes.

Classical massage will be applied for 20 minutes using the Swedish technique. The technique will be performed on the upper and neck region of the back with 3 strokes, 3 kneading and 3 strokes. The patient will be massaged while lying in the prone position.

Stretching/Posture Exercises Exercises will be applied as a 5-10 minute warm-up-cool-down program at the beginning and end of the study. Cervical flexor, lateral flexor, rotator muscles, pectorals, inferior shoulder joint capsule will be stretched. In addition to this, posture exercises will also be done.

Interventions

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Classical Physiotherapy Program + Cervical Stabilization Exercises

First of all, patients will be taught correct craniocervical flexion movement without activation of superficial muscles in different positions (supine, prone, crawling, sitting, standing). The program will be continued by asking to maintain the cranio-cervical flexion position during all movements. In order to gain dynamic stabilization, unilateral, bilateral, contralateral, ipsilateral and reciprocal extremity movements will be added to the program together with craniocervical flexion movement. Resistance will be added to the exercises as control of the movement is achieved. The exercises will progress from static to dynamic, from stationary floors to moving floors, from simple movements to complex movements.

Intervention Type OTHER

Classical Physiotherapy Program + Oculomotor Exercises

Oculomotor Exercises is a program consisting of exercises that support proprioception in the cervical region. It consists of 4 main contents; Sacadic Eye movements, Gaze stability, Head/eye coordination, Head repositioning exercise.

Intervention Type OTHER

Classical Physiotherapy Program

Conventional TENS will be applied to apply analgesic current. TENS application will be made to the cervical paravertebral region, using four 5 x 5 cm adhesive surface electrodes, at 80 Hz frequency for 20 minutes, 100 msec.

All participants will be asked to lie in a prone position. The neck will be in a neutral position. The hot pack will be applied to the cervical region for 20 minutes.

Classical massage will be applied for 20 minutes using the Swedish technique. The technique will be performed on the upper and neck region of the back with 3 strokes, 3 kneading and 3 strokes. The patient will be massaged while lying in the prone position.

Stretching/Posture Exercises Exercises will be applied as a 5-10 minute warm-up-cool-down program at the beginning and end of the study. Cervical flexor, lateral flexor, rotator muscles, pectorals, inferior shoulder joint capsule will be stretched. In addition to this, posture exercises will also be done.

Intervention Type OTHER

Other Intervention Names

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Cervical Stabilization Oculomotor Exercises Classical Physiotherapy

Eligibility Criteria

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Inclusion Criteria

* Men and women between the ages of 30-55,
* Neck pain for at least 3 months,
* Sedentary or non-regular exercise habit (3 days a week, less than 30 min of physical activity per day)
* According to the Numerical Pain Scale, the pain intensity is 4 cm and above

Exclusion Criteria

* • Has received any physiotherapy program due to neck or back pain in the last 6 months,

* Congenital anomaly in the cervical region (such as Klippel Feil Syndrome)
* Having structural scoliosis at any level of the vertebral column,
* Acute or chronic neurological deficits (sensory and motor loss),
* With vertebrobasillary artery failure,
* Thoracic Outlet Syndrome,
* Any vestibular problem,
* With marked diplopia and oculomotor muscle insufficiency,
* Having a cervical rib,
* Having a history of fractures in the cervical vertebrae,
* Colorblind,
* Suffering from whiplash injury,
* Those with serious rheumatic diseases such as Ankylosing Spondylitis, Rheumatoid Arthritis
* Having undergone spine surgery from any region,
* Tumor or spinal cord compression due to another reason,
* Using any pain reliever drug other than simple analgesics.
* Those who have problems related to the lumbar region such as lumbal stenosis, lumbar disc herniation
Minimum Eligible Age

30 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hacettepe University

OTHER

Sponsor Role collaborator

Eastern Mediterranean University

OTHER

Sponsor Role lead

Responsible Party

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Cemaliye Hürer

Master of Science, Physiotherapist, Lecturer, Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Zafer Erden

Role: PRINCIPAL_INVESTIGATOR

Hacettepe University

Locations

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Eastern Mediterranean University

Famagusta, , Cyprus

Site Status

Countries

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Cyprus

References

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Jull GA, Falla D, Vicenzino B, Hodges PW. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther. 2009 Dec;14(6):696-701. doi: 10.1016/j.math.2009.05.004. Epub 2009 Jul 25.

Reference Type BACKGROUND
PMID: 19632880 (View on PubMed)

Revel M, Minguet M, Gregoy P, Vaillant J, Manuel JL. Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomized controlled study. Arch Phys Med Rehabil. 1994 Aug;75(8):895-9. doi: 10.1016/0003-9993(94)90115-5.

Reference Type BACKGROUND
PMID: 8053797 (View on PubMed)

Jull G, Falla D, Treleaven J, Hodges P, Vicenzino B. Retraining cervical joint position sense: the effect of two exercise regimes. J Orthop Res. 2007 Mar;25(3):404-12. doi: 10.1002/jor.20220.

Reference Type BACKGROUND
PMID: 17143898 (View on PubMed)

Strimpakos N, Sakellari V, Gioftsos G, Kapreli E, Oldham J. Cervical joint position sense: an intra- and inter-examiner reliability study. Gait Posture. 2006 Jan;23(1):22-31. doi: 10.1016/j.gaitpost.2004.11.019.

Reference Type BACKGROUND
PMID: 16311191 (View on PubMed)

Other Identifiers

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HU

Identifier Type: -

Identifier Source: org_study_id