Effects of Home-Based Exercise Manual on Pain and Disability in Patients of Postural Neck Pain

NCT ID: NCT05261698

Last Updated: 2022-05-10

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

COMPLETED

Clinical Phase

NA

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-07-09

Study Completion Date

2022-05-02

Brief Summary

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The main aim of this study is to determine the effects of routine physical therapy with and without home-based exercise manual on pain and disability in patients of postural neck pain. To exceptional time, the effects and outcomes of home-based exercise manual for the patients with postural neck pain have not yet been explored. Due to the current Covid-19 pandemic and social isolation, most of the individuals with office based occupations are performing their duties from their homes, which has some negative impact on their neck biomechanics and leads to the postural neck pain, this study will not only enlighten the beneficial effects of home-based exercise manual for the patients of postural neck pain, to reduce the risk of disability and improve their quality of life, but it will also be cost effective for them.

Detailed Description

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After back pain, most commonly found musculoskeletal ailment is the neck pain. Due to the poor neck posture, postural neck pain appears. It is estimated that, about 60% of the neck pain patients' have the forward head posture. Many people visit hospitals or other medical centers at least once in their life due to this problem.

Those individuals with chronic neck pain who work in offices, industries or perform other computer-based tasks, that require sitting for longer period of time have altered postural behaviors. Persistent neck pain has the negative impact as it has the potential to change the biomechanics of cervical spine specifically in individuals who spend most of their time in sitting position in front of computer screens. Continuous postural neck pain may lead to the forward head posture that rises load on the posterior structures of the cervical spine such as ligaments, muscles, bones and joint capsules and brings changes in scapular kinetics and kinematics.

According to the previous researches, forward head posture causes tightening of the shoulder and anterior neck muscles, shortening of the posterior neck extensors, and affects the kinematics and position of the scapula. Proper posture of the body is believed to be the state in which there is a musculoskeletal balance and minimal amount of strain and stress on the body. However most of the people are not able to maintain that equilibrium in the musculoskeletal structures of the body.

An ideal posture is considered only when the external auditory meatus is lined up with the vertical postural line. As seen in in the lateral view, the vertical line passes through external auditory meatus, the shoulder joint, slightly behind the hip joint, through the center of the knee joint and slightly in front of the ankle joint. Postural neck pain is believed to be associated with the forward head posture and is one of the common types of poor head posture seen in patients with neck disorders.

Neck pain is the most commonly occurring clinical condition, and its associated social and economic costs related to disability and days off work are just about equal to the lumbar pain. Individuals with the postural neck pain have been reported with the change in muscular control such as increased activity of the superficial muscles of the cervical spine and upper trapezius. Although the exact association between posture and neck pain is unresolved. Cervical neck posture is believed to have impact on dorsal neck muscle activity during lifting or even at rest. Moreover, postural neck pain may lead to the forward head posture linked with the thoracic kyphosis which has indirect impact on the rotational range of motion and cervical flexion. Occupations with sustained computer use and prolong computer usage may lead to the functional kyphosis, that seems to affect posture of the neck and scapular positioning and activity of the upper trapezius. Modifications in the workplace environment and postural correction have been shown in reducing postural neck pain.

The main aim of the study is to compare the effects of routine physical therapy with and without home-based exercise manual on pain and disability in patients of postural neck pain.

Conditions

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Postural Neck Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Arms

Control group: in control group moist heating pads along with TENS shall be applied on neck for 10 minutes and then neck isometrics and strengthening exercises shall be performed.

Group Type ACTIVE_COMPARATOR

Conventional PT

Intervention Type OTHER

In this group patients will receive routine physical therapy including hot pack for 10 minutes, stretching, strengthening exercise and TENS at the end of each session.

Assigned Interventions

Experimental group: in the experimental group we will provide moist heating pads along with TENS on the neck for 10 minutes and then neck isometrics and strengthening exercises shall be performed. Patients in the experimental group will also receive a home-based exercise manual.

Group Type EXPERIMENTAL

Home-based Exercise Manual

Intervention Type OTHER

in the experimental group we will provide moist heating pads along with TENS on the neck for 10 minutes and then neck isometrics and strengthening exercises shall be performed. Patients in the experimental group will also receive a home-based exercise manual.

Interventions

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Home-based Exercise Manual

in the experimental group we will provide moist heating pads along with TENS on the neck for 10 minutes and then neck isometrics and strengthening exercises shall be performed. Patients in the experimental group will also receive a home-based exercise manual.

Intervention Type OTHER

Conventional PT

In this group patients will receive routine physical therapy including hot pack for 10 minutes, stretching, strengthening exercise and TENS at the end of each session.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* All patients with postural neck pain aged 18-60 years shall be included.
* Patients experiencing postural neck pain at least once a week.
* A symptom duration of greater than 3 months.
* Postural neck pain that is aggravated by the sustained postural loading, and relieved by postural modification.
* Patients who are able to read and write.

Exclusion Criteria

* Neck pain due to specific causes i.e. disc protrusion, radicular syndrome
* Any accidental injury of spine
* Inflammatory rheumatic disease
* Congenital deformity of the spine
* Spinal canal stenosis
* Neoplasm
* Females who are pregnant
* Patients who had spinal surgery within the previous 12 months or any other invasive treatment of the spine within the previous 4 weeks.
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Lahore

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Muhammad Adil, MPHIL-MSK*

Role: PRINCIPAL_INVESTIGATOR

University of Lahore

Locations

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Pakistan Society for Rehabilitation of the Disabled

Lahore, Punjab Province, Pakistan

Site Status

Countries

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Pakistan

References

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Gupta BD, Aggarwal S, Gupta B, Gupta M, Gupta N. Effect of Deep Cervical Flexor Training vs. Conventional Isometric Training on Forward Head Posture, Pain, Neck Disability Index In Dentists Suffering from Chronic Neck Pain. J Clin Diagn Res. 2013 Oct;7(10):2261-4. doi: 10.7860/JCDR/2013/6072.3487. Epub 2013 Oct 5.

Reference Type BACKGROUND
PMID: 24298492 (View on PubMed)

Argent R, Daly A, Caulfield B. Patient Involvement With Home-Based Exercise Programs: Can Connected Health Interventions Influence Adherence? JMIR Mhealth Uhealth. 2018 Mar 1;6(3):e47. doi: 10.2196/mhealth.8518.

Reference Type BACKGROUND
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Cramer H, Lauche R, Hohmann C, Ludtke R, Haller H, Michalsen A, Langhorst J, Dobos G. Randomized-controlled trial comparing yoga and home-based exercise for chronic neck pain. Clin J Pain. 2013 Mar;29(3):216-23. doi: 10.1097/AJP.0b013e318251026c.

Reference Type BACKGROUND
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Reference Type BACKGROUND
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Baggetta R, D'Arrigo G, Torino C, ElHafeez SA, Manfredini F, Mallamaci F, Zoccali C, Tripepi G; EXCITE Working group. Effect of a home based, low intensity, physical exercise program in older adults dialysis patients: a secondary analysis of the EXCITE trial. BMC Geriatr. 2018 Oct 20;18(1):248. doi: 10.1186/s12877-018-0938-5.

Reference Type BACKGROUND
PMID: 30342464 (View on PubMed)

Damasceno GM, Ferreira AS, Nogueira LAC, Reis FJJ, Andrade ICS, Meziat-Filho N. Text neck and neck pain in 18-21-year-old young adults. Eur Spine J. 2018 Jun;27(6):1249-1254. doi: 10.1007/s00586-017-5444-5. Epub 2018 Jan 6.

Reference Type BACKGROUND
PMID: 29306972 (View on PubMed)

Korakakis V, O'Sullivan K, O'Sullivan PB, Evagelinou V, Sotiralis Y, Sideris A, Sakellariou K, Karanasios S, Giakas G. Physiotherapist perceptions of optimal sitting and standing posture. Musculoskelet Sci Pract. 2019 Feb;39:24-31. doi: 10.1016/j.msksp.2018.11.004. Epub 2018 Nov 17.

Reference Type BACKGROUND
PMID: 30469124 (View on PubMed)

Im B, Kim Y, Chung Y, Hwang S. Effects of scapular stabilization exercise on neck posture and muscle activation in individuals with neck pain and forward head posture. J Phys Ther Sci. 2016 Mar;28(3):951-5. doi: 10.1589/jpts.28.951. Epub 2016 Mar 31.

Reference Type BACKGROUND
PMID: 27134391 (View on PubMed)

Edmondston S, Bjornsdottir G, Palsson T, Solgard H, Ussing K, Allison G. Endurance and fatigue characteristics of the neck flexor and extensor muscles during isometric tests in patients with postural neck pain. Man Ther. 2011 Aug;16(4):332-8. doi: 10.1016/j.math.2010.12.005. Epub 2011 Jan 20.

Reference Type BACKGROUND
PMID: 21256071 (View on PubMed)

Mani S, Sharma S, Singh DK. Concurrent validity and reliability of telerehabilitation-based physiotherapy assessment of cervical spine in adults with non-specific neck pain. J Telemed Telecare. 2021 Feb;27(2):88-97. doi: 10.1177/1357633X19861802. Epub 2019 Jul 4.

Reference Type BACKGROUND
PMID: 31272309 (View on PubMed)

Nasir MF, Jawed R, Baig NN, Younus M, Arshad A, Tahir A. A study to observe the effects of physiotherapy with and without manual therapy in the management postural neck pain: A randomized control trial. J Pak Med Assoc. 2021 Jan;71(1(A)):8-11. doi: 10.47391/JPMA.186.

Reference Type BACKGROUND
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Wegner S, Jull G, O'Leary S, Johnston V. The effect of a scapular postural correction strategy on trapezius activity in patients with neck pain. Man Ther. 2010 Dec;15(6):562-6. doi: 10.1016/j.math.2010.06.006. Epub 2010 Jul 21.

Reference Type BACKGROUND
PMID: 20663706 (View on PubMed)

Pillastrini P, de Lima E Sa Resende F, Banchelli F, Burioli A, Di Ciaccio E, Guccione AA, Villafane JH, Vanti C. Effectiveness of Global Postural Re-education in Patients With Chronic Nonspecific Neck Pain: Randomized Controlled Trial. Phys Ther. 2016 Sep;96(9):1408-16. doi: 10.2522/ptj.20150501. Epub 2016 Mar 24.

Reference Type BACKGROUND
PMID: 27013576 (View on PubMed)

Richards KV, Beales DJ, Smith AJ, O'Sullivan PB, Straker LM. Neck Posture Clusters and Their Association With Biopsychosocial Factors and Neck Pain in Australian Adolescents. Phys Ther. 2016 Oct;96(10):1576-1587. doi: 10.2522/ptj.20150660. Epub 2016 May 12.

Reference Type BACKGROUND
PMID: 27174256 (View on PubMed)

Other Identifiers

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ULahore Muhammad Adil

Identifier Type: -

Identifier Source: org_study_id

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