Additional Effect of Cranial Base Release on Cervical Range and Proprioception in Patients With Mechanical Neck Pain

NCT ID: NCT05777408

Last Updated: 2025-08-14

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 20 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-01-01
• Study Completion Date: 2023-07-01

Brief Summary

Mechanical Neck pain is the second most commonly occurring musculoskeletal disorder worldwide, ranking 4th in overall disability. It is referred to as Nonspecific generalized neck pain with mechanical characteristics with a primary location between the supranuchal line and the first thoracic spinous process, includingpatients suffering from mechanical neck pain are reported to have several impairments, including pain, reduced cervical ROM, neck disability, and proprioceptive dysfunction. The treatment indicated involves the use of electrotherapy and thermal modalities. In addition, the use of different manual therapy techniques is advocated; however, the most effective management is still debatable. Evidence suggests that Natural Apophyseal glides have a significant positive effect on mechanical neck pain patients. So the study will identify the additional effect of cranial base release with natural apophyseal glides in alleviating pain and its effects on proprioception.

Conditions

Neck Pain

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Control Group

Participants of this group will receive the conventional physical therapy protocol mentioned above. In addition to this, they will receive Natural apophyseal glides 3 sets of 10 repetitions.

• Frequency: 3 times a week for 2 weeks. 6 sessions in total.
• Mobilizations will be performed in Grade 1 initially and then progressed to Grade 2 and 3 depending on the patients pain status and compliance.

Group Type: ACTIVE_COMPARATOR

Conventional Physical Therapy

Intervention Type: PROCEDURE

• 15 mins of TENS (frequency 100 Hz, phase duration 50 μs) with moist heat over the area of pain
• Isomeric Stretching of neck muscles followed by neck isometrics

Natural Apophyseal glides

Intervention Type: PROCEDURE

-Will be applied in sitting position Therapist right hand would cradle the head such that the little finger would rest on the spinous process of the vertebra that is to be mobilized. The other hands thumb would be used to apply over pressure. Direction of force will be parallel to highly irritable-grossly restricted cervical facet joints. Intervention would involve 3 sets of 20 repetitions in 15minutes, 3 days a week for 2 weeks comprising of total 6 session.

Experimental Group

• Participants of this Group will receive the conventional physical therapy protocol mentioned above. In addition to this, they will receive Natural apophyseal glides and cranial base release.
• Frequency: 3 times a week for 2 weeks. 6 sessions in total.
• Cranial base release would be given for around 1-4minutes until the tissues relax and would be given once daily

Group Type: EXPERIMENTAL

Conventional Physical Therapy

Intervention Type: PROCEDURE

• 15 mins of TENS (frequency 100 Hz, phase duration 50 μs) with moist heat over the area of pain
• Isomeric Stretching of neck muscles followed by neck isometrics

Natural Apophyseal glides

Intervention Type: PROCEDURE

-Will be applied in sitting position Therapist right hand would cradle the head such that the little finger would rest on the spinous process of the vertebra that is to be mobilized. The other hands thumb would be used to apply over pressure. Direction of force will be parallel to highly irritable-grossly restricted cervical facet joints. Intervention would involve 3 sets of 20 repetitions in 15minutes, 3 days a week for 2 weeks comprising of total 6 session.

Cranial Base Release

Intervention Type: PROCEDURE

Will be performed in lying position. therapist fingers will contact the sub occipital muscles and upward pressure would be given until the tissues and muscles relax. it will be given once daily for 3 days a week and will continue for 2 weeks

Interventions

Conventional Physical Therapy

• 15 mins of TENS (frequency 100 Hz, phase duration 50 μs) with moist heat over the area of pain
• Isomeric Stretching of neck muscles followed by neck isometrics

Intervention Type: PROCEDURE

Natural Apophyseal glides

-Will be applied in sitting position Therapist right hand would cradle the head such that the little finger would rest on the spinous process of the vertebra that is to be mobilized. The other hands thumb would be used to apply over pressure. Direction of force will be parallel to highly irritable-grossly restricted cervical facet joints. Intervention would involve 3 sets of 20 repetitions in 15minutes, 3 days a week for 2 weeks comprising of total 6 session.

Intervention Type: PROCEDURE

Cranial Base Release

Will be performed in lying position. therapist fingers will contact the sub occipital muscles and upward pressure would be given until the tissues and muscles relax. it will be given once daily for 3 days a week and will continue for 2 weeks

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Patients diagnosed with mechanical neck pain having reproducible non-specific neck pain with a primary location between the supranuchal line and the first thoracic spinous process
• Male and Female
• Age 18-40 years
• Pain severity on NPRS >3
• Neck Disability score of 20% or above
• Problem not older than 2 months

Exclusion Criteria

• Patients with history of
• Recent significant trauma (including whiplash)
• Radiculopathy
• Cervical fracture
• Neck surgery
• Dizziness, vertigo
• Myelopathy, Malignancy
• Metabolic disease
• Diagnosed Osteoporosis, Rheumatoid arthritis
• Long-term corticosteroid and/or painkiller drug use

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 40 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Foundation University Islamabad

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Foundation University College of Physical Therapy

Rawalpindi, Punjab Province, Pakistan

Countries

Pakistan

Other Identifiers

FUI/CTR/2023/3

Identifier Type: -

Identifier Source: org_study_id