Efficacy of Cervical Stabilization Exercises on Hand Grip Strength in Chronic Myofascial Neck Pain

NCT ID: NCT06468904

Last Updated: 2024-06-26

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 52 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-10-01
• Study Completion Date: 2024-08-31

Brief Summary

The purpose of this study is to examine effect of cervical stabilization exercises on hand grip strength, key pinch strength, pain intensity, pain pressure threshold and hand function in chronic myofascial neck pain patients.

Detailed Description

Myofascial pain of the trapezius is considered one of the main causes of neck pain and characterized by deep, intense pain of the skeletal muscles and their fascia and by the presence of one or more MTrPs, Although MTrPs can be formed in any muscle or muscle group, previous studies concluded that the upper trapezius(UT) muscle is the most commonly affected muscle.

Considering the role of synergistic function of the UT muscle in scapula-humeral rhythm during shoulder movement, it is not surprising that MTrPs in UT muscle can result in shoulder dysfunction and disability. Muscle activity of proximal parts is necessary for activation of distal parts. In fact, the stable activity of distal parts needs controlling the proximal parts. Thus, the stability of shoulder girdle is required for activity of distal parts such as fingers, wrists and elbows. In addition, trigger points in the UT can affect grip strength, which depends on shoulder joint and scapular stability. Thus, UT muscle dysfunction can reduce grip strength.

However, little research has been carried out to determine the therapeutic effects of cervical stabilization exercises on chronic neck pain, and up till now, there is a gap in literature to explore efficacy of cervical stabilization exercises on chronic neck pain and hand grip strength. Therefore, this study aims to investigate whether cervical stabilization exercises has an effect on hand grip strength in chronic myofascial neck pain.

Conditions

Chronic Neck Pain

Study Design

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

Study Groups

cervical stabilization exercises and integrated neuromuscular inhibition technique

patients received cervical stabilization exercises and integrated neuromuscular inhibition technique for 3 sessions / week for 4 weeks. Cervical stabilization included chin tucks, isometric holds, ball squeeze.

Integrated neuromuscular inhibition technique included:

1. ischemic compression: therapist applied an intermittent ischemic compression on upper trapezius trigger point by thumb for 90sec.

2. Strain counter-strain: therapist applied pressure at trigger point. patient's head was laterally flexed towards the affected side passively by one hand of the therapist. The other hand held the subject's forearm and moved the affected shoulder to 90degree of abduction and external rotation for 90 secs.

3. Muscle energy technique: patient laterally flexed the neck to opposite side patient was moved the stabilized shoulder and ear towards each other. The contraction was maintained for 10 sec followed by 5 seconds of relaxation. The muscle was stretched for 30 secs.

Group Type: EXPERIMENTAL

cervical stabilization exercises and integrated neuromuscular technique.

Intervention Type: PROCEDURE

Patients received cervical stabilization exercises and integrated neuromuscular inhibition technique. Cervical stabilization protocol included strengthening exercises of deep cervical flexors muscles which included chin tucks, isometric holds, ball squeeze, as well as deep cervical extensors muscles which included cranio-cervical flexion from neutral, upper cervical rotation and extension of cervical spine.

integrated technique includes ischemic compression, muscle energy technique and strain counter strain.

Integrated neuromuscular inhibition technique

patients received integrated neuromuscular inhibition technique for 3 sessions / week for 4 weeks.it included Ischemic compression, Strain counter-strain and muscle energy technique.

1. ischemic compression. therapist applied an intermittent ischemic compression on upper trapezius trigger point by thumb for 90 sec.

2. Strain counter-strain: therapist applied pressure at trigger point. patient laterally flexed towards the affected side passively by one hand of the therapist. The other hand held the subject's forearm and moved the affected side shoulder passively to 90degree of abduction and external rotation for 90 secs.

3. Muscle energy technique: patient was asked to laterally flex the neck to opposite side. patient was requested to move the stabilized shoulder and ear towards each other. The contraction was maintained for 10 sec followed by 5 seconds of relaxation. The muscle was stretched for 30 secs.

Group Type: ACTIVE_COMPARATOR

cervical stabilization exercises and integrated neuromuscular technique.

Intervention Type: PROCEDURE

Patients received cervical stabilization exercises and integrated neuromuscular inhibition technique. Cervical stabilization protocol included strengthening exercises of deep cervical flexors muscles which included chin tucks, isometric holds, ball squeeze, as well as deep cervical extensors muscles which included cranio-cervical flexion from neutral, upper cervical rotation and extension of cervical spine.

integrated technique includes ischemic compression, muscle energy technique and strain counter strain.

Interventions

cervical stabilization exercises and integrated neuromuscular technique.

Patients received cervical stabilization exercises and integrated neuromuscular inhibition technique. Cervical stabilization protocol included strengthening exercises of deep cervical flexors muscles which included chin tucks, isometric holds, ball squeeze, as well as deep cervical extensors muscles which included cranio-cervical flexion from neutral, upper cervical rotation and extension of cervical spine.

integrated technique includes ischemic compression, muscle energy technique and strain counter strain.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

1. Chronic neck pain for more than 3 months.

2. Active MTrPs in the UT muscle with a tender nodule.

3. Constant neck pain, a jump sign during palpation of UT muscle.

4. Referred pain.

5. Symptoms of ipsilateral hand muscles weakness.

Exclusion Criteria

1. Signs of severe pathology such as malignancy of the cervical area.

2. Fractures of the cervical spine.

3. Cervical radiculopathy or myelopathy.

4. Diabetes.

5. Trauma, congenital anomalies and surgery around neck, shoulder and hand.

6. Fibromyalgia or vascular syndromes such as vertebra-basilar insufficiency.

7. Pregnancy.

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 45 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: No

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Fatma Alzahraa Mohamed Ali Ramadan

principle invesyigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

soheir sh Rezkallah, PHD

Role: STUDY_DIRECTOR

professor of physaical therapy

Ghada Abd Elmoneim, PHD

Role: STUDY_DIRECTOR

assistant professor of physical therapy

Haidy S Roshdy, PHD

Role: STUDY_DIRECTOR

lecturer of physical therapy

Locations

Cairo University

Giza, , Egypt

Site Status: COMPLETED

Faculty of physical therapy

Giza, , Egypt

Site Status: RECRUITING

Countries

Egypt

Central Contacts

Fatma Alzahraa M Ali, Master

Role: CONTACT

fatmaalzahraa@pt.bsu.edu.eg

01028371924

Other Identifiers

P.T.REC/012/004710

Identifier Type: -

Identifier Source: org_study_id