Effects of Chiropractic and Exercise on Wrist Proprioception and Grip Strength in Individuals With Mechanical Neck Pain

NCT ID: NCT06625021

Last Updated: 2024-10-04

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-12-28

Study Completion Date

2024-07-15

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The aim of this study is to compare the effectiveness of chiropractic and different physiotherapy applications on bilateral hand grip strength, grip sensitivity, two-point separation and joint position sense in individuals with mechanical neck pain (NPMO). It is known that the decrease in grip strength and hand functions, especially with increasing age, causes disability in daily life activities and even death. The planned study aims to improve hand functions in individuals with NPMO.

48 individuals diagnosed with mechanical neck pain were included in the study. The 48 individuals were randomly divided into 4 groups via the Randomizer.org website.

* The first group is the control group (n=12); transcutaneous electric nerve stimulation, ultrasound and appropriate neck exercises are planned to be applied every day for 4 weeks.
* The second group is the chiropractic group and will be applied twice a week for 3 weeks by me, a Bahcesehir University Chiropractic Masters graduate (2017), targeting the lower cervicals.
* Classic hand-wrist exercises such as ROM, stretching and strengthening were applied to the third group in all directions of the wrist.
* In the fourth group, proprioceptive exercises such as joint approximation, traction and mobilization, similar to the classic hand-wrist exercise group, will be performed every day for 4 weeks.

The researcher will compare the effects of chiropractic and other physiotherapy techniques with the control group. Measurements will be repeated 4 weeks after the end of the treatment to measure whether the effects after the treatment continue. As a result of the evaluations recorded in a total of 8 weeks, statistical analyses will be performed first for the changes within the four groups and then for the changes between the groups.

The basic questions it aims to answer are as follows:

1. Is there a difference between the control group and chiropractic application, classic hand-wrist exercises and proprioceptive exercises in terms of the effects on grip strength, grip sensitivity, joint position sense and two-point discrimination test in individuals with NPMO?
2. Is there an improvement in the pain levels and functional disabilities of the participants?
3. Are the short-term results of the treatments sufficient?

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The brains primary means of survival is to receive and interpret sensory input. Therefore, it needs functional afferent inputs that can adapt to changing internal and external environmental conditions and update themselves. Most of this occurs through joint-based proprioceptive and muscle spindle information coming to the spinal code. The spinal cord is not only a center responsible for transmitting sensations coming to the dorsal horn to the brain, but also responsible for regulating these sensations. Due to the continuous afferent firing of the neck pain of mechanical origin (NPMO), the sensory-motor integration of the spinal cord decreases. When the afferent input of the spinal cord changes, it will not be possible to perceive correctly what is happening in the relevant region. It can be said that this situation affects itself in a cycle by changing sensory processing, sensory filtering and sensory integration. It can also cause the vertebral column to be exposed to microtrauma. With the decrease in the firing of the existing altered sensory inputs, joint position sense and motor control reach an optimum level, and increases have been observed in the regulation of developmental and physiological processes, especially in postural strength and upper extremity muscle strength. It is aimed to examine the relationship between the improvement of proprioceptive input with treatment methods and the elimination of abnormal motor control and abnormal neuronal processing with improved proprioceptive input. In this context, it was planned to evaluate the superiority of chiropractic, classical hand-wrist exercises and proprioceptive exercises against each other and against the control group in individuals with NPMO by applying grip strength, grip sensitivity, wrist joint position sense and 2-point discrimination test. It was planned to use visual analog scale and neck pain and disability score to assess pain in NPMO and Copenhagen neck functional disability scale to assess functionality.

With this study;

1. Ensuring normal integration in individuals with NPMO,
2. Ensuring sensory-motor integration by keeping the internal and external body schemas of the brain working healthily and up-to-date,
3. Increasing the pain and disability in daily activities and increasing the functionality by improving the strength and proprioception parameters of the hand and wrist,
4. Obtaining information about the general health of the individual by evaluating the grip strength and proprioception,
5. Providing higher quality health services with the findings obtained,
6. Guiding patients with evidence during the treatment process,
7. Providing the most appropriate treatment to patients is aimed.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Neck Pain

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

48 individuals diagnosed with mechanical neck pain were included in the study. The 48 individuals were randomly divided into 4 groups via the Randomizer.org website.

* The first group is the control group(n=12); transcutaneous electrical nerve stimulation, ultrasound and appropriate neck exercises are planned to be applied every day for 4 weeks.
* The second group is the chiropractic group(n=12) and will be applied twice a week for 3 weeks by me, a Bahcesehir University Chiropractic Masters graduate, targeting the lower cervicals.
* Classic hand-wrist exercises group(n=12) such as range of motion, stretching and strengthening were applied to the third group in all directions of the wrist.
* In the fourth group, proprioceptive exercises group(n=12) such as joint approximation, traction and mobilization, similar to the classic hand-wrist exercise group, will be performed every day for 4 weeks.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Control group

-The first group is the control group (n=12); Transcutaneous electrical nerve stimulation, ultrasound and appropriate neck exercises are planned to be applied every day for 4 weeks.

Group Type EXPERIMENTAL

Exercises to be done for neck pain of mechanical origin

Intervention Type PROCEDURE

Conservative treatment, which is frequently used in the treatment of mechanical neck pain, was planned. A warm-up period was defined with stretching exercises in all areas of neck movement. Again, isometric exercise should be 10 seconds in all directions. In addition to neck and shoulder mobility exercises, neck region posture exercises were included. It was planned to do these exercises for 4 weeks, 5 days a week, in all 4 groups.

Chiropractic Group

-The second group is the chiropractic group and will be applied twice a week for 3 weeks by me, a Bahcesehir University Chiropractic Masters graduate (2017), targeting the lower cervicals.

Group Type ACTIVE_COMPARATOR

Chiropractic manipulation

Intervention Type PROCEDURE

Chiropractic manipulation: Lower cervical chiropractic manipulation is a technique used to increase mobility and relieve pain in the lower vertebrae of the neck. However, such procedures should only be performed by trained chiropractors; if done incorrectly, they can lead to serious problems. The patient should be placed in a comfortable position. The supine or side-lying position is usually preferred. Contact is established with the transverse processes of the lower cervical vertebrae. High-velocity, Low-amplitude thrust is applied within anatomical limits.

As a graduate of Bahcesehir University Chiropractic Masters Degree, I applied chiropractic twice a week for 3 weeks.

Exercises to be done for neck pain of mechanical origin

Intervention Type PROCEDURE

Conservative treatment, which is frequently used in the treatment of mechanical neck pain, was planned. A warm-up period was defined with stretching exercises in all areas of neck movement. Again, isometric exercise should be 10 seconds in all directions. In addition to neck and shoulder mobility exercises, neck region posture exercises were included. It was planned to do these exercises for 4 weeks, 5 days a week, in all 4 groups.

Classic Hand-Wrist Exercises Group

-Classic hand-wrist exercises such as range of motion, stretching and strengthening were applied to the third group in all directions of the wrist.

Group Type ACTIVE_COMPARATOR

Exercises to be done for neck pain of mechanical origin

Intervention Type PROCEDURE

Conservative treatment, which is frequently used in the treatment of mechanical neck pain, was planned. A warm-up period was defined with stretching exercises in all areas of neck movement. Again, isometric exercise should be 10 seconds in all directions. In addition to neck and shoulder mobility exercises, neck region posture exercises were included. It was planned to do these exercises for 4 weeks, 5 days a week, in all 4 groups.

Classic Hand-Wrist Exercises

Intervention Type PROCEDURE

The participants of this group will be subjected to wrist range of motion (ROM), stretching and strengthening exercises. Measurements will be made in all axes of motion of the wrist, which are extension, flexion, ulnar and radial deviation. ROM exercises and stretching exercises were applied passively to all axes of motion within anatomical limits. At the last angles of the movement, the individual was forced and stretched without causing discomfort and waited at the last angles for a short time. Stretching exercises were performed five times for each movement. Strengthening exercises for all axes of movement of the wrist will be performed using dumbbells weighing 1 and 2 kilograms and an exercise band suitable for the persons endurance and strength. In exercises performed with dumbbells, all movements of the wrist will be performed against gravity. All applications were applied to the classical hand-wrist exercise group for at least half an hour every day for 4 weeks.

Proprioceptive Exercises Group

-In the fourth group, proprioceptive exercises such as joint approximation, traction and mobilization, similar to the classic hand-wrist exercise group, will be performed every day for 4 weeks.

Group Type ACTIVE_COMPARATOR

Exercises to be done for neck pain of mechanical origin

Intervention Type PROCEDURE

Conservative treatment, which is frequently used in the treatment of mechanical neck pain, was planned. A warm-up period was defined with stretching exercises in all areas of neck movement. Again, isometric exercise should be 10 seconds in all directions. In addition to neck and shoulder mobility exercises, neck region posture exercises were included. It was planned to do these exercises for 4 weeks, 5 days a week, in all 4 groups.

Proprioceptive exercise group

Intervention Type PROCEDURE

Similar to the classical wrist exercise group, the participants in this group were applied joint range of motion, stretching and strengthening exercises as well as proprioceptive exercises such as joint approximation, traction and mobilization. In addition to all axes of motion of the wrist, active and passive stretching exercises were applied to the forearm flexor and extensor muscles five times each. The resistance and repetition number were gradually increased according to the wrist strength and endurance of the individuals to at least 10 repetitions. Repetitive contraction and rhythmic stabilization techniques were used from proprioceptive neuromuscular facilitation methods. Joint approximation technique and taping of forearm flexor and extensor muscles were used to increase the level of contraction and stimulation of joint receptors. External stabilization and perturbation exercises were performed with an exercise ball against the wall at different angles of the upper extremity.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Chiropractic manipulation

Chiropractic manipulation: Lower cervical chiropractic manipulation is a technique used to increase mobility and relieve pain in the lower vertebrae of the neck. However, such procedures should only be performed by trained chiropractors; if done incorrectly, they can lead to serious problems. The patient should be placed in a comfortable position. The supine or side-lying position is usually preferred. Contact is established with the transverse processes of the lower cervical vertebrae. High-velocity, Low-amplitude thrust is applied within anatomical limits.

As a graduate of Bahcesehir University Chiropractic Masters Degree, I applied chiropractic twice a week for 3 weeks.

Intervention Type PROCEDURE

Exercises to be done for neck pain of mechanical origin

Conservative treatment, which is frequently used in the treatment of mechanical neck pain, was planned. A warm-up period was defined with stretching exercises in all areas of neck movement. Again, isometric exercise should be 10 seconds in all directions. In addition to neck and shoulder mobility exercises, neck region posture exercises were included. It was planned to do these exercises for 4 weeks, 5 days a week, in all 4 groups.

Intervention Type PROCEDURE

Classic Hand-Wrist Exercises

The participants of this group will be subjected to wrist range of motion (ROM), stretching and strengthening exercises. Measurements will be made in all axes of motion of the wrist, which are extension, flexion, ulnar and radial deviation. ROM exercises and stretching exercises were applied passively to all axes of motion within anatomical limits. At the last angles of the movement, the individual was forced and stretched without causing discomfort and waited at the last angles for a short time. Stretching exercises were performed five times for each movement. Strengthening exercises for all axes of movement of the wrist will be performed using dumbbells weighing 1 and 2 kilograms and an exercise band suitable for the persons endurance and strength. In exercises performed with dumbbells, all movements of the wrist will be performed against gravity. All applications were applied to the classical hand-wrist exercise group for at least half an hour every day for 4 weeks.

Intervention Type PROCEDURE

Proprioceptive exercise group

Similar to the classical wrist exercise group, the participants in this group were applied joint range of motion, stretching and strengthening exercises as well as proprioceptive exercises such as joint approximation, traction and mobilization. In addition to all axes of motion of the wrist, active and passive stretching exercises were applied to the forearm flexor and extensor muscles five times each. The resistance and repetition number were gradually increased according to the wrist strength and endurance of the individuals to at least 10 repetitions. Repetitive contraction and rhythmic stabilization techniques were used from proprioceptive neuromuscular facilitation methods. Joint approximation technique and taping of forearm flexor and extensor muscles were used to increase the level of contraction and stimulation of joint receptors. External stabilization and perturbation exercises were performed with an exercise ball against the wall at different angles of the upper extremity.

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Individuals diagnosed with mechanical neck pain
* Presence of mechanical neck pain that has been ongoing for at least 14 days
* Newly starting conservative treatment for mechanical neck pain

Exclusion Criteria

* Individuals wanting to withdraw from the study
* Not signing the informed consent form
* Using painkillers for neck pain of mechanical origin pain during the application period
* Presence of upper extremity trauma that may affect grip strength and proprioceptive sense in the last 3 months
* Vertebrobasilar artery insufficiency
* Presence of mental retardation and/or inability to communicate
* Having undergone surgery in the cervical region
* Presence of neck pain of neurological origin such as stenosis and herniation of cervical segments
* Presence of sensory deficit in the hand
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Kahramanmaras Sutcu Imam University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Ersin Cozvelioglu

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Ersin COZVELIOGLU, Ph.D

Role: PRINCIPAL_INVESTIGATOR

Kahramanmaras Sutcu Imam University

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Kahramanmaras Sutcu Imam University Health Practice and Research Hospital

Kahramanmaraş, , Turkey (Türkiye)

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Turkey (Türkiye)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

01- Chiropractic.vs.exercise

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.