Comparison of the Immediate Effects of Manual Therapy Techniques in Non-Specific Neck Pain

NCT ID: NCT06959160

Last Updated: 2025-08-03

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 39 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-09-15
• Study Completion Date: 2025-01-10

Brief Summary

The aim of this study is to investigate the effects of manual therapy techniques on joint range of motion, pain tolerance, grip strength, and functionality in individuals with non-specific neck pain. The study is experimental in design. Individuals aged between 18 and 55 who were diagnosed with non-specific neck pain and met the inclusion criteria participated in the study.

Detailed Description

Participants who agreed to take part and signed the informed consent form were asked to complete the "Patient Assessment Form" during the initial interview.

In addition, the following assessment tools were used: the Cervical Range of Motion (CROM) device to evaluate joint range of motion, a hand dynamometer to assess grip strength, an algometer to measure pain tolerance, and the "Neck Disability Index" to evaluate functionality.

Participants were then randomly assigned to one of three groups:

Group 1: Atlanto-occipital manipulation

Group 2: Cervical mobilization

Group 3: Trigger point therapy

Participants in the first group received atlanto-occipital manipulation, those in the second group underwent Grade II-III mobilization techniques, and those in the third group received trigger point therapy, which consisted of ischemic compression followed by myofascial stretching on the upper trapezius muscle.

Immediately after the treatments, joint range of motion, pain tolerance, and functionality were reassessed. The manual therapy interventions for all three groups were performed by different specialized physiotherapists trained in these techniques. The evaluations, however, were conducted by another physiotherapist who was blinded to the treatments (double-blind study).

The data were statistically analyzed using the Statistical Package for the Social Sciences program, and a p-value of less than 0.05 was considered statistically significant.

Conditions

Manual Therapies; Neck Pain

Study Design

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

Study Groups

Atlanto-occipital Manipulation Group

Participants in the first group received atlanto-occipital manipulation.

Group Type: EXPERIMENTAL

Atlanto-occipital manipulation

Intervention Type: OTHER

Participants in the first group received atlanto-occipital manipulation. The patient was positioned in a supine position, with the head rotated to one side. The therapist placed the middle and ring fingers of one hand on the patient's mastoid process, while the palm of the other hand made contact with the patient's jawline and cheek. A gentle traction force was applied to the cranial region using both hands. When the therapist sensed joint tension, a high-velocity, low-amplitude thrust was delivered in the direction of the traction with a slight rotational force. The procedure was performed bilaterally and lasted approximately 5 minutes.

Cervical Mobilization Group

Participants in the second group underwent Grade II-III cervical mobilization techniques.

Group Type: EXPERIMENTAL

Cervical mobilization

Intervention Type: OTHER

Participants in the second group underwent Grade II-III cervical mobilization techniques, administered over a period of 10 minutes. The patient was positioned in a supine position, and the physiotherapist performed 10 minutes of Grade II-III mobilizations with an upward and downward incline (postero-anterior and antero-posterior mobilizations following the movement plane of the cervical zygapophyseal joints).

Trigger Point Therapy Group

Participants in the third group received trigger point therapy, which included ischemic compression followed by myofascial stretching on the upper trapezius muscle.

Group Type: EXPERIMENTAL

Trigger point therapy

Intervention Type: OTHER

Participants in the third group received trigger point therapy, which included ischemic compression followed by myofascial stretching on the upper trapezius muscle. The patient was positioned in a supine position, and the physiotherapist performed 10 minutes of Grade II-III mobilizations with an upward and downward incline (postero-anterior and antero-posterior mobilizations following the movement plane of the cervical zygapophyseal joints).

Interventions

Atlanto-occipital manipulation

Participants in the first group received atlanto-occipital manipulation. The patient was positioned in a supine position, with the head rotated to one side. The therapist placed the middle and ring fingers of one hand on the patient's mastoid process, while the palm of the other hand made contact with the patient's jawline and cheek. A gentle traction force was applied to the cranial region using both hands. When the therapist sensed joint tension, a high-velocity, low-amplitude thrust was delivered in the direction of the traction with a slight rotational force. The procedure was performed bilaterally and lasted approximately 5 minutes.

Intervention Type: OTHER

Cervical mobilization

Participants in the second group underwent Grade II-III cervical mobilization techniques, administered over a period of 10 minutes. The patient was positioned in a supine position, and the physiotherapist performed 10 minutes of Grade II-III mobilizations with an upward and downward incline (postero-anterior and antero-posterior mobilizations following the movement plane of the cervical zygapophyseal joints).

Intervention Type: OTHER

Trigger point therapy

Participants in the third group received trigger point therapy, which included ischemic compression followed by myofascial stretching on the upper trapezius muscle. The patient was positioned in a supine position, and the physiotherapist performed 10 minutes of Grade II-III mobilizations with an upward and downward incline (postero-anterior and antero-posterior mobilizations following the movement plane of the cervical zygapophyseal joints).

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Be between the ages of 18 and 55
• Have been diagnosed with non-specific neck pain by a specialized physician
• Have been experiencing neck pain for less than 3 months
• Have a neck pain level of at least 3 on the Visual Analog Scale
• Have bilateral active trigger points in the upper trapezius muscle
• Have restricted active cervical range of motion

Exclusion Criteria

• Presence of neurological deficit or radicular pain
• History of pathology or surgery in the cranio-cervical region
• Positive response in the extension-rotation test
• Use of anticoagulants or corticosteroids
• Presence of one or more red flags defined for non-specific neck pain

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 55 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Halic University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Seda Saka, assoc. prof.

Role: PRINCIPAL_INVESTIGATOR

Halic University

Locations

Halic University

Istanbul, Eyupsultan, Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

Acetinkaya006

Identifier Type: -

Identifier Source: org_study_id