Scapular Motor Control for Chronic Mechanical Neck Pain

Effect of Scapular Motor Control Exercise in Patient With Chronic Mechanical Neck Pain

The purpose of this study is to investigate the effect of motor control training using scapular PNF exercise on neck pain, function, proprioception, and scapular muscle strength in patients with chronic mechanical neck pain.

Study Overview

• Status: Recruiting
• Conditions: Chronic Mechanical Neck Pain
• Intervention / Treatment: Other: scapular PNF technique

Detailed Description

Chronic mechanical neck pain (CMNP) is defined as generalized neck and/ or shoulder pain for more than 3 months with symptoms provoked by neck movement, neck postures, or palpation of the cervical muscles .

regional interdependence (RI) is defined as the concept that a patient's primary musculoskeletal symptom(s) may be directly or indirectly related or influenced by impairments from various body regions and systems regardless of proximity to the primary symptom(s)'.

Changes in scapular posture and alteration of muscle activation patterns of scapulothoracic muscles are cited as potential risk factors for neck pain the structural connectivity of the cervical spine and scaopulothorathic muscles . The bones and muscles of the cervical spine and the shoulders are connected to each other mechanically, thus a continuously applied mechanical load on the shoulders directly increases the load on the cervical region, which may cause joint and ligament pain Scapular malalignment can contribute to prolonged compressive loading of the posterior cervical structures .

It has been suggested that abnormal joint stress affects the firing of cervical afferents, leading to changes in proprioceptive function. Moreover, pain leads to changes in motor control . we believe that scapular motor control exercises using PNF technique may help to restore normal alignment and reverse this vicious circle PNF Technique is based on movement patterns to facilitate and correct sensory-motor function it has been suggested that PNF correct the impaired impulses emerging from proprioceptive receptors in the muscle. Therefore, it decreases pain and desires to improve the strength of muscles. PNF position renders a greater amount of sensory input coming from the periphery than that in the neutral position .The purpose of this study is to investigate the effect of motor control training using scapular PNF exercise on neck pain, function, proprioception, and scapular muscle strength in patients with chronic mechanical neck pain.

• Study Type: Interventional
• Enrollment (Anticipated): 56
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Aisha said, master; Phone Number: 01061157728; Email: aishasaid1960@gmail.com
• Study Contact Backup: Name: mohammed abdelmaged; Phone Number: +1 (909) 583-4966

Study Locations

• Egypt
  • Tala, Egypt
    • Not yet recruiting
    • Tala Central Hospital
  • Munofia
    • Tala, Munofia, Egypt
      • Recruiting
      • Tala Central Hospital
      • Contact: mohammed mostafa, second; Phone Number: 01061157728; Email: mohammedabdelbary24@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• -The subject will be referred from orthopedic surgeon with diagnosis of CMNP.
• Subjects with CMNP of more than 3 months with age range between 18 and 45 years
• Subjects having a baseline NDI score of at least 20% (10 points)
• At least 3/10 pain intensity on VAS

Exclusion Criteria:

• Spinal canal stenosis.
• Traumatic injury to the cervical spine.
• Previous surgery related to cervical spine.
• Hypermobility of the cervical spine,
• Any red flags e.g. cervical instability, history of cancer, long use of corticosteroids.
• Presence of an inflammatory rheumatologic disease,

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: interventinal group; 28 subject will receive a program of scapular motor control exercises using PNF technique in addition to the conventional treatment for 18 sessions (3 sessions per week for six weeks)	Other: scapular PNF technique; PNF Technique is based on movement patterns to facilitate and correct sensory-motor function,then correct the impaired impulses emerging from proprioceptive receptors in the muscle. Therefore, it decreases pain and improve the strength of muscles. PNF position renders a greater amount of sensory input coming from the periphery than that in the neutral position .
No Intervention: control group; 28 subject will receive conventional physical therapy program (heat-TENS) for 18 sessions (3 sessions per week for six weeks)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
change in cervical pain	by using the Arabic version of Numeric pain rating scale , ranging from 0 ("no pain") to 10 ("worst pain imaginable")	one week after end of treatment
change in neck function	by using the Arabic version of neck disability index that consists of 10 questions: pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, and recreation. Each item is scored from 0 (no disability) to 5 (total disability). The maximum possible score is 50.	one week after end of treatment
change in proprioceptive inputs of cervical	Bubble Inclinometer will be used to assess proprioceptive inputs of cervical; flexion - extension; right side bending - left side bending; cervical right rotate - cervical left rotation	one week after end of treatment
change in muscle strength	Hand-held dynamometer will be used to assess muscle strength; upper trapezius - middle trapezius; lower trapezius - serratus anterior	one week after end of treatment

Collaborators and Investigators

• Sponsor: Cairo University

Publications and helpful links

Helpful Links

• Bansal, R., & Paul, M. (2020). Effectiveness of Motor Control Therapeutic Exercise Vs. Proprioceptive Neuromuscular Facilitation in Subjects With Cervical Spondylosis on Pain and Functional Disability. International Journal of Physiotherapy and Researc
• Alghadir, A. H., Anwer, S., & Iqbal, Z. A. (2016). The psychometric properties of an Arabic numeric pain rating scale for measuring osteoarthritis knee pain. Disability and Rehabilitation, 38(24), 2392-2397. https://doi.org/10.3109/09638288.2015.1129441
• Celenay, S. T., Kaya, D. O., & Akbayrak, T. (2016). Cervical and scapulothoracic stabilization exercises with and without connective tissue massage for chronic mechanical neck pain: A prospective, randomised controlled trial. Manual Therapy, 21, 144-150.
• Ha, S. min, Kwon, O. yun, Yi, C. hwi, Jeon, H. seon, & Lee, W. hwee. (2011). Effects of passive correction of scapular position on pain, proprioception, and range of motion in neck-pain patients with bilateral scapular downward-rotation syndrome. Manu
• 25. Ijspeert, J., Kerstens, H. C. J. W., Janssen, R. M. J., Geurts, A. C. H., Van Alfen, N., & Groothuis, J. T. (2019). Validity and reliability of serratus anterior hand held dynamometry. BMC Musculoskeletal Disorders, 20(1), 1-8.

Study record dates

Study Major Dates

• Study Start (Anticipated): May 1, 2023
• Primary Completion (Anticipated): May 1, 2024
• Study Completion (Anticipated): June 1, 2024

Study Registration Dates

• First Submitted: March 25, 2023
• First Submitted That Met QC Criteria: May 3, 2023
• First Posted (Estimate): May 5, 2023

Study Record Updates

• Last Update Posted (Estimate): May 5, 2023
• Last Update Submitted That Met QC Criteria: May 3, 2023
• Last Verified: May 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Neck Pain
• Other Study ID Numbers: motor control in neck pain

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No