Effects of Neural Mobilization on Respiratory Parameters in Chronic Neck Pain

Effects of Neural Mobilization on Respiratory Parameters, Pain, Range of Motion, and Neck Awareness in Patients With Chronic Neck Pain: A Randomized Controlled Trial

Objective: Neural mobilization (NM) is commonly used to treat nerve disorders, and it is useful for disorders associated with neck and arm pain. This study aimed to determine the effects of NM on respiratory function in patients with chronic neck pain.

Methods: Overall, 26 patients with neck pain were randomly assigned to two groups: NM or control. In these participants, respiratory function and active cervical range of motion were assessed before and after intervention. Furthermore, the participants were provided a visual analog scale (VAS) and Fremantle Neck Awareness Questionnaire (FreNAQ). Each participant underwent 15 treatment sessions (5 days per week for 3 weeks). Further, in the NM group, in addition to conventional treatment, 10 sessions of neural mobilization were performed.

Study Overview

• Status: Completed
• Conditions: Neck Pain; Respiratory
• Intervention / Treatment: Other: Neural Mobilization

• Study Type: Interventional
• Enrollment (Actual): 26
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Kocaeli
    • Gebze, Kocaeli, Turkey
      • Medical Park Gebze Hosptal

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Individuals aged 25-65 years,
• those with neck pain for >3 months
• those with complaints of pain, tension
• numbness on neurodynamic nerve tests

Exclusion Criteria:

• individuals with spinal stenosis,
• neurological diagnosis, malignancy,
• upper extremity vascular problems,
• osteoporosis,
• pregnancy,
• history of newly repaired peripheral nerves,
• inflammatory processes,
• cervical spine and upper extremity surgeries,
• conditions affecting lung capacity (such as asthma, bronchitis, and diabetes mellitus)

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Neural Mobilization Group; Each participant underwent 15 treatment sessions (5 days per week for 3 weeks). Further, in the NM group, in addition to conventional treatment, 10 sessions of neural mobilization were performed.	Other: Neural Mobilization; Radial Nerve Mobilization, Medial Mobilization, Ulnar Mobilization
Experimental: Control Group; Each participant underwent 15 treatment sessions (5 days per week for 3 weeks).	Other: Neural Mobilization; Radial Nerve Mobilization, Medial Mobilization, Ulnar Mobilization

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pulmonary function test	PFTs were performed using a spirometer (Schiller SP-260). Spirometric measurements were obtained using a nasal clamp while the patient was in a sitting position. At least three measurements were obtained for each participant, and the best value was considered for the study. In PFT measurements, forced expiratory volume in the 1st second (FEV1), forced vital capacity (FVC), and FEV1/FVC values were compared between the two groups	Change from baseline respiratory function at 3 weeks
Range of Motion (ROM) of the Joint	Participants' ROM of the neck was measured using a universal goniometer at baseline. The measurements for neck flexion, extension, lateral flexion, and rotation were made during active neck movements while the patient was in a seating position. For the measurement of ROM during neck flexion and extension, the goniometer was placed on the acromion, and the ROM was measured by following the midline of the ear. To measure ROM during lateral flexion, the goniometer was placed on the spinous process of the cervical vertebra 7, and the ROM was measured by tracking its movement. For the measurement of ROM during rotation, the goniometer was placed in the center of the head, and the ROM was measured by following the nose. All measurements were reported in degrees.	Change from baseline ROM at 3 weeks
Pain Intensity	Pain intensity was assessed using Visual Analog Scale. A description of the parameter being evaluated was written at either end of a 10-cm horizontal line, with scores ranging from 0 (no pain) to 10 (excruciating pain). The participants were asked to choose the score that best described their pain	Change from baseline pain intensity at 3 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Fremantle Neck Awareness Questionnaire (FreNAQ in Turkish (FreNAQ-T)	FreNAQ-T is a Likert-type questionnaire that assesses individual-specific altered perception (0 = I never felt/never feel this way, 1 = I rarely feel this way, 2 = I sometimes or some of the time feel this way, 3 = I often feel this way, 4 = I always or most of the time feel this way). The questionnaire consists of nine questions, for example, about how they perceive their neck in relation to their body and how they perceive their body position. The total score ranges from 0 to 36. High score indicates a poor prognosis. Onan et al. (2020) developed the Turkish version of the questionnaire and assessed its validity and reliability.	Change from baseline FreNAQ-T at 3 weeks

Collaborators and Investigators

• Sponsor: Okan University
• Investigators: Study Director: Elif Tunç, Msc, Medical Park Gebze Hospital

Study record dates

Study Major Dates

• Study Start (Actual): June 26, 2023
• Primary Completion (Actual): October 27, 2023
• Study Completion (Actual): October 27, 2023

Study Registration Dates

• First Submitted: May 9, 2023
• First Submitted That Met QC Criteria: May 17, 2023
• First Posted (Actual): May 19, 2023

Study Record Updates

• Last Update Posted (Actual): August 1, 2024
• Last Update Submitted That Met QC Criteria: July 30, 2024
• Last Verified: July 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Neck Pain
• Other Study ID Numbers: 009 (Other Identifier: Nahrain Medical Research Collective (NMRC))

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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