Physiotherapy for Non-specific Neck Pain in Working Age Persons

Comparative Effect of Post Isometric Relaxation and Self-stretching on Non-specific Neck Pain in Working Age Persons

The goal of this clinical trial is to learn about the effects of two different physiotherapy methods on non-specific neck pain in working age individuals. The main questions it aims to answer are:

• What is the effect of self stretching exercise on non-specific neck pain, functional disability, range of motion of the cervical spine and hand muscle strength in working age individuals?
• What is the effect of post-isometric relaxation exercise on non-specific neck pain, functional disability, range of motion of the cervical spine and hand muscle strength in working age individuals?
• Is any of the applied interventions (self-stretching or post-isometric relaxation exercise) superior to each other?

Participants will:

• be evaluated by an experienced physiotherapist who will perform the interview and physical examination. Interview includes questions about the age, sex, work profile, pain intensity and duration, and other complaints. Physiotherapy examination includes a range of motion measurement, hand grip muscle strength and functional disability index evaluation.
• Two different interventions will be prescribed to the randomly assigned study participants: post-isometric relaxation and self-stretching. Duration of interventions for both groups is 4 weeks (3 times per week, 12 sessions). Duration of one session - 45 min.

Study Overview

• Status: Completed
• Conditions: Neck Pain; Non-specific Neck Pain
• Intervention / Treatment: Other: Self-stretching exercise group; Other: Post-isometric relaxation exercise group

Detailed Description

The goal of this clinical trial is to learn about the effects of two different physiotherapy methods on non-specific neck pain in working age individuals. The main questions it aims to answer are:

What is the effect of self stretching exercise on non-specific neck pain, functional disability, range of motion of the cervical spine and hand muscle strength in working age individuals? What is the effect of post-isometric relaxation exercise on non-specific neck pain, functional disability, range of motion of the cervical spine and hand muscle strength in working age individuals? Is any of the applied interventions (self-stretching or post-isometric relaxation exercise) superior to each other?

Participants will:

be evaluated by an experienced physiotherapist who will perform the interview and physical examination. Interview includes questions about the age, sex, work profile, pain intensity and duration, and other complaints. Physiotherapy examination includes a range of motion measurement, hand grip muscle strength and functional disability index evaluation.

Two different interventions will be prescribed to the randomly assigned study participants: post-isometric relaxation and self-stretching. Duration of interventions for both groups is 4 weeks (3 times per week, 12 sessions). Duration of one session - 45 min.

• Study Type: Interventional
• Enrollment (Actual): 50
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Lithuania
  • Kaunas, Lithuania
    • Lithuanian Sports University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• current neck pain,
• neck pain duration for at least 12 weeks,
• admission through outpatient clinic in Lithuania.

Exclusion Criteria:

• neurological disorders related to neck pain,
• red flags (night pain, severe muscle spasm, loss of involuntary weight, symptom mismatch),
• previous neck surgery,
• low back pain,
• medications used for pain.

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: Self-stretching exercise group; Static neck muscle self-stretching exercises were performed for 30 min. after the TENS procedure. Every muscle in the neck region (head rotator cuff, neck stair muscles, upper part of the trapezius muscle, scapula levator muscle, semiscapular neck muscle, upper oblique head muscle, girdle head and neck muscles, and deep anterior neck flexor muscles) were stretched 3 times for 30 seconds per muscle group. While performing exercises, the subjects applied resistance with their hands. All exercises were performed without causing pain.	Other: Self-stretching exercise group; Static neck muscle self-stretching exercises were performed for 30 min. after the TENS procedure. Every muscle in the neck region (head rotator cuff, neck stair muscles, upper part of the trapezius muscle, scapula levator muscle, semiscapular neck muscle, upper oblique head muscle, girdle head and neck muscles, and deep anterior neck flexor muscles) were stretched 3 times for 30 seconds per muscle group. While performing exercises, the subjects applied resistance with their hands. All exercises were performed without causing pain.
Experimental: Post-isometric relaxation exercise group; The investigators used one of the autogenic inhibition techniques - post-isometric relaxation (PIR), known as the muscle "contraction-relaxation" technique, during which, the subject is lying on his back, he is asked to press his head in the specified direction (50% of the subject's maximum pressure force). to the resistance provided by the therapist. During the press, resistance was provided for 10 seconds and followed by a passive stretch of the muscle in the opposite direction of movement. A total of 5 repetitions are performed for each muscle with a 5-second break. All movements are performed without causing pain of more than moderate intensity.	Other: Post-isometric relaxation exercise group; The investigators used one of the autogenic inhibition techniques - post-isometric relaxation (PIR), known as the muscle "contraction-relaxation" technique, during which, the subject is lying on his back, he is asked to press his head in the specified direction (50% of the subject's maximum pressure force). to the resistance provided by the therapist. During the press, resistance was provided for 10 seconds and followed by a passive stretch of the muscle in the opposite direction of movement. A total of 5 repetitions are performed for each muscle with a 5-second break. All movements are performed without causing pain of more than moderate intensity.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain intensity	Neck pain intensity was assessed using a visual analogue scale (VAS) on a 10-cm line with end-point descriptors such as 'no pain' marked at the left end and 'worst pain imaginable' marked at the right end. Patients were asked to mark a point on the line that best represented their pain at the time of the evaluation. The distance from 'no pain' to the patient's mark was then measured and recorded as the VAS score: 0 cm was defined as no pain, 1-3 cm as mild pain, 4 or 5 cm as moderate pain, 6-8 cm as severe pain and 9 or 10 cm as the worst pain imaginable.	Change from Baseline Quality of Life at 4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cervical spine range of motion	ROM was measured using bubble inclinometer, which was placed on the top of the patient's head, along the sagittal plane to measure neck flexion and extension, when the patient was in sitting position. Side bending was measured from the same starting position just as the inclinometer was placed in the frontal plane on the top of the patient's head. Rotations to the left and right were taken from the supine position with an inclinometer placed on the forehead. The inclinometer's reading at the starting position was 0. The readings of ROM were taken when the end point of movement was reached. In our study, three repetitions were performed in each direction, and the average value was taken for analysis.	Change from Baseline Quality of Life at 4 weeks
Hand grip strength	Hand grip strength was measured using a hand dynamometer (Saehan SH5001, Germany). Grip strength of the dominant and non-dominant hand was measured when seated with the shoulder neutrally rotated and adducted, the elbow flexed at 90°, and the wrist and forearm in a neutral position. The maximum grip strength was measured in kilograms (kg). Three measurements were taken with 60 s rest between each trial and the average result was recorded.	Change from Baseline Quality of Life at 4 weeks
The Neck Disability Index	The Neck Disability Index (NDI) questionnaire consists of 10 items. Each item on the scale is scored from 0 to 5, where all the scores are added to total points and interpreted as percentages i.e., 0 point or 0% means no activity limitation, and 50 points or 100% means complete activity limitation. The NDI is a reliable and valid questionnaire in neck pain patients with intraclass correlation ranges between 0.50-0.98. Patients scored between 0-4 points (0-8%) are considered with no disability, between 5-14 points (10-28%) with mild disability, 15-24 points (30-48%) - moderate disability, 25-34 points (50- 64%) - severe disability, and 35-50 points (70-100%) - complete disability	Change from Baseline Quality of Life at 4 weeks

Collaborators and Investigators

• Sponsor: Lithuanian Sports University
• Investigators: Principal Investigator: Vilma Dudoniene, Lithuanian Sports University

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2023
• Primary Completion (Actual): November 30, 2023
• Study Completion (Actual): December 15, 2023

Study Registration Dates

• First Submitted: December 28, 2023
• First Submitted That Met QC Criteria: December 28, 2023
• First Posted (Actual): January 10, 2024

Study Record Updates

• Last Update Posted (Actual): January 12, 2024
• Last Update Submitted That Met QC Criteria: January 10, 2024
• Last Verified: January 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Neck Pain
• Other Study ID Numbers: LithuanianSportsU-19

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