Comparison of Eccentric Muscle Training and Proprioceptive Neuromuscular Facilitation Techniques in Neck Pain

August 11, 2026 updated by: Doç.Dr.Ömer Şevgin, Uskudar University

Comparison of Eccentric Muscle Training and Proprioceptive Neuromuscular Facilitation Techniques in Individuals With Non-specific Neck Pain

This trial compared eccentric exercise training and the proprioceptive neuromuscular facilitation (PNF) technique, each added to a common cervical stretching and stabilisation programme, in individuals with non-specific neck pain. Outcomes were neck-related disability, multidimensional pain, cervical range of motion, deep cervical flexor endurance, kinesiophobia and health-related quality of life, assessed at baseline and after 6 weeks.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The study was planned as a quantitative study. Volunteer individuals with nonspecific neck pain between the ages of 18-65 will be included in the study, and the participants will be randomly distributed into 3 groups. Control group (n=15), proprioceptive neuromuscular facilitation technique application group (n=15), eccentric muscle training technique application group (n=15). People included in the study will be explained in detail and will be asked to sign a voluntary consent form approved by the ethics committee. Demographic information of individuals in all three groups will be recorded first. Participants in all three groups will be evaluated at the beginning and end of the applications. In our study, participants were evaluated with the McGill Pain Questionnaire to evaluate the character and character of pain, their physical fitness with the Deep Neck Flexor Endurance Test, their functionality related to daily living activities with the Neck Disability Index (NDI, and their quality of life with the World Health Organization Short Form of Quality of Life (WHOQOL-BREF) Tampa Kinesiophobia Scale and a goniometer for Cervical Region Joint Range of Motion Measurement will be used to evaluate kinesiophobia, which is the fear of pain and re-injury, as well as anxiety towards activity and physical movement. This study will be planned five times a week for six weeks. Stretching and stabilization exercises will be applied to the control group in 3 sets of 10 repetitions.

Study Type

Interventional

Enrollment (Actual)

45

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

INCLUSION CRITERIA

  • Being between the ages of 18-65
  • Deep cervical flexor endurance time of less than 60 seconds on the modified craniocervical flexor endurance test at screening. Candidates able to hold the test position for 60 seconds or longer were considered to have sufficient deep cervical flexor endurance and were not enrolled.
  • History of neck pain that has persisted for at least 7 days
  • Agreeing to participate in the study
  • Having the ability to read and write Turkish. EXCLUSION CRITERIA
  • Radiculopathy and structural disorder in the cervical region,
  • Surgery to the cervical region,
  • Inflammatory disease,
  • Severe psychological illness,
  • Presence of infection in the bone and soft tissue in the cervical spine,
  • Malignancy,
  • Advanced osteoporosis,
  • Those with upper extremity pathologies,
  • Having a neurological disease that will prevent treatment
  • Having previously undergone cervical region and spine surgery
  • Having been included in a physiotherapy program for the neck and back area in the last 6 months,
  • It was defined as the administration of drugs such as NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) and opioids in the last 24 hours.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: proprioceptive
proprioceptive neuromuscular facilitation technique application
Other: proprioceptive neuromuscular facilitation technique group
Proprioceptive Neuromuscular Facilitation Technique group; In addition to the exercises applied to the participants and the control group, combined isotonic contractions and dynamic stabilization will be used as facilitation techniques, and hold-relax technique will be used as an inhibition technique.
Experimental: eccentric
eccentric muscle training technique application
Other: eccentric muscle training technique application group
Eccentric Muscle Training Technique: Participants will receive eccentric muscle training in addition to the exercises given to the control group. Before the application, 5-minute warm-up exercises will be given to the neck area. Eccentric muscle training will be applied to the muscles of the participants in the cervical region. Eccentric exercise will be strengthened in the cervical region muscles in the direction of movement in each plane, that is, flexion / extension and lateral flexion. The movements will first be explained and demonstrated to the patient.
Active Comparator: Control
Participants performed a cervical stretching and stabilisation exercise programme only, without any additional technique.
Other: Control
Cervical stretching and stabilisation exercise programme. Stretching was applied in flexion, extension, rotation and lateral flexion (30-second hold, 10 repetitions). Stabilisation exercises were performed with the participant applying self-resistance from a seated position (10-second contraction, 15-second rest). Both components were performed in 3 sets of 10 repetitions with 1-minute rest between sets, in 45-minute sessions, 5 days per week for 6 weeks. This programme was also delivered as the base programme to both experimental groups.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Cervical Deep Flexor Muscle Endurance Test
Time Frame: Baseline (before the first session) and 6 weeks (immediately after the final session of the intervention period). No further follow-up.
Patients were asked to lie in a supine position with knees flexed at 90° and hands on the abdomen in a hook position. A 0.5 kilogram (kg) weight was placed on the forehead with the help of a band passed over the ears. The patients were asked to first perform cervical retraction and then 10° cervical flexion, and the degree of flexion was determined with the help of a goniometer. The patients were asked to maintain this position and the time was determined with a stopwatch and recorded in seconds. Patients must be able to maintain this position for 60 seconds (sec) in order to have sufficient muscle endurance. Those below this period have insufficient muscle endurance. Cervical flexion for 60 seconds. Patients holding it above were considered to have sufficient endurance and were not included in the study.
Baseline (before the first session) and 6 weeks (immediately after the final session of the intervention period). No further follow-up.
World Health Organization Quality of Life Survey Short Form
Time Frame: Baseline (before the first session) and 6 weeks (immediately after the final session of the intervention period). No further follow-up.
The scale measures 28 general health, physical, psychological, social and environmental well-being and consists of 26 questions. Turkey version consists of 27 questions. The 27th question is the national question that determines the Environmental Score. Since each domain expresses the quality of life in its own field independently of each other, domain scores are calculated between 4-20. As the score increases, the quality of life increases.
Baseline (before the first session) and 6 weeks (immediately after the final session of the intervention period). No further follow-up.
Neck Disability Index
Time Frame: Baseline (before the first session) and 6 weeks (immediately after the final session of the intervention period). No further follow-up.
Neck Disability Index will be used to evaluate the disability specific to neck pain. The Neck Disability Index has been modified from the Oswestry Disability Index. It consists of 10 sections: pain intensity, personal care, weight bearing, reading, headache, concentration, working, driving, sleep and recreational activities. Each section consists of 6 answers and is scored from 0, no disability, to 5, representing total disability. According to total score; 0-4: no limitation, 5-14: mild limitation, 15-24: moderate limitation, 25-34: severe limitation, 34 and above: completely limited.
Baseline (before the first session) and 6 weeks (immediately after the final session of the intervention period). No further follow-up.
Tampa Kinesiophobia Scale
Time Frame: Baseline (before the first session) and 6 weeks (immediately after the final session of the intervention period). No further follow-up.
Tampa Kinesiophobia Scale was used to evaluate kinesiophobia, which is a state of anxiety that develops against activity and physical movement due to fear of pain and re-injury. It was developed to differentiate between non-excessive fear and phobia in patients with chronic musculoskeletal pain. It is frequently used in the literature to evaluate movement-related fear and anxiety. The scale is a 17-item scale that includes parameters of injury, re-injury and fear-avoidance in work-related activities. As the score increases, it is accepted that the kinesiophobia of the individual with pain increases.Results consist of a total raw score (range between 17 and 68) A low score indicates low kinesiophobia.
Baseline (before the first session) and 6 weeks (immediately after the final session of the intervention period). No further follow-up.
Cervical joint goniometric measurements
Time Frame: Baseline (before the first session) and 6 weeks (immediately after the final session of the intervention period). No further follow-up.
Goniometric measurements in the neck are methods used to evaluate and record neck joint range of motion. These measurements are important to evaluate the patient's condition during the treatment process, follow the progress and create the treatment plan.
Baseline (before the first session) and 6 weeks (immediately after the final session of the intervention period). No further follow-up.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
McGill Pain Questionnaire (long form)
Time Frame: Baseline (before the first session) and 6 weeks (immediately after the final session of the intervention period).
The long-form McGill Pain Questionnaire was used to characterise the multidimensional quality of pain, including pain localisation, the sensory, affective and evaluative word-descriptor dimensions, the number of words chosen, the pain-time relationship, and present pain intensity. Higher scores indicate greater pain.
Baseline (before the first session) and 6 weeks (immediately after the final session of the intervention period).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Uskudar University

Investigators

  • Study Chair: Büşra SÖKMEN YILDIRIM, Uskudar University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 9, 2024

Primary Completion (Actual)

July 30, 2024

Study Completion (Actual)

January 10, 2025

Study Registration Dates

First Submitted

May 6, 2024

First Submitted That Met QC Criteria

May 6, 2024

First Posted (Actual)

May 9, 2024

Study Record Updates

Last Update Posted (Actual)

August 14, 2026

Last Update Submitted That Met QC Criteria

August 11, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Uskudar4

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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