Efficacy of Cervical Stabilization Exercises on Hand Grip Strength in Chronic Myofascial Neck Pain

June 24, 2024 updated by: Fatma Alzahraa Mohamed Ali Ramadan, Cairo University

Efficacy of Cervical Stabilization Exercises on Hand Grip Strength, Pinch Strength, Pain Pressure Threshold in Patients With Chronic Myofascial Neck Pain

The purpose of this study is to examine effect of cervical stabilization exercises on hand grip strength, key pinch strength, pain intensity, pain pressure threshold and hand function in chronic myofascial neck pain patients.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Myofascial pain of the trapezius is considered one of the main causes of neck pain and characterized by deep, intense pain of the skeletal muscles and their fascia and by the presence of one or more MTrPs, Although MTrPs can be formed in any muscle or muscle group, previous studies concluded that the upper trapezius(UT) muscle is the most commonly affected muscle.

Considering the role of synergistic function of the UT muscle in scapula-humeral rhythm during shoulder movement, it is not surprising that MTrPs in UT muscle can result in shoulder dysfunction and disability. Muscle activity of proximal parts is necessary for activation of distal parts. In fact, the stable activity of distal parts needs controlling the proximal parts. Thus, the stability of shoulder girdle is required for activity of distal parts such as fingers, wrists and elbows. In addition, trigger points in the UT can affect grip strength, which depends on shoulder joint and scapular stability. Thus, UT muscle dysfunction can reduce grip strength.

However, little research has been carried out to determine the therapeutic effects of cervical stabilization exercises on chronic neck pain, and up till now, there is a gap in literature to explore efficacy of cervical stabilization exercises on chronic neck pain and hand grip strength. Therefore, this study aims to investigate whether cervical stabilization exercises has an effect on hand grip strength in chronic myofascial neck pain.

Study Type

Interventional

Enrollment (Estimated)

52

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 Contact

Study Locations

  • Egypt
      • Giza, Egypt, 11251
        • Completed
        • Cairo University
      • Giza, Egypt, 11251
        • Recruiting
        • Faculty of Physical Therapy

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

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Chronic neck pain for more than 3 months.
  2. Active MTrPs in the UT muscle with a tender nodule.
  3. Constant neck pain, a jump sign during palpation of UT muscle.
  4. Referred pain.
  5. Symptoms of ipsilateral hand muscles weakness.

Exclusion Criteria:

  1. Signs of severe pathology such as malignancy of the cervical area.
  2. Fractures of the cervical spine.
  3. Cervical radiculopathy or myelopathy.
  4. Diabetes.
  5. Trauma, congenital anomalies and surgery around neck, shoulder and hand.
  6. Fibromyalgia or vascular syndromes such as vertebra-basilar insufficiency.
  7. Pregnancy.

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: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: cervical stabilization exercises and integrated neuromuscular inhibition technique

patients received cervical stabilization exercises and integrated neuromuscular inhibition technique for 3 sessions / week for 4 weeks. Cervical stabilization included chin tucks, isometric holds, ball squeeze.

Integrated neuromuscular inhibition technique included:

  1. ischemic compression: therapist applied an intermittent ischemic compression on upper trapezius trigger point by thumb for 90sec.
  2. Strain counter-strain: therapist applied pressure at trigger point. patient's head was laterally flexed towards the affected side passively by one hand of the therapist. The other hand held the subject's forearm and moved the affected shoulder to 90degree of abduction and external rotation for 90 secs.
  3. Muscle energy technique: patient laterally flexed the neck to opposite side patient was moved the stabilized shoulder and ear towards each other. The contraction was maintained for 10 sec followed by 5 seconds of relaxation. The muscle was stretched for 30 secs.
Procedure: cervical stabilization exercises and integrated neuromuscular technique.

Patients received cervical stabilization exercises and integrated neuromuscular inhibition technique. Cervical stabilization protocol included strengthening exercises of deep cervical flexors muscles which included chin tucks, isometric holds, ball squeeze, as well as deep cervical extensors muscles which included cranio-cervical flexion from neutral, upper cervical rotation and extension of cervical spine.

integrated technique includes ischemic compression, muscle energy technique and strain counter strain.
Active Comparator: Integrated neuromuscular inhibition technique

patients received integrated neuromuscular inhibition technique for 3 sessions / week for 4 weeks.it included Ischemic compression, Strain counter-strain and muscle energy technique.

  1. ischemic compression. therapist applied an intermittent ischemic compression on upper trapezius trigger point by thumb for 90 sec.
  2. Strain counter-strain: therapist applied pressure at trigger point. patient laterally flexed towards the affected side passively by one hand of the therapist. The other hand held the subject's forearm and moved the affected side shoulder passively to 90degree of abduction and external rotation for 90 secs.
  3. Muscle energy technique: patient was asked to laterally flex the neck to opposite side. patient was requested to move the stabilized shoulder and ear towards each other. The contraction was maintained for 10 sec followed by 5 seconds of relaxation. The muscle was stretched for 30 secs.
Procedure: cervical stabilization exercises and integrated neuromuscular technique.

Patients received cervical stabilization exercises and integrated neuromuscular inhibition technique. Cervical stabilization protocol included strengthening exercises of deep cervical flexors muscles which included chin tucks, isometric holds, ball squeeze, as well as deep cervical extensors muscles which included cranio-cervical flexion from neutral, upper cervical rotation and extension of cervical spine.

integrated technique includes ischemic compression, muscle energy technique and strain counter strain.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
primary outcome measure
Time Frame: up to four weeks
hand grip strength was measured by hand held dynamometer.
up to four weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
secondary outcome measures
Time Frame: up to four weeks
pain pressure threshold was measured by pressure algometer.
up to four weeks
secondary outcome measure
Time Frame: up to four weeks
pinch strength was measured by pinch gauge
up to four weeks
secondary outcome measure
Time Frame: up to four weeks
hand function was measured by michigan quesstionaire.The Michigan Hand Outcomes Measure comprises 37 items with rating scale ranging 1 to 5. Every single domain was scored and converted to values that range from 0-100. A high score indicates better results, with the exception of pain in which a high score indicates a more intense pain.
up to four weeks
secondary outcome measure
Time Frame: up to 4 weeks
pain intensity was measured by visual analogue scale.The level of pain on the VAS was recorded on a 10 cm line distinct at one end 'no pain' and marked at the other end 'the worst pain. Subjects were asked to state their pain level by placing a mark on this horizontal line
up to 4 weeks

Collaborators and Investigators

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

Sponsor

Cairo University

Investigators

  • Study Director: soheir sh Rezkallah, PHD, professor of physaical therapy
  • Study Director: Ghada Abd Elmoneim, PHD, assistant professor of physical therapy
  • Study Director: Haidy S Roshdy, PHD, Lecturer of physical therapy

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)

October 1, 2023

Primary Completion (Estimated)

August 1, 2024

Study Completion (Estimated)

August 1, 2024

Study Registration Dates

First Submitted

June 5, 2024

First Submitted That Met QC Criteria

June 16, 2024

First Posted (Actual)

June 21, 2024

Study Record Updates

Last Update Posted (Actual)

June 26, 2024

Last Update Submitted That Met QC Criteria

June 24, 2024

Last Verified

June 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • P.T.REC/012/004710

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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