Chiropractic Care for Neck Pain: Comparing Diversified Technique and Drop Table Method (CDTDTM)

Comparison of Chiropractic Diversified Technique and Drop Table Application in Patients With Neck Pain

This study aims to compare the effects of two different chiropractic techniques, Diversified and Drop Table, on pain levels, cervical joint range of motion, and neck muscle strength in individuals with non-specific neck pain.

Study Overview

• Status: Not yet recruiting
• Conditions: Spinal Manipulation; Neck Pain; Non Specific Neck Pain; Chiropractic
• Intervention / Treatment: Other: Cervical Spine Manipulation; Other: Drop Table Technique

Detailed Description

This randomized controlled trial aims to compare the effectiveness of two chiropractic techniques - the Diversified Technique and the Drop Table Technique - in individuals with mechanical neck pain. Mechanical neck pain is a common musculoskeletal condition associated with impaired cervical mobility, pain, and reduced quality of life.

Participants will be randomly assigned to one of three arms: (1) Diversified Technique group, (2) Drop Table Technique group, and (3) control group with no intervention. The interventions will be administered twice per week for four weeks by a chiropractor following standardized protocols. All participants will undergo evaluations at baseline and at the end of the 4-week intervention period.

The primary outcome measure is pain intensity and quality, assessed using the full version of the McGill Pain Questionnaire (MPQ), which evaluates sensory, affective, and evaluative components of pain. Secondary outcomes include cervical range of motion (CROM) and isometric neck muscle strength, measured with a goniometer and handheld dynamometer, respectively.

This study seeks to provide evidence on the comparative clinical effectiveness of two widely used chiropractic techniques for neck pain management. The findings may guide clinicians in selecting appropriate manual therapy approaches for patients with non-specific mechanical neck pain.

• Study Type: Interventional
• Enrollment (Estimated): 45
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: SEFA H HATIK, Asst. Prof.; Phone Number: +905058761553; Email: haktanhtk@gmail.com
• Study Contact Backup: Name: OMER D KIZIL, PhD.; Phone Number: +905415233691; Email: omerdiclekizil@gmail.com

Study Locations

• Turkey
  • Sinop, Turkey
    • Sinop University
    • Contact: SEFA H HATIK, Asst. Prof.; Phone Number: 905058761553; Email: haktanhtk@gmail.com
    • Principal Investigator: SEFA H HATIK, Asst. Prof.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Sign a voluntary informed consent form.
• Be between 18 and 65 years of age.
• Have previously consulted an orthopedist or physical therapist for neck pain.
• Have no contraindications to chiropractic interventions.
• Have no history of cervical surgery.
• Report neck pain lasting longer than 7 days.

Exclusion Criteria:

• Are under 18 or over 65 years of age.
• Have experienced cervical trauma within the last month.
• Have any systemic illness.
• Have any contraindication for chiropractic intervention (e.g., brain tumor, cervical fracture).

Study Plan

How is the study designed?

Design Details

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

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control Group; This group did not undergo any interventions.
Experimental: Diversified Group; Participants in this group will receive chiropractic treatment using the Diversified Technique. The intervention will be applied twice per week for 4 weeks by a chiropractor. The treatment will focus on cervical spine adjustments targeting areas of joint dysfunction associated with mechanical neck pain. Each session will last approximately 20 minutes. Standardized protocols will be followed to ensure consistency.	Other: Cervical Spine Manipulation; Cervical spinal manipulation (SM) will be applied with the participant supine to restrictions found on motion palpation, following the technique described by Bergmann and Peterson. The participant's head and neck will be simultaneously rotated and laterally flexed over the contact point-specifically, the posterior supramastoid groove or zygomatic arch (C0-C1), the posterior aspect of the transverse process (C1-C2), or the posterior articular pillar of superior vertebrae (C2-C7)-to the end of passive range of motion (ROM). Subsequently, a high-velocity, low-amplitude thrust will be delivered in the direction of restricted movement. Participants with greater ROM restriction in the lateral plane will receive more laterally-to-medially directed thrusts. Participants with more restriction in rotation will be given thrusts in the direction of restricted axial rotation, and those with more restriction in extension will receive more anteriorly directed thrusts.
Experimental: Drop Table Group; Participants in this group will receive chiropractic treatment using the Drop Table Technique. The intervention will be applied twice per week for 4 weeks by a chiropractor. The treatment will involve high-velocity, low-amplitude thrusts delivered with the assistance of a segmented drop table designed to reduce resistance and enhance precision during spinal adjustments. The focus will be on the cervical spine region related to mechanical neck pain. Each session will last approximately 20 minutes, following standardized protocols to ensure treatment consistency.	Other: Drop Table Technique; The Drop Table Technique is a chiropractic intervention that utilizes a segmented treatment table with adjustable sections that can be elevated slightly and then dropped. During the procedure, a high-velocity, low-amplitude (HVLA) thrust is applied while the specific segment of the table drops slightly in coordination with the thrust. This technique aims to reduce the resistance experienced during the adjustment and to enhance the mechanical effect on targeted spinal joints. In this study, the Drop Table Technique will be specifically applied to the cervical spine to address mechanical neck pain. All applications will be performed by a licensed chiropractor using standardized positioning and adjustment protocols to ensure consistency across sessions.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
McGill Pain Questionnaire (MPQ)	Pain will be assessed using the full version of the McGill Pain Questionnaire (MPQ), which evaluates both the sensory, affective, evaluative, and miscellaneous components of pain. The MPQ includes: A list of 78 pain descriptors grouped into 20 categories, The Pain Rating Index (PRI), derived from the sum of rank values for selected descriptors, A Present Pain Intensity (PPI) score, rated on a scale of 0 (no pain) to 5 (excruciating), A Visual Analog Scale (VAS) for overall pain intensity. The primary outcome will be the change in total PRI and PPI scores from baseline to the end of the 4-week intervention. Measure Type: Ordinal and Continuous (PRI: rank-based score; PPI: 0-5 scale) Unit of Measure: Score (no unit)	Baseline and Week 4

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cervical Range of Motion	Measured in degrees using a goniometer in all planes of cervical motion.	Baseline and 4th week
Isometric Neck Muscle Strength	Isometric neck muscle strength in flexion, extension, and right and left lateral flexion will be manually assessed using a microFET2 handheld dynamometer (Hoggan Health Industries).	Baseline and 4th week

Collaborators and Investigators

• Sponsor: SEFA HAKTAN HATIK
• Investigators: Principal Investigator: SEFA H HATIK, Asst. Prof., Sinop University

Study record dates

Study Major Dates

• Study Start (Estimated): June 14, 2025
• Primary Completion (Estimated): July 14, 2025
• Study Completion (Estimated): August 14, 2025

Study Registration Dates

• First Submitted: June 13, 2025
• First Submitted That Met QC Criteria: June 13, 2025
• First Posted (Actual): June 24, 2025

Study Record Updates

• Last Update Posted (Actual): June 24, 2025
• Last Update Submitted That Met QC Criteria: June 13, 2025
• Last Verified: June 1, 2025

More Information

Terms related to this study

• Keywords: Neck pain; Chiropractic; Spinal Manipulation; Drop Table
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Neck Pain
• Other Study ID Numbers: CMT0007

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