Effects of Myokinetic Stretching Technique and Post Facilitation Stretching on Pain, Range of Motion, and Functional Disability in Patients With Cervical Radicular Pain

Cervical radicular pain (CRP) is a musculoskeletal condition characterized by neck pain radiating to the upper limb due to compression or irritation of cervical nerve roots. It significantly affects daily activities, cervical mobility, and overall quality of life. Conventional physical therapy focuses on reducing pain and improving function; however, there is limited evidence comparing the effectiveness of different stretching techniques used in clinical practice.

This randomized controlled trial aims to compare the effectiveness of Myokinetic Stretching Technique (MST) and Post Facilitation Stretching (PFS) on pain intensity, cervical range of motion, and functional disability in patients with cervical radicular pain.

A total of 70 participants with cervical radicular pain (>4 weeks) will be randomly allocated into two groups:

Group A (Myokinetic Stretching Technique Group) - receiving MST along with conventional therapy including hot pack application, cervical isometric exercises, neurodynamic gliding, and continuous cervical traction.

Group B (Post Facilitation Stretching Group) - receiving Post Facilitation Stretching along with the same conventional therapy.

The intervention will be conducted for 4 weeks, with 3 sessions per week on alternate days, each session lasting approximately 45 minutes.

Outcome measures will include:

Pain intensity assessed using the Visual Analogue Scale (VAS) Cervical range of motion measured using a goniometer Functional disability assessed using the Neck Disability Index (NDI)

This study aims to determine the more effective stretching technique for reducing pain, improving cervical mobility, and enhancing functional outcomes, thereby supporting evidence-based physiotherapy practice in managing cervical radicular pain.

Study Overview

• Status: Recruiting
• Conditions: Cervical Radicular Pain
• Intervention / Treatment: Other: Myokinetic Stretching Technique; Other: Post facilitation stretching

Detailed Description

Cervical radicular pain (CRP) is a condition characterized by neck pain radiating to the upper limb due to compression or irritation of cervical nerve roots. It is commonly associated with reduced cervical range of motion, muscle tightness, and functional disability, significantly affecting daily activities and quality of life. Conservative physiotherapy interventions, including stretching techniques, play a key role in managing this condition.

Among commonly used techniques, Myokinetic Stretching Technique(MST) and Post Facilitation Stretching (PFS) are widely applied to improve muscle flexibility, reduce pain, and enhance functional mobility. MST focuses on controlled contraction and gradual stretching to promote neuromuscular relaxation, whereas PFS involves maximal voluntary contraction followed by rapid passive stretching to achieve muscle lengthening. Despite their frequent use in clinical practice, there is limited comparative evidence regarding their effectiveness in patients with cervical radicular pain.

This study is designed as a single-blinded, two-arm parallel randomized controlled trial. A total of 40 participants diagnosed with cervical radicular pain will be recruited using a convenience sampling technique. Participants will be randomly allocated into two groups using computer-generated randomization with a 1:1 allocation ratio. Allocation concealment will be ensured by an independent administrator, and outcome assessment will be performed by a blinded assessor.

Both groups will receive conventional physiotherapy treatment consisting of hot pack application for 10 minutes, cervical isometric exercises (flexion, extension, lateral flexion, and rotation), neurodynamic gliding techniques, and continuous cervical traction.

Participants in Group A will receive Myokinetic Stretching Technique, applied to the cervical musculature with emphasis on trapezius stretching combined with myofascial release techniques. Participants in Group B will receive Post Facilitation Stretching, involving strong voluntary contraction followed by rapid passive stretching of the targeted muscles.

The intervention will be conducted over a period of 4 weeks, with 3 sessions per week on alternate days. Each treatment session will last approximately 45 minutes.

Outcome measures will include pain intensity assessed using the Number Pain Rating scale Scale (NPRS), cervical range of motion measured using a goniometer, and functional disability assessed using the Neck Disability Index (NDI). Assessments will be conducted at baseline and after completion of the intervention.

Data will be analyzed using SPSS software. Normality of data will be assessed using the Shapiro-Wilk test. Appropriate parametric or non-parametric tests will be applied for within-group and between-group comparisons.

This study aims to provide evidence regarding the comparative effectiveness of Myokinetic Stretching Technique and Post Facilitation Stretching in improving pain, cervical mobility, and functional outcomes in patients with cervical radicular pain, thereby supporting evidence-based physiotherapy practice.

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Dr.Tariq Shafi, MSPT; Phone Number: 03454190056; Email: muhammad.tariq@ubas.edu.pk
• Study Contact Backup: Name: Irsa Khan, MSPT; Phone Number: 03096761081; Email: irsakhan096@gmail.com

Study Locations

• Pakistan
  • Lahore, Pakistan
    • Recruiting
    • Hameed Latif
    • Contact: Rehana Niazi, Phd Scholar; Phone Number: 03334734783; Email: rehana.yasmeen@rlmc.edu.pk
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 54000
      • Not yet recruiting
      • Hameed Latif Hospital
      • Contact: Rehana Niazi, MSPT; Phone Number: 03334734783; Email: Doctor_niazi@yahoo.com

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

1. Both male and female gender
2. Age 30 to 60 years with a +ve spurling test and radiating arm pain for more than 4 weeks
3. Unilateral cervical radicular pain
4. +ve upper limb tension test and neck disability index <50%

Exclusion Criteria:

1. History of cervical spinal surgery
2. Severe facet joint osteoarthritis
3. History of fracture in the head and neck region
4. Patient with cognitive dysfunction or mental illness, severe cardiovascular, cerebrovascular, liver, or kidney dysfunction
5. History of dizziness, vertigo, and vomiting
6. Osteoporosis and prolonged use of steroids
7. Cervical myelopathy, tumor, or infectious disease

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: Myokinetic Stretching Technique; Participants in this group will receive Myokinetic Stretching Technique (MST) along with conventional physiotherapy, including hot pack application, cervical isometric exercises, neurodynamic gliding, and continuous cervical traction. The intervention will be conducted for 4 weeks, with 3 sessions per week, each lasting approximately 45 minutes. MST will be applied to the cervical muscles, particularly the trapezius, using controlled stretching and myofascial release techniques.	Other: Myokinetic Stretching Technique; Participants in this group will receive Myokinetic Stretching Technique (MST) along with conventional physiotherapy treatment. The program will be delivered for 4 weeks, with 3 sessions per week on alternate days, each session lasting approximately 45 minutes. Conventional treatment will include hot pack application to the cervical region, cervical isometric exercises (flexion, extension, lateral flexion, and rotation), neurodynamic gliding techniques, and continuous cervical traction. MST will be applied to the cervical musculature, particularly the trapezius muscle. The participant will be positioned in supine, and the therapist will perform controlled lateral flexion stretching followed by myofascial release using sustained pressure (5-10 seconds). The technique will be performed in sets with brief rest intervals to improve muscle flexibility and reduce pain.
Active Comparator: post Facilitation stretching; Participants in this group will receive Post Facilitation Stretching (PFS) along with conventional physiotherapy, including hot pack application, cervical isometric exercises, neurodynamic gliding, and continuous cervical traction. The intervention will be conducted for 4 weeks, with 3 sessions per week, each lasting approximately 45 minutes. PFS will be applied to the cervical muscles, particularly the trapezius, using a sequence of strong voluntary contraction followed by rapid passive stretching to improve muscle flexibility and reduce pain.	Other: Post facilitation stretching; Participants in this group will receive Post Facilitation Stretching (PFS) along with conventional physiotherapy treatment. The program will be conducted for 4 weeks, with 3 sessions per week on alternate days, each session lasting approximately 45 minutes. Conventional treatment will include hot pack application to the cervical region, cervical isometric exercises (flexion, extension, lateral flexion, and rotation), neurodynamic gliding techniques, and continuous cervical traction. PFS will be applied to the cervical musculature, particularly the trapezius muscle. The participant will be positioned in supine, and the therapist will guide the muscle into a neutral position followed by a strong voluntary contraction for approximately 10 seconds. After relaxation, a rapid passive stretch will be applied and held briefly. The procedure will be repeated in sets with short rest intervals to improve muscle extensibility and reduce pain.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Numeric Pain Rating scale	Pain intensity will be assessed using the Numeric Pain Rating Scale. The scale ranges from 0 to 10, where 0 indicates no pain and 10 indicates the worst possible pain. Higher scores indicate greater pain.	Baseline and 4 weeks
Neck Disability Index	Functional disability will be assessed using the Neck Disability Index . The total score ranges from 0 to 50, with higher scores indicating greater disability.	Baseline and 4 weeks
Goniometer	Cervical range of motion will be measured in degrees using a universal goniometer. Higher values indicate greater cervical range of motion.	Baseline and 4 week

Collaborators and Investigators

• Sponsor: Lahore University of Biological and Applied Sciences
• Investigators: Study Chair: Shoaib Waqas, Lahore University of Biological and Applied Sciences

Study record dates

Study Major Dates

• Study Start (Actual): June 29, 2026
• Primary Completion (Estimated): July 30, 2026
• Study Completion (Estimated): September 15, 2026

Study Registration Dates

• First Submitted: July 9, 2026
• First Submitted That Met QC Criteria: July 21, 2026
• First Posted (Actual): July 24, 2026

Study Record Updates

• Last Update Posted (Actual): July 24, 2026
• Last Update Submitted That Met QC Criteria: July 21, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: UBAS/ERB/26/04/011

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: baseline participants

IPD Sharing Time Frame

Start Date: De-identified individual participant data (IPD) along with supporting materials will be made available following publication of the main trial findings, anticipated around 12 months after the study concludes.

End Date: The data will be accessible for a period of 5 years from the commencement date to eligible researchers who provide a formal application and consent to the data use agreement.

IPD Sharing Access Criteria

De-identified individual participant data (IPD) along with supporting documents will be available to qualified researchers for academic and non-commercial use only. To access the data, researchers must submit a written application detailing their study objectives and proposed use of the dataset. All requests will be assessed by the principal investigator Irsa and the institutional ethics committee to ensure ethical compliance and protection of participant privacy.

Data Available:

The shared dataset will include anonymized participant information, such as age and sex.

• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; CSR

Drug and device information, study documents

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