Effects Of Scapulothoracic Intervention With Or Without Neural Mobilization In Patients With Cervico-Brachialgia

July 21, 2026 updated by: Riphah International University

Effects Of Scapulothoracic Intervention With Or Without Neural Mobilization On Pain, Function, And Neural Mechano-Sensitivity In Patients With Cervico Brachialgia

Cervicobrachialgia is a common musculoskeletal condition characterized by neck pain radiating into the upper limb due to neural and musculoskeletal dysfunctions. It is often associated with pain, functional disability, and increased neural mechanosensitivity, significantly affecting daily activities and quality of life. Various physiotherapy interventions have been used to manage this condition, including neural mobilization and scapulothoracic rehabilitation. However, evidence regarding the combined effectiveness of these interventions remains limited.

Study Overview

Detailed Description

The aim of the study is to determine the effects of scapulothoracic intervention with or without neural mobilization on pain, function, and neural mechanosensitivity in patients with cervicobrachialgia.

Methods: A randomized controlled trial will be conducted on 40 patients diagnosed with cervicobrachialgia. Participants will be randomly allocated into two groups, with 20 participants in each group. Group A received scapulothoracic rehabilitation combined with neural mobilization (ST+NM), while Group B received neural mobilization alone (NM). Treatment will be administered according to the study protocol over the intervention period. Outcome measures includes the Numeric Pain Rating Scale (NPRS) for pain intensity, Neck Pain Questionnaire (NPQ) for neck-related disability, PainDETECT Questionnaire (PDQ) for neuropathic pain symptoms, and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire for upper limb function. Assessments were performed before and after the intervention. Data will be analyzed using paired sample t-tests, independent sample t-tests, Mann-Whitney U tests, and Wilcoxon Signed Rank tests with a significance level of p<0.05.

Study Type

Interventional

Enrollment (Estimated)

44

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

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:

  • Cervicobrachial pain
  • Females and males
  • Aged 30-50 years
  • Able to communicate and follow the instructions
  • Able to perform cervical exercises according to cervicogenic pain

Exclusion Criteria:

  • Negative neurodynamic test
  • Neck and upper extremity surgery
  • Vertebral instability
  • Vertebral spine infection
  • Neurological disease of genetic, infection, or neuroplastic origin
  • Inflammatory or systemic disease
  • VBI symptoms
  • Rheumatoid arthritis
  • Subjects with presence of any fractures.
  • Heart/diabetic patient

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: Scapulothoracic intervention with Neural Mobilization
Group A received Scapulothoracic intervention with Neural Mobilization

Neural Mobilization: Pain-free tension

  1. Scapular Mobilization:

    • Grades III-IV joint mobs (elevation/depression/retraction)
    • 3 sets × 10 reps
  2. Strengthening:

    • Serratus punches (progress to resistance bands)
    • Lower trap raises (prone Y-lifts)
    • 3 sets × 12 reps
  3. Neural Mobilization:

    • ULNT1 sliding technique (6 sec hold/6 sec rest)
Active Comparator: Neural Mobilization
Group B received Neural Mobilization alone.

Neural Mobilization: Pain-free tension

  1. Cervical Isometrics:

    • 4-way neck contractions (5-sec hold)
    • 3 sets × 10 reps
  2. Postural Education:

    • Ergonomics training

  3. Modalities:

    • TENS (80Hz, 100μs) or moist heat pack

  4. Neural Mobilization:

    • ULNT1 (same as Group A)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Visual Analogue Scale (VAS)
Time Frame: upto 6 weeks
The VAS is a common, subjective measurement tool that is used to measure the level of pain severity using an 11-point range with zero (no pain) and ten (heaviest pain imaginable). Patients use a subjective scale to rate their pain verbally and the following scales apply to 1-3 mild, 4-6 moderate, and 7-10 severe pain.
upto 6 weeks
Northwick Park Neck Pain Questionnaire (NPQ)
Time Frame: upto 6 weeks
The NPQ is a 9- questionnaire assessing neck pain disability with each question put on a scale of 0 to 4(code converted to percentage). It examines nocturnal sleep, activities during the day, and social goals. With cervicobrachialgia, it is used to measure functional restrictiveness such as neck/arm pain. Scores: 0-20 percent (light), 21-40 percent (moderate), >40 percent (severe).
upto 6 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
PainDETECT questionnaire (PD-Q)
Time Frame: upto 6 weeks
It is a 9-item instrument that has 7 scored items 0-5, and 2 items of the pain pattern characteristics of neuropathic pain in cervicobrachialgia. score 0-38: <13 (not likely neuropathic), 13-18 (indeterminate), >=19 (probable neuropathic). It assesses the quality of pain (burning, tingling etc.), radiation patterns.
upto 6 weeks
Disability of Arm, Shoulder and Hand (DASH)
Time Frame: upto 6 weeks
The DASH assesses upper limb disability and is a 30 item questionnaire scaled 1-5. The total point (0-100) is counted: [(the sum of the responses/n) -1] x 25. The higher the score and the more they are disabled. The course is minimal clinically significant difference, 10 points. In case of cervicobrachialgia, it examines the impairment of arm functioning.
upto 6 weeks
FABF Questionnaire (FABQ)
Time Frame: upto 6 weeks
FABQ contains 16 items consisting of two subscales namely, physical activity (4 items, 0-24) and work (7 items, 0-42). The more the score, the higher fear-avoidance. In cervicobrachialgia, scores above 14 (work) or 12 (physical activity), predict an unsatisfactory recovery.
upto 6 weeks

Collaborators and Investigators

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

Investigators

  • Principal Investigator: Ramish Safraz, Riphah International 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 (Estimated)

July 1, 2026

Primary Completion (Estimated)

November 30, 2026

Study Completion (Estimated)

December 30, 2026

Study Registration Dates

First Submitted

July 21, 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

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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