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Integrated Neuromuscular Inhibition Technique Versus Instrument-Assisted Soft Tissue Mobilization On Neck Disability, Endurance, and Proprioception Of Nonspecific Chronic Neck Pain (CNP)

14. maj 2026 opdateret af: Nabil Mahmoud Ismail Abdel-Aal, Cairo University
this study will be conducted to compare INIT versus IASTM on neck disability, cervical muscle endurance and proprioception, cervical alignment, pain intensity, pressure pain threshold in patients with neck pain

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Neck pain arises from a variety of factors, which may include ergonomic considerations and individual characteristics such as age, behavioral attitudes, or psychosocial issues like anxiety and job satisfaction. Since most cases of neck pain do not have a specific identifiable cause and are often linked to posture or mechanical issues, they are typically classified as nonspecific chronic neck pain. The primary goals of treating neck pain and MTrPs are to resolve the spasm, ease the pain, and deactivate the TrPs. One of these methods is the integrated neuromuscular inhibition technique (INIT). Instrument-assisted soft tissue mobilization (IASTM) with the M2T blade (M2T-Blade: IASTM Technology, Hamilton, ON, Canada) is a multifunctional instrument. Instrument-assisted soft tissue mobilization is inexpensive and has a variety of planes that can be used in treatment. Many studies have demonstrated its effectiveness in alleviating patients' symptoms.According to the literature, IASTM and INIT were effective as well as nonexhaustive treatment methods for patients experiencing mechanical neck pain. But there was a lack of literature that compared IASTM and INIT on neck disability, endurance, and proprioception on patients with neck pain.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

60

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

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Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • All participants ages will range from 18 to 50 years.
  • BMI ranged from 18.5 to 30.
  • have TrPs in their UT muscle, pain at rest, a jump sign when pressure is applied, limited range of motion (ROM), and referred pain.
  • The participants will report pain in the posterior or posterior lateral aspect of the neck in the previous 3 months

Exclusion Criteria:

  • Participants of cervical spine disorders (cervical disc disease, cervical spondylitis, cervical myelopathy.
  • Participants with musculoskeletal conditions.
  • Pregnant women.
  • Participants with congenital postural deformities.
  • Participants who had a definite visual disability.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Integrated Neuromuscular Inhibition Technique
twenty patients will receive the integrated neuromuscular inhibition technique plus traditional therapy three times a week for four weeks
Andet: Integrated Neuromuscular Inhibition Technique
For the integrated neuromuscular inhibition technique, the participant will be in a supine lying position. During the PPT evaluation process, the site of the TrP will be determined and will be marked. First, intermittent IC will be initiated by using the thumb and index finger to apply a pincer grip to the TrP in the middle of the UT. Second, applying pressure to the trigger point and asking the participants how much pain they will experience. The participants' heads will passively flexed laterally to the affected side. The therapist then will hold the participant's forearm and passively will move the shoulder to about 90° of abduction while monitoring the discomfort induced by the TrP, and then will ask the patient about the intensity of pain. If the pain will decrease by 70% from the start, the position will be held for 30 seconds and repeated 2 to 3 times. Then muscle energy technique is applied plus tradional therapy.
Andet: tradional therapy
the patients will receive tradional therapy in the form of 10 minutes of moist heat (hot pack) isometric strengthening exercises for all cervical muscles by applying manual resistance on the side of the head for side bending, the occiput for extension, and the forehead for flexion.The resistance will be sustained for 10 seconds and repeated 10 to 15 times, then they will receive stretching exercises for extensor muscles for 30 seconds and repeated 3 times in every session. Finally, active ROM exercises for the neck and chin will be performed
Eksperimentel: Instrument-Assisted Soft Tissue Mobilization
twenty patients will receive instrument-assisted soft tissue mobilization plus traditional therapy three times a week for four weeks
Andet: tradional therapy
the patients will receive tradional therapy in the form of 10 minutes of moist heat (hot pack) isometric strengthening exercises for all cervical muscles by applying manual resistance on the side of the head for side bending, the occiput for extension, and the forehead for flexion.The resistance will be sustained for 10 seconds and repeated 10 to 15 times, then they will receive stretching exercises for extensor muscles for 30 seconds and repeated 3 times in every session. Finally, active ROM exercises for the neck and chin will be performed
Andet: Instrument-Assisted Soft Tissue Mobilization
For IASTM, the M2T blade will be used to identify specific parts of the limitation on the right UT. After that, treatment planes 1-2-3 will be used. Prior to treatment, Vaseline will be applied as a lubricant to the skin around the neck area, and an alcohol pad will be used to clean the instrument. Then, using an M2T blade at a 45° angle, long, slow strokes over the muscle will be performed, beginning at its insertion and ending at its origin, for 2 to 3 minutes . If the participant felt a burning sensation, it will be instructed to apply an ice pack plus tradional therapy.
Aktiv komparator: traditional therapy
twenty patients will receive traditional therapy three times a week for four weeks
Andet: tradional therapy
the patients will receive tradional therapy in the form of 10 minutes of moist heat (hot pack) isometric strengthening exercises for all cervical muscles by applying manual resistance on the side of the head for side bending, the occiput for extension, and the forehead for flexion.The resistance will be sustained for 10 seconds and repeated 10 to 15 times, then they will receive stretching exercises for extensor muscles for 30 seconds and repeated 3 times in every session. Finally, active ROM exercises for the neck and chin will be performed

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
neck disability
Tidsramme: up to four weeks
The arabic version of Neck Disability Index (NDI) will be used. it is a 10-item, self-administered questionnaire measuring neck pain-related disability, with scores ranging from 0-50 or 0-100%. Higher scores indicate greater disability.
up to four weeks

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
pain intensity
Tidsramme: up to four weeks
visual analogue scale will be used to assess pain intensity. The most simple VAS is a straight horizontal line of fixed length, usually 100 mm. The ends are defined as the extreme limits of the parameter to be measured (symptom , pain ,health) orientated from the left (worst) to the right (best).
up to four weeks
cervical range of motion
Tidsramme: up to four weeks
cervical range of motion device will be used to assess cervical range of motion
up to four weeks
joint position error (cervical proprioception)
Tidsramme: up to four weeks
Proprioception is the ability to sense the position and movement of our body without visual feedback. The cervical spine works as a sensory system that relies heavily on mechanoreceptors, like muscle spindles, that detect mechanical changes within tissue. cervical proprioception will be measured by cervical range of motion device.
up to four weeks
pressure pain threshold
Tidsramme: up to four weeks
pressure algometer device will be used to assess pressure pain threshold
up to four weeks
The Absolute Rotation Angle (ARA) C2-C7
Tidsramme: up to four weeks
The Absolute Rotation Angle (ARA) C2-C7 is a key measurement of sagittal cervical lordosis on standing lateral radiographs, typically calculated as the angle between the inferior endplates of C2 and C7. A normal range often falls between 10° and 35°. C2-C7 Cobb angle (measured differently, from C2 inferior endplate to C7 inferior endplate). Kinovea software will be used to assess ARA.
up to four weeks
The relative rotation angle between the occiput (C0) and C2
Tidsramme: up to four weeks
The relative rotation angle between the occiput (C0) and C2 is a critical metric for evaluating upper cervical spine mobility and stability. In healthy individuals, the average O-C2 angle (often reported as the O-C2 angle or OC2A) is approximately 14.5° ± 3.7°. this angle will be measured by Kinovea software.
up to four weeks
relative rotatory angle between c1 and c2
Tidsramme: up to four weeks
This angle between the axis and the atlas. The normal range is 29 degree. this angle will be measured by kinovea softwear.
up to four weeks
Anterior head translation (AHT) distance
Tidsramme: up to four weeks
Anterior head translation (AHT), or forward head posture, is typically measured as the horizontal distance between the vertical line of the C7 spinous process and the posterior superior corner of the C2 vertebra (or tragus of the ear). A normal head position generally shows an anterior displacement of less than 15 mm, while values exceeding this are classified as forward head posture.this disatance will be measured by kinovea softwear.
up to four weeks
deep cervical flexor endurance
Tidsramme: up to four weeks
cranio cervical flexion test with pressure biofeedback will be used to assess deep cervical flexor endurance.During the CCF test, the pressure biofeedback instrument was placed under the neutral cervical spine below the occiput and inflated up to 20 mmHg. CCF (gentle head nodding of head as if saying "yes") movements were demonstrated during the test. Substitution with superficial neck flexors, head retraction. The subjects performed this movement at 5 different pressure levels, i.e., 22, 24, 26, 28, and 30 mmHg, with 30 s rest between each repetition. Each level was supposed to be held for 10 s, and the test was terminated if they were unable to hold the position for 10 s at any level or if the maximum level was achieved (30 mmHg). This value was used to create an index to score the muscle endurance out of a total of 100, and the minimum requirement for satisfactory endurance was 26 mmHg
up to four weeks

Samarbejdspartnere og efterforskere

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Sponsor

Cairo University

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

25. maj 2026

Primær færdiggørelse (Anslået)

25. maj 2027

Studieafslutning (Anslået)

25. maj 2027

Datoer for studieregistrering

Først indsendt

14. maj 2026

Først indsendt, der opfyldte QC-kriterier

14. maj 2026

Først opslået (Faktiske)

20. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

20. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

14. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • P.T.REC/012/006464

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