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Effects of the Timing of Vagus Nerve Stimulation Combined With Exercise in Chronic Neck Pain

2026년 8월 12일 업데이트: Ismail Saracoglu, Kutahya Health Sciences University

Does Timing Matter? Effects of Transcutaneous Auricular Vagus Nerve Stimulation Before and After Exercise in Chronic Neck Pain: A Randomized Controlled Trial

This randomized controlled trial aims to investigate whether the timing of transcutaneous auricular vagus nerve stimulation (taVNS) relative to exercise influences clinical and autonomic outcomes in individuals with chronic neck pain.

Participants will be randomly allocated to one of three groups: taVNS applied before exercise, taVNS applied after exercise, or exercise alone. All groups will receive a standardized exercise program designed for chronic neck pain. The intervention will be conducted over a 6- to 8-week period.

The effects of the interventions will be evaluated using pain intensity, neck-related disability, sleep quality, heart rate variability, and exercise adherence. The study will determine whether applying taVNS before or after exercise provides additional benefits compared with exercise alone and whether the timing of stimulation influences treatment outcomes.

연구 개요

상태

아직 모집하지 않음

정황

개입 / 치료

상세 설명

Chronic neck pain is a common musculoskeletal condition associated with pain, functional limitations, sleep disturbances, and alterations in autonomic nervous system activity. Exercise therapy is one of the main conservative treatment approaches for chronic neck pain. Transcutaneous auricular vagus nerve stimulation (taVNS) is a non-invasive neuromodulation method that aims to stimulate the auricular branch of the vagus nerve and may influence parasympathetic activity and pain modulation.

The purpose of this randomized controlled trial is to investigate whether the timing of taVNS relative to exercise influences clinical and physiological outcomes in individuals with chronic neck pain.

A total of 81 participants with chronic neck pain will be randomly allocated to three parallel groups. Participants in the first group will receive taVNS before performing a standardized exercise program. Participants in the second group will perform the same exercise program followed by taVNS. Participants in the control group will receive the exercise program alone.

The exercise program will include postural correction exercises, deep cervical flexor activation exercises, cervical mobility exercises, scapular stabilization exercises, and stretching exercises. The intervention period will last approximately 6-8 weeks.

Participants will be evaluated before and after the intervention period. Pain intensity will be assessed using the Numeric Pain Rating Scale, neck-related disability using the Neck Disability Index, sleep quality using the Pittsburgh Sleep Quality Index, and autonomic nervous system activity using heart rate variability, particularly the root mean square of successive differences (RMSSD). Exercise adherence and session attendance will also be recorded.

The study will compare changes in these outcomes among the three groups to determine whether the timing of taVNS relative to exercise influences the effectiveness of rehabilitation in individuals with chronic neck pain.

연구 유형

중재적

등록 (추정된)

81

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

연구 장소

    • Türkiye
      • Kütahya, Türkiye, 터키 (Türkiye), 43100
        • Kutahya Health Sciences University Physical Therapy and Rehabilitation Research Center
        • 부수사관:
          • Merve Akdeniz LEBLEBİCİER, MD
        • 연락하다:
        • 수석 연구원:
          • Batuhan YUKSEL, Msc.

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 성인
  • 고령자

건강한 자원 봉사자를 받아들입니다

아니

설명

Inclusion Criteria:

  • Diagnosis of chronic neck pain confirmed by a physical medicine and rehabilitation physician.
  • Age between 18 and 65 years.
  • Neck pain persisting or recurring for at least 3 months.
  • Ability to participate in the exercise program included in the study protocol.
  • No contraindication to transcutaneous auricular vagus nerve stimulation.
  • Willingness to provide written informed consent.
  • Willingness to participate regularly in the planned exercise and assessment sessions.

Exclusion Criteria:

  • Cervical radiculopathy or specific neurological findings.
  • Previous cervical spine surgery.
  • Serious cardiovascular disease.
  • Serious neurological or systemic disease.
  • Pregnancy.
  • Orthopedic or musculoskeletal conditions preventing participation in exercise.
  • Cognitive or communication problems that prevent completion of the assessment instruments.
  • Inability or unwillingness to comply with the study protocol or attend scheduled sessions.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 더블

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: taVNS Before Exercise
Participants will receive transcutaneous auricular vagus nerve stimulation before performing the standardized exercise program.
Transcutaneous auricular vagus nerve stimulation will be delivered non-invasively through an auricular stimulation device targeting the auricular branch of the vagus nerve. Stimulation will be administered under researcher supervision using standardized stimulation parameters according to the device instructions and study protocol.
Participants will perform a standardized exercise program for chronic neck pain including postural correction, deep cervical flexor activation, cervical mobility, scapular stabilization, and stretching exercises. Exercises will be performed under researcher supervision during the intervention period.
실험적: taVNS After Exercise
Participants will first perform the standardized exercise program and will subsequently receive transcutaneous auricular vagus nerve stimulation.
Transcutaneous auricular vagus nerve stimulation will be delivered non-invasively through an auricular stimulation device targeting the auricular branch of the vagus nerve. Stimulation will be administered under researcher supervision using standardized stimulation parameters according to the device instructions and study protocol.
Participants will perform a standardized exercise program for chronic neck pain including postural correction, deep cervical flexor activation, cervical mobility, scapular stabilization, and stretching exercises. Exercises will be performed under researcher supervision during the intervention period.
활성 비교기: Exercise only
Participants will receive the standardized exercise program without transcutaneous auricular vagus nerve stimulation.
Participants will perform a standardized exercise program for chronic neck pain including postural correction, deep cervical flexor activation, cervical mobility, scapular stabilization, and stretching exercises. Exercises will be performed under researcher supervision during the intervention period.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Change in Pain Intensity - Numeric Pain Rating Scale
기간: Baseline and immediately after completion of the 6 week interventions
Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS). Participants will rate their neck pain on an 11-point scale ranging from 0 to 10, where 0 indicates "no pain" and 10 indicates "worst imaginable pain." Higher scores indicate greater pain intensity. Change from baseline will be compared between groups.
Baseline and immediately after completion of the 6 week interventions
Change in Neck-Related Disability - Neck Disability Index
기간: Baseline and immediately after completion of the 6 weeks interventions.
Neck-related disability will be assessed using the Neck Disability Index (NDI). The questionnaire consists of 10 sections scored from 0 to 5, producing a total score ranging from 0 to 50. Higher scores indicate greater neck-related disability.
Baseline and immediately after completion of the 6 weeks interventions.
Change in Sleep Quality - Pittsburgh Sleep Quality Index
기간: Baseline and immediately after completion of the 6 weeks intervention.
Sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI). The PSQI evaluates seven components of sleep and provides a global score ranging from 0 to 21. Higher scores indicate poorer sleep quality.
Baseline and immediately after completion of the 6 weeks intervention.

2차 결과 측정

결과 측정
측정값 설명
기간
Exercise Adherence
기간: Throughout the 6-8-week intervention period.
Exercise adherence will be assessed based on participant attendance at scheduled treatment sessions. Adherence will be expressed as the number and/or percentage of completed sessions relative to the total number of planned sessions.
Throughout the 6-8-week intervention period.
Change in Heart Rate Variability - RMSSD
기간: Baseline and immediately after completion of the 6 weeks intervention.
Autonomic nervous system activity will be assessed using heart rate variability. The root mean square of successive differences between normal heartbeats (RMSSD), expressed in milliseconds, will be used as the primary heart rate variability parameter. Higher RMSSD values generally represent greater parasympathetic/vagal activity.
Baseline and immediately after completion of the 6 weeks intervention.

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (추정된)

2026년 9월 14일

기본 완료 (추정된)

2027년 6월 30일

연구 완료 (추정된)

2027년 9월 15일

연구 등록 날짜

최초 제출

2026년 8월 12일

QC 기준을 충족하는 최초 제출

2026년 8월 12일

처음 게시됨 (실제)

2026년 8월 17일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 8월 17일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 8월 12일

마지막으로 확인됨

2026년 8월 1일

추가 정보

이 연구와 관련된 용어

기타 연구 ID 번호

  • BatuPHD

개별 참가자 데이터(IPD) 계획

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아니요

약물 및 장치 정보, 연구 문서

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아니

미국 FDA 규제 기기 제품 연구

아니

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