Effect of Cervical Force Control Training on Force Sense and Steadiness in Chronic Non-Specific Neck Pain
Chronic non-specific neck pain (CNSNP) is a very common issue among young adults, often linked to poor posture, prolonged screen time, and sedentary habits. This persistent pain can change how the neck muscles work and control movement. The purpose of this study is to investigate whether a specific type of rehabilitation-called "cervical force control training"-can help improve how well people can feel and control their neck muscle strength, and whether this reduces their pain and improves their daily function.
Researchers will invite young adults (18 to 24 years old) who have had neck pain for at least 3 months to participate. Participants will be randomly divided into two groups:
Force Control Training Group: Will receive a new training program that uses a handheld dynamometer with a screen to help them practice holding steady, precise neck muscle contractions with visual feedback.
Conventional Exercise Group: Will receive a standard physical therapy program consisting of neck muscle stretches and shoulder-blade strengthening exercises.
Both groups will perform their exercises 3 times a week for 8 weeks. Researchers will measure participants' neck muscle steadiness, pain levels, and neck disability before the program starts, right after the 8-week program ends, and again at a 3-month follow-up to evaluate the long-lasting effects.
研究概览
地位
条件
详细说明
Chronic non-specific neck pain (CNSNP) involves persistent cervical pain without an identifiable structural pathology. Recent evidence suggests that CNSNP is closely associated with sensorimotor control deficits, including impaired proprioception and diminished force steadiness (the neuromuscular ability to produce and sustain precise submaximal force levels with minimal fluctuations). While conventional exercises improve strength and reduce pain, they often neglect the fine-motor precision and sensorimotor integration necessary for optimal neck function.
This randomized controlled trial (RCT) is designed to investigate the effect of cervical force control training compared to conventional neck exercises on force sense, force steadiness, pain intensity, and functional disability in young adults (18-24 years) with CNSNP.
Following baseline assessments for maximum voluntary isometric contraction (MVIC), force sense, and force steadiness (quantified by the coefficient of variation) using a Handheld Dynamometer (HHD), as well as clinical measures (VAS for pain, NDI for disability), eligible participants will be randomized into two groups:
Experimental Group (Force Control Training):
Participants will undergo an 8-week targeted training program (3 sessions/week, 30-40 mins each). The protocol utilizes submaximal isometric contractions with visual feedback via an HHD device paired with an application. The program progresses systematically through three phases: Phase 1 (Calibration & Reference at MVIC), Phase 2 (Acquisition using descending submaximal intensities 25% to 10% MVIC with continuous visual tracking), and Phase 3 (Retention & Transfer involving faded/no feedback and complex dual-tasking, such as auditory monitoring or arithmetic).
Control Group (Conventional Exercise Training):
Participants will undergo an 8-week program (3 sessions/week, 30 mins each) consisting of standard cervical stretching (upper trapezius and levator scapulae) and scapular strengthening/stabilization exercises (e.g., side-lying external rotation, side-lying forward flexion, prone extension, and push-up plus). Resistance will be tailored based on gender and body weight.
Re-evaluations will be conducted immediately post-intervention (at 8 weeks) and at a 3-month follow-up. The study aims to establish whether integrating specific force-control tasks offers superior benefits in restoring sensorimotor function and alleviating symptoms in patients with CNSNP compared to conventional rehabilitation alone.
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习联系方式
- 姓名：Mohamed M Refaey, M.Sc.
- 电话号码：00201030290667
- 邮箱：mohamed_salama@pt.kfs.edu.eg
研究联系人备份
- 姓名：Refaey
- 邮箱：mohamed_salama@pt.kfs.edu.eg
学习地点
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Kafr el-Sheikh Governorate
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Kafr ash Shaykh、Kafr el-Sheikh Governorate、埃及
- Faculty of Physical Therapy
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接触：
- Mohamed M Refaey, M.Sc.
- 电话号码：00201030290667
- 邮箱：mohamed_salama@pt.kfs.edu.eg
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首席研究员：
- Mohamed M Refaey, M.Sc.
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参与标准
资格标准
适合学习的年龄
- 成人
接受健康志愿者
描述
Inclusion Criteria:
- Patients diagnosed with Chronic Non-Specific Neck Pain (CNSNP) lasting >= 3 months.
- Body mass index (BMI) between 18.5 and 29.9 kg/m² (non-obese).
- Pain intensity >= 30 mm on the Visual Analogue Scale (VAS).
- Neck disability ranging from mild to moderate (10% to 48%) on the Neck Disability Index (NDI).
- Able to perform isometric contractions with visual feedback.
Exclusion Criteria:
- Shoulder/upper limb fractures or replacement (<12 months), or moderate-severe shoulder osteoarthritis (OA).
- Cervical radiculopathy/myelopathy, peripheral neuropathy, vestibular disorders, or history of stroke/Transient Ischemic Attack (TIA).
- Upper limb pathology (tendinopathy, capsulitis), thoracic outlet syndrome, or fibromyalgia.
- Received neck-specific physiotherapy within the last 3 months.
- Severe osteoporosis, uncontrolled diabetes (HbA1c >9%), or active infection/inflammation.
- Cervical injections or surgery within the last 6 months.
- Inability to follow 2-step instructions.
学习计划
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：单身的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的：Experimental Group: Force Control Training
Patients in this group will receive an 8-week cervical force control training program (3 sessions/week).
The training involves submaximal isometric neck contractions using visual feedback via a Handheld Dynamometer, progressing from simple feedback-assisted holds to complex dual-task exercises.
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An 8-week program (3 sessions/week, 30-40 mins each) utilizing submaximal isometric neck contractions with visual feedback via a Handheld Dynamometer.
The protocol progresses through three phases: initial calibration, acquisition using descending target intensities (25% to 10% MVIC) with continuous visual tracking, and retention/transfer using faded or no feedback combined with dual-tasking (e.g., auditory monitoring or arithmetic).
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有源比较器：Active Comparator: Conventional Exercise Training
Patients in this group will receive an 8-week conventional exercise program (3 sessions/week).
The program includes standard cervical stretching (upper trapezius and levator scapulae) and scapular strengthening and stabilization exercises.
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An 8-week program (3 sessions/week, 30 mins each) consisting of standard cervical stretching for the upper trapezius and levator scapulae muscles, alongside scapular strengthening and stabilization exercises (e.g., side-lying external rotation, side-lying forward flexion, prone extension, and push-up plus).
Resistance is tailored based on patient gender and body weight.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Cervical Force Sense
大体时间：Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up
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Assessed using a Handheld Dynamometer (HHD) during force reproduction tasks.
It is measured by calculating the absolute error between a target submaximal force and the reproduced force without visual feedback.
Lower error values indicate better force sense and proprioception.
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Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up
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Cervical Force Steadiness
大体时间：Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up
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Evaluated by calculating the Coefficient of Variation (CoV) of force during submaximal isometric cervical contractions using a Handheld Dynamometer (HHD).
Lower CoV percentages indicate better force steadiness and neuromuscular control.
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Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Neck Functional Disability (Neck Disability Index - NDI)
大体时间：Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up
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A 10-item patient-completed questionnaire assessing how neck pain affects the ability to manage everyday life activities.
Total scores range from 0 to 50, which can be expressed as a percentage (0-100%).
Higher scores indicate greater patient-rated functional disability.
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Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up
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Pain Intensity (Visual Analogue Scale - VAS)
大体时间：Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up
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Pain intensity is assessed using a 100-mm horizontal line, anchored by "no pain" at 0 mm and "worst imaginable pain" at 100 mm.
Lower scores indicate a lower level of pain.
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Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up
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合作者和调查者
出版物和有用的链接
一般刊物
- Peng B, Yang L, Li Y, Liu T, Liu Y. Cervical Proprioception Impairment in Neck Pain-Pathophysiology, Clinical Evaluation, and Management: A Narrative Review. Pain Ther. 2021 Jun;10(1):143-164. doi: 10.1007/s40122-020-00230-z. Epub 2021 Jan 12.
- Vaillancourt DE, Slifkin AB, Newell KM. Inter-digit individuation and force variability in the precision grip of young, elderly, and Parkinson's disease participants. Motor Control. 2002 Apr;6(2):113-28. doi: 10.1123/mcj.6.2.113.
- Arvanitidis M, Falla D, Sanderson A, Martinez-Valdes E. Does pain influence control of muscle force? A systematic review and meta-analysis. Eur J Pain. 2025 Feb;29(2):e4716. doi: 10.1002/ejp.4716. Epub 2024 Aug 23.
- Vannebo KT, Iversen VM, Fimland MS, Mork PJ. Test-retest reliability of a handheld dynamometer for measurement of isometric cervical muscle strength. J Back Musculoskelet Rehabil. 2018;31(3):557-565. doi: 10.3233/BMR-170829.
- Zaidi, S., Khan, S. A., Zaki, S., Sundus, H., Alam, M. F., & Nuhmani, S. (2025). Effectiveness of sensorimotor training on pain, cervical joint position sense, range of motion, balance, and disability in chronic neck pain: A systematic review. Heliyon, 11(10), Article e43409.
- Muceli S, Farina D, Kirkesola G, Katch F, Falla D. Reduced force steadiness in women with neck pain and the effect of short term vibration. J Electromyogr Kinesiol. 2011 Apr;21(2):283-90. doi: 10.1016/j.jelekin.2010.11.011. Epub 2010 Dec 30.
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- P.T.REC/012/006579
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)？
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