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Additional Effects of Semispinalis Cervicis Strengthening With Craniocervical Flexion Training on Chronic Neck Pain
Sponsor: Foundation University Islamabad
Summary
Chronic neck pain affects 30-50% of individuals annually and is a leading cause of disability, often linked to muscle imbalances and compensatory over activation of superficial muscles. While craniocervical flexion trainning (CCFT) improves neuromuscular control and reduces pain, limited researches has examined the additional benefits of semispinalis cervicis strengthening. This randomized controlled trial, conducted at Fauji Foundation Hospital and Foundation University College of Physical Therapy will assess the effects of combining semispinalis cervicis strengthening with CCFT on pain, cervical erange of motion, muscle strength and functional disability. Participants will be randomly assigned to either CCFT alone or CCFT with semispinalis cervicis strengthening, performed three times per week for four weeks. Data will be collected at baseline, mid study (week 2) and end of study (week 4) using the Numeric pain rating scale, Goniometer, Sphygmomanometer and Nexk disability index. This study addresses a research gap by exploring deep cervical extensors strengthening alongside CCFT, potentially improving rehabilitation strategies for pain relief, cervical stability and functional recovery.
Key Details
Gender
All
Age Range
18 Years - 35 Years
Study Type
INTERVENTIONAL
Enrollment
42
Start Date
2025-09-30
Completion Date
2026-11-01
Last Updated
2025-09-23
Healthy Volunteers
No
Conditions
Interventions
Craniocervical Flexion Training alone
10-minute hot pack treatment before starting the protocol. Week 1: Muscle Activation, • Hold for 5-10 seconds. * Perform in supine with a sphygmomanometer device. * Nod head gently as if saying "yes," aiming for 20-22 mmHg. Week 2: Endurance Training Goal: • Hold for 10-15 seconds. Increase holding time and precision. Exercise: • Maintain the contraction at 24-26 mmHg on the device. Week 3: Strength and Postural Training •Hold for 15 seconds. Exercise: * Perform CCFT in sitting or standing. Week 4: Functional Integration * Maintain contraction during functional tasks (e.g., desk work). * Hold for 15-20 seconds. * Sets/Reps: 3 sets of 8-12 repetitions.
Semispinalis Cervicis strengthening with Craniocervical Flexion Training:
Craniocervical flexion training will be same as given to group A. Week 1: Semispinalis Cervicis Activation: * Patient sits upright with neutral spine. * Therapist applies gentle manual resistance at C2 vertebra while the patient resists backward motion. * Hold for 3-5 seconds, then relax. Week 2: Progressive Activation with Increased Resistance: * Apply moderate manual resistance at C2. * Hold for 5 seconds, focusing on controlled movement. Week 3: Strength and Functional Coordination with Dynamic Resistance: * Introduce light movement (e.g., slight backward head tilt) under resistance. * Therapist adjusts resistance dynamically. Week 4: Advanced Endurance and Functional Integration with Functional Movements: * Combine resistance training with controlled head rotations or slight lateral flexion. * Maintain resistance and stability. * Reps/Sets: 3-4 sets of 12 reps.
Locations (1)
Foundation University Islamabad
Islamabad, Punjab Province, Pakistan