Clinical Research Directory

Acute Effects of Motor Imagery and Motor Control Exercises in Individuals With Chronic Neck Pain

The aim of this study is to compare the effects of single-session motor imagery and motor control exercises on pain, pressure pain threshold, cervical proprioception, and motor imagery in individuals with chronic neck pain.

The Effectiveness of the Polyvagal Theory in Chronic Neck Pain

This study aimed to examine the effectiveness of a polyvagal theory-based exercise approach on joint position sense, pain, range of motion, functionality, depression, and quality of life in individuals with chronic neck pain. H0 = The polyvagal theory-based exercise approach has no significant effect on joint position sense, neck pain, range of motion, functionality, depression, or quality of life. H1 = The polyvagal theory-based exercise approach has a significant effect on joint position sense, neck pain, range of motion, functionality, depression, and quality of life.

Masseter Muscle Thickness in Individuals With Chronic Neck Pain

The primary objective of our study is to compare the thickness of the masseter muscle, measured by ultrasound, in individuals with chronic neck pain to that of healthy individuals. The secondary objective of the study is to examine the relationships between masseter muscle thickness and pain intensity, neck disability level, pain catastrophizing level, and clinical diagnostic criteria in individuals with chronic neck pain.

Symmetrical Scapula-pelvis Proprioceptive Neuromuscular Facilitation and Superficial Back Line in Chronic Neck Pain With Hamstring Tightness

A research study will be conducted at Physiotherapy department of the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan. Overall 156 patients with 18-40 years old individuals with neck pain will be eligible and they will be included through non-probability, purposive sampling technique. The written informed consent will be taken from all the patients. They will be divided through Simple random sampling (computer generated software) method into two groups, 78 in each group. Group A (experimental group) will receive PNF Symmetrical Scapula-Pelvis Patterns (PNF-SSPP), group B (control group) will receive sub occipital muscle inhibition technique (SMI) and static stretching (SS) of hamstring muscle. All participants will be assessed using assessment form. Outcome measures will be Pain, disability, disability, neck range of motions, hamstring tightness, head posture, and levator scapulae index. An independent assessor blinded to the treatment will assess all the patients for treatment outcome assessment at baseline, after first session and post treatment. Treatment sessions will be given thrice a week for 6 weeks.

Effects of Different Exercise Protocols on Physical and Cognitive Changes in People With Chronic Neck Pain

This study aims to investigate the effects of different exercise approaches on physical status, cognitive functions, brain structures, and blood biomarkers in individuals with chronic neck pain.

Kinematic Training in Patients With Neck Pain Based on Machine Learning Classification Approach

The goal of this clinical trial is to study if kinematic training based on novel kinematic assessment clasification approach can decrease chronic neck pain and prevent its reoccurance better than conventional kinematic training in adults. The main question\[s\] it aims to answer \[is/are\]: Does clustering patients with neck pain based on head and neck movement characteristics lead to more efficient kinematic rehabilitation training and improved clinical outcomes Researchers will compare effects of cluster specific kinematic training to see if it effects pain levels and its reoccurance. Participants will \[describe the main tasks participants will be asked to do, interventions they'll be given and use bullets if it is more than 2 items\].

The Effectiveness of Dynamic Neuromuscular Stabilization (DNS) Exercises Compared to Localized Exercises and Standard Care on Pain Intensity, Neck Dysfunction, and Upper Cervical Range of Motion in Patients With Chronic Neck Pain: A Pilot Randomized Controlled Trial (RCT)

Many people experience long-lasting neck pain, which can affect daily life, work, and overall well-being. This study aims to find out which type of exercise program is most effective in reducing neck pain, improving neck movement, and making daily activities easier. What Is Being Studied?: The study compares three different types of treatment: DNS Exercises (Dynamic Neuromuscular Stabilization): Whole-body exercises focusing on posture, breathing, and core stability. Localized Neck Exercises: Targeted exercises for the neck and shoulder muscles. Standard Care: Usual physiotherapy treatment commonly provided in clinical practice. Study Procedures: Participants are randomly assigned to one of the three groups. Each participant receives individual exercise instruction from a physiotherapist. Participants are also given simple home exercises to perform on their own. The study lasts for about 12 weeks. What Will Be Measured?: At the beginning, during, and at the end of the study, the following will be assessed: Neck pain intensity (pain scale) Neck range of motion How much the pain affects daily life and activities Possible Benefits: Participants may experience: Less neck pain Improved neck mobility Better overall body awareness Even if not every participant notices improvement, taking part will help researchers improve future treatment options for chronic neck pain. Risks: No major risks are expected. All exercises are supervised by qualified physiotherapists and adjusted to each participant's abilities. Participation can be stopped at any time if discomfort or pain occurs. Voluntary Participation and Data Privacy: Participation is completely voluntary. All personal data will be kept confidential and analyzed anonymously for research purposes only. Participants may withdraw from the study at any time without any disadvantages.

Effects of Post Isometric Relaxation as Compared to Post Isometric Stretching Muscle Energy Technique in the Management of Neck Pain: a Randomized Controlled Trial

This study aims to compare the effects of post-isometric relaxation (PIR) and post isometric stretching (PIS) techniques on reducing neck pain, improving range of motion, and decreasing neck disability in individuals with neck pain. A randomized controlled trial will be conducted with 50 participants, who will be randomly assigned to one of two groups: one receiving PIR and the other receiving PIS. A single-blind method will be used, meaning the participants will not know which group they belong to. Participants will be selected based on specific criteria related to neck pain and will then be randomly allocated to the PIR or PIS group. Initially, all participants will receive two standard treatments: Transcutaneous Electrical Nerve Stimulation (TENS) and hot pack application. After these treatments, one group will undergo post-isometric relaxation (PIR), which involves 3-5 repetitions of muscle contraction and relaxation, conducted over five consecutive sessions. The other group will receive post-isometric stretching (PIS), which involves stretching after muscle contraction and relaxation, also administered over five consecutive sessions. At the end of the intervention, pain, range of motion, and neck disability will be measured. Pain will be assessed using a standardised pain scale, range of motion will be measured with a goniometer or other appropriate tools, and neck disability will be evaluated using the Neck Disability Index (NDI). Statistical analysis will be performed to compare the effectiveness of PIR and PIS in terms of pain reduction, range of motion improvement, and decreased neck disability.

Progressive Muscle Relaxation Vs Muscle Energy Technique on Nonspecific Neck Pain in Prolonged Computer Users.

The objective of this randomized controlled trial is to assess the potential effectiveness of Progressive muscle relaxation technique (PMRT) vs Muscle energy technique (MET) as an intervention for releasing trigger points in SCM and upper trapezius in prolonged computer users. The study will be conducted in a workplace setting, where desk-type computer users are expected to regularly engage in their professional activities for ≥ 6 hours throughout the day, intermittently. This study will be conducted at the Outpatient Physiotherapy department of Sindh Institute of Physical Medicine and Rehabilitation, Karachi among 60 patients with nonspecific chronic neck pain on the basis of non-probability purposive sample technique. After taking informed consent, all participants will be randomly allocated into two groups through a investigator (blinded) the same investigator will be screening the individuals, doing baseline assessment, and post treatment assessment while another investigator will be providing intervention. Group 1 will receive Progressive muscle relaxation technique while Group 2 will receive Muscle Energy Technique on sternocleidomastoid and upper trapezius bilaterally. Patients will also be blinded. A total of 12 sessions will be provided. Outcomes will be assessed at baseline and post treatment after 2 weeks intervention.

Effects of Neck Stabilizers Retraining on Chronic Neck Pain

The present study aims to evaluate the effects of deep neck stabilizers retraining with pressure biofeedback on cervical range of motion, pain, and temporomandibular dysfunction in patients with chronic neck pain. Participants will receive biofeedback-assisted deep neck flexor retraining in one group, while the other group will perform conventional exercises. The neurological connection between the TMJ and neck means that therapies such as neck flexion exercises and biofeedback can alleviate neck pain and jaw issues.

Vacuum Massage vs Tactile Massage for the Treatment of Chronic Neck Pain

Chronic pain significantly impacts individuals and society, with about 30% of Norwegian adults affected, making it the leading cause of long-term sick leave and disability benefits. Concerns over addiction to pain medications highlight the need for non-pharmacological treatments, though many such therapies, often complementary or alternative, are not widely available in conventional healthcare. Unclear biomechanisms of these therapies pose challenges for clinical trials and acceptance. This pilot study aims to explore the effects of two types of massage-cupping massage (CM, intense) and tactile massage (TM, soft)-on chronic neck pain, focusing on their mechanisms of action. Quantitative sensory testing (QST) will be used as a biomarker to assess changes in the pain pathway. A previous feasibility study on CM and QST conducted in Germany informs this research. The study will recruit 60 patients with chronic neck pain, randomized to CM or TM, with six weekly treatment sessions. QST will be measured before and after treatment to understand therapy-induced changes in the pain pathway. Findings will help tailor massage therapies to individual needs, improve clinical trial quality, and promote the integration of non-pharmacological treatments into conventional care, benefiting a large population in need.

Effects of Schroth-Based Exercise on Kyphosis Angle, Muscle Strength, Balance, Pain, and Quality of Life in Hyperkyphosis With Chronic Neck Pain

The normal thoracic kyphosis angle of the spine is 20-40°, however, an angle of more than 40° is referred to as postural kyphosis, increased kyphosis or hyperkyphosis. Although postural kyphosis negatively affects individuals' general health status, physical performance, and quality of life, there is still no standardized protocol for correcting the thoracic kyphosis angle. Conservative treatment approaches such as postural training and exercises, manual therapy, postural corrective kinesiotaping, and orthotic use have been recommended for managing increased thoracic kyphosis. While numerous studies have demonstrated the effectiveness of three-dimensional exercise programs in the treatment of scoliosis, research examining their impact on kyphosis remains considerably limited.Nevertheless, the potential of these exercises to promote neuromuscular reorganization suggests that they may be similarly effective in individuals with thoracic kyphosis. This randomized controlled trial aims to evaluate the effects of a Schroth-based three-dimensional exercise program on kyphosis angle, trunk muscle strength, balance, pain, and quality of life in individuals with postural hyperkyphosis and chronic neck pain.

Effects of a Multimodal Telerehabilitation Program in Patients With Chronic Non-Specific Neck Pain.

The purpose of this study is to evaluate the clinical results in pain intensity, neck disability, range of motion, endurance deep cervical muscles, forward head position and kinesiophobia through thoracic spine mobility, deep neck muscles and thoracic strength training and pain education protocol versus a thoracic spine mobility, thoracic strength training and pain education protocol in patients with chronic non-specific neck pain.

Acute Effects of TENS on Cervical Muscle Stiffness and Pain in Neck Pain

This randomized controlled trial investigates the acute effects of transcutaneous electrical nerve stimulation (TENS) on passive cervical muscle stiffness (MyotonPro "dynamic stiffness", N/m) and pain (0-10 VAS) in adults with chronic/mechanical neck pain. Participants will be allocated 1:1 to TENS or control/sham. Outcomes are measured immediately before and immediately after a single 15-minute session.

Virtual Reality Application for Assessing Neck Movement and Position Sense

The goal of this observational study is to examine whether a virtual reality application developed by our team can be used to evaluate cervical range of motion (ROM) and joint position sense (JPS) in individuals with chronic neck pain. The main questions it aims to answer are: * Does the virtual reality application provide reliable measurements of cervical ROM? * Does the application accurately assess cervical JPS when compared with a standard clinical tool (Cervical Range of Motion device, CROM)? Researchers will compare results from the VR application with results from the CROM device to see if the two methods give similar outcomes. Participants will: * Complete a demographic and clinical evaluation. * Perform standardized neck movements (flexion, extension, left/right lateral flexion, left/right rotation). * Be assessed using both the CROM device and the VR application for ROM and JPS.

Virtual Reality Program for Managing Chronic Neck Pain

The goal of this clinical trial is to find out if a virtual reality-based rehabilitation program developed by our team can help people with chronic neck pain. The main questions it aims to answer are: * Does the VR program reduce neck pain? * Does it improve daily function and quality of life? Participants will: * Take part in a supervised virtual reality exercise program for 8 weeks, attending 3 sessions per week (24 sessions in total). * Each session will last about 45 minutes. * Complete tests and questionnaires about their pain, disability, and overall well-being before and after the program.

Additional Effects of Semispinalis Cervicis Strengthening With Craniocervical Flexion Training on Chronic Neck Pain

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.

Tech-Assisted Exercise Training in Chronic Neck Pain

In this study, women with chronic neck pain residing in Afyonkarahisar, Turkey, will participate in an exercise-based intervention. Both the control and experimental groups will engage in conventional exercise programs; however, the experimental group will also receive an additional technology-assisted exercise program. It is anticipated that these interventions will positively impact participants' daily living activities and functional abilities. The study aims to assess whether the inclusion of technology-supported exercises leads to superior outcomes compared to conventional exercises alone. The findings are expected to provide valuable evidence on the effectiveness of integrating technology-assisted exercise programs into physiotherapy and rehabilitation practices for women with chronic neck pain.

Comparison of Efficiency of Interferential Current Application Methods in Chronic Neck Pain

The aim of this study is to evaluate the effects of Interferential Current Therapy on pain, disability, and quality of life in patients with chronic neck pain and to compare the effects of applying Interferential Current Therapy with vacuum electrodes versus carbon-silicon pad electrodes.

Reliability of MRI and Ultrasound in Cervical Epidural Needle Depth Estimation

This study aims to evaluate the reliability of magnetic resonance imaging (MRI) and ultrasound (USG) in predicting needle depth during cervical epidural injections, compared to fluoroscopy. The goal is to identify alternative imaging methods that reduce radiation exposure while maintaining procedural accuracy and patient safety.

Phrenic Nerve Infiltration in Neck Pain

Neck pain frequently present comorbidities in peridiaphragmatic organs. The innervation of these organs include the phrenic nerve. It is known that peridiaphragmatic organs trigger referred pain in the neck area. As well, previous studies have shown that visceral disorders increase sensitization in somatic tissues. This study aims to analyze the ability of phrenic nerve infiltration to diminish sensitization and improve neck symptoms in the absence of neurological, traumatic or infectious pathology that justifies the pain, by means of a randomized controlled trial.

Chronic Low Back Pain and Neck Pain Prospective Study

This prospective observation multifaceted study aims: 1. To perform a large prospective study and identify multiple "omics" biomarkers in chronic low back pain 2. To validate identified biomarkers for progression of acute to chronic low back pain 3. To validate identified biomarkers and test their heritability/validity in additional cohorts 4. To identify pathways and relevant individual variations for generation, propagation and subsidence of pain 5. To identify new imaging biomarkers related to chronic low back pain 6. To develop a registry of neck and low back pain subjects to help monitor the health-care management and utility to improve protocols and patient outcomes.

Comparison of Cervical Retraction Exercise and Facet Oscillatory Mobilization in Chronic Mechanical Neck Pain

To compare the effects of Cervical Retraction Exercise and Facet Oscillatory Mobilization in chronic Mechanical Neck pain. To compare the effects of Cervical Retraction Exercise and Facet Oscillatory Mobilization in chronic Mechanical Neck pain at improving Neck Disability. To compare the effects of Cervical Retraction Exercise and Facet Oscillatory Mobilization in chronic Mechanical Neck pain at Improving Range of Motion The study design used for this literature would be Randomized Control Trial This study would include total 32 participants which would be divided into two groups, 16 each.

The Effect of Low-load Endurance Training of Upper Trapezius on Pain, Pressure Pain and Muscle Stiffness in Chronic Neck-shoulder Pain Compared to Stretching Exercise

This study aims to investigate the effectiveness of low-load endurance exercise as compared to stretching exercise on upper trapezius on pain, pressure pain and muscle stiffness in patients with chronic neck-shoulder pain. The hypothesis is that endurance exercise of the upper trapezius should result in significantly better improvement in terms of neck-shoulder pain, pressure pain threshold and muscle stiffness than stretching exercise. Participants with unilateral neck-shoulder pain will either perform low-load endurance exercise or stretching exercise of the upper trapezius muscle of the affected side in a 5-week period. Before and after the 5-week training, outcomes will be assessed by investigators in order to compare the effectiveness of two exercises on pain, pressure pain, muscle stiffness, and muscle endurance. Secondary outcomes include Neck Disability Index (NDI) to assess various aspects of daily living impacted by neck pain, and Disabilities of Shoulder, Arm and Hand (DASH) Questionnaire to evaluate the ability to perform various upper limb activities. Findings to be obtained from this study will help inform the clinical management in particular for self-care of this chronic neck pain group of participants, by refining the exercise prescription for promoting the clinical outcomes for individuals suffering from neck-shoulder pain. In addition, results of this study will also inform physiotherapists the possible mechanisms underlying the improvement of neck-shoulder pain by examination of the relationship between biomechanical properties of muscles, such as muscle endurance or muscle stiffness, and neck-shoulder pain.