Clinical Research Directory

The Effectiveness of Chuna Maintenance Therapy for Chronic Bothersome Neck Pain

This study is a pragmatic randomized controlled study that assessed 250 subjects complaining of chronic bothersome neck pain with mild discomfort in a 1:1 ratio: chuna maintenance therapy group (125 subjects, 1 time/2 weeks, total 20 weeks) and lifestyle management \& self-exercise group (125 subjects, exercise method education 1 time/4 weeks, total 20 weeks).

HOME EXERCISE AND KINESIO TAPING IN NON-SPECIFIC NECK PAIN AMONG CHAIN MARKET WORKERS

Non-specific neck pain (NSNP) is a common musculoskeletal disorder associated with pain and functional limitations. Female chain market workers are exposed to ergonomic risk factors such as prolonged standing, repetitive movements, and static postures, which may contribute to the development of neck pain. Exercise therapy is considered an effective non-pharmacological treatment approach for NSNP, while kinesio taping has been reported to improve pain and functionality. However, studies investigating the combined effects of home exercise and kinesio taping in female chain market workers are limited. This study aims to evaluate the effects of home exercise and kinesio taping on pain, functionality, and work performance in female chain market workers with non-specific neck pain.

Dual Frequency Low-Level Laser Therapy in Myofascial Trigger Points of Upper Trapezius

The goal of this clinical trial is to determine whether dual frequency low-level laser therapy can reduce pain, improve function, and increase neck movement in patients with myofascial trigger points in the upper trapezius muscle. The study includes men and women aged 20 to 55 years who have been diagnosed with upper trapezius myofascial pain syndrome. The main questions it aims to answer are: * Does dual frequency low-level laser therapy reduce pain more effectively than single wavelength laser therapy? * Does dual frequency low-level laser therapy improve functional ability and cervical range of motion more than other treatments? Researchers compared three groups of participants receiving different treatments to evaluate their effects. Participants were randomly assigned to one of three groups: * Group A received red wavelength low-level laser therapy with conventional physiotherapy * Group B received infrared low-level laser therapy with conventional physiotherapy * Group C received dual frequency low-level laser therapy with conventional physiotherapy All participants received treatment twice weekly for four weeks. Conventional therapy included stretching exercises, strengthening exercises, and postural correction.

Scapular Repositioning for Neck Pain and Scapular Dysfunction

This randomized controlled trial is designed to evaluate the effects of scapular repositioning in individuals with neck pain and scapular dysfunction. The main questions it aims to answer are: 1. Does scapular repositioning reduce neck pain, increase range of motion, and improve joint position sense and pressure pain threshold? 2. Which type of scapular repositioning technique is more effective? Participants will be randomly assigned to one of three groups: 1. Active scapular repositioning: The examiner will first passively position the scapula in a neutral position on the posterior chest wall. The participant will then be instructed to actively maintain that position for 10 seconds. This procedure will be repeated for 10 repetitions, with a 10-second rest interval between each repetition. 2. Passive scapular repositioning: The examiner will passively position and hold the scapula in a neutral position for 10 seconds. This procedure will be repeated for 10 repetitions, with a 10-second rest interval between each repetition. 3. Sham scapular repositioning (control): The examiner will perform gentle shoulder movements that do not alter scapular positioning. Each movement will be held for 10 seconds, repeated 10 times, with a 10-second rest interval between repetitions. All participants will undergo pre- and post-intervention assessments (immediately after the intervention and at 30 minutes post-intervention). The primary outcomes include neck pain intensity, cervical range of motion, cervical and shoulder proprioception, and pressure pain threshold. All outcomes will be compared between groups and across time points (pre- and post-intervention).

Dual-Task Effects on Gait in Nonspecific Neck Pain

The aim of this study is to examine the impact of motor and cognitive dual-task conditions on gait variability and gait symmetry in individuals with NSNP, compared with healthy controls. This cross-sectional trial will recruit participants aged 18-60, including 21 patients with NSNP and 21 age-matched healthy controls. Gait parameters will be assessed using a wearable sensor system (BTS G-Walk). Primary outcomes are gait variability and gait symmetry under single-task, motor dual-task, and cognitive dual-task walking conditions.

AI-Assisted Camera-Based Progressive Muscle Relaxation for Office Workers

This randomized controlled trial evaluates the effectiveness of an AI-assisted, camera-based progressive muscle relaxation application in office workers aged 20 to 40 years. Participants are randomly allocated to an intervention group or a control group. The intervention group completes a 4-week progressive muscle relaxation program using the PhysioTR Academic application, which provides camera-based real-time movement analysis and exercise guidance. The control group continues their usual daily routine and completes baseline and post-intervention assessments only. Outcomes include pain/tension intensity, musculoskeletal symptoms, perceived stress, neck disability, work productivity, functionality, and AI-based adherence metrics.

Common Pain Mechanisms in Migraine, Migraine-Related Neck Pain, and Lower Back Pain: A Cross Sectional Study

Migraine is one of the primary headache disorders with a high prevalence worldwide, leading to significant disability and reduced quality of life. Trigeminal nerve activation and alterations in central pain processing mechanisms play a crucial role in the pathophysiology of migraine. Recent studies suggest that migraine may not only be a headache disorder but also a systemic pain disorder associated with changes in central pain processing mechanisms. Central sensitization is defined as increased sensitivity of nociceptive neurons in the central nervous system to afferent stimuli and is considered a key mechanism in the development and maintenance of chronic pain conditions. This condition is characterized by pain hypersensitivity, allodynia, and generalized pain sensitivity. In addition to headaches, other musculoskeletal pains are also frequently reported in migraine patients. Spinal pain, particularly neck and lower back pain, can occur in migraine sufferers, with central sensitization contributing to the condition, considering the spine as a chain. Large population-based studies have shown a significant association between primary headaches and persistent low back pain, and a higher prevalence of concomitant low back pain has been reported in individuals with chronic migraine and chronic tension-type headaches. This association is suggested to be explained by the shared nociceptive pathways of the head and spinal structures and the changes in central pain processing seen in chronic pain conditions. This relationship between migraine and musculoskeletal pain is also explained by the presence of shared neuroanatomical structures such as the trigemino-cervical complex. Nociceptive afferents from the upper cervical spine and cranial structures converge at the trigemino-cervical complex level in the brainstem, creating a predisposition to the co-occurrence of head and neck pain. This mechanism suggests that pain or dysfunction in the cervical region in migraine patients may be related to headache symptoms. Studies have shown that neck pain is more common in individuals with migraine than in the general population, and research suggests this rate may be approximately 10-12 times higher compared to healthy individuals. Furthermore, it has been reported that individuals with migraine more frequently experience tenderness in cranio-cervical muscles such as the upper trapezius, sternocleidomastoid, and suboccipital muscles, myofascial trigger points, and increased muscle sensitivity. The literature also emphasizes that these cervical symptoms may be related to migraine frequency, attack severity, and headache-related disability. These findings suggest that migraine should be considered not only as a primary headache disorder but also as a complex neurobiological condition associated with widespread pain sensitivity and musculoskeletal symptoms. A better understanding of the relationship between migraine and musculoskeletal pain could be important for developing multidisciplinary treatment approaches. However, clinical studies in the literature that evaluate migraine, accompanying neck pain, and lower back pain together in terms of common pain mechanisms are quite limited. Therefore, the rationale for this study is that examining factors such as central sensitization, pain threshold, pain catastrophizing, psychological factors, body awareness, and regional disability together in migraine patients can lead to a better understanding of the pathophysiology of migraine-related musculoskeletal pain. Based on all these reasons and evidence, the aim of this study is to investigate the possible common pain mechanisms and musculoskeletal pathophysiological processes of migraine-related neck and back pain in migraine patients with accompanying neck and/or back pain by evaluating factors such as central sensitization, pain threshold, pain catastrophizing, psychological factors, body awareness, and regional disability together.

Cervical Spine Focused Treatment for Patients With Persistent Concussion Symptoms and Neck Pain

Assess the feasibility of recruiting, enrolling and randomizing patients with concussion symptoms and neck pain to receive manual therapy and cervical rehabilitative exercises in addition to standard concussion treatment. In the usual care workflow provided at the participating concussion clinic, cervical spine rehab is not typically introduced until after week 4. The rationale is that neck pain is often a self-limiting condition that may resolve spontaneously, without the need for specific cervical spine rehab. This study is chiefly focused on feasibility aims that revolve around developing changes to barriers in workflow issues at the participating concussion clinic, that would allow for earlier introduction of cervical spine rehab.

The Effectiveness of Manipulation Treatment in Cervical Region

Neck pain is the second most common musculoskeletal pain after lumbar pain. Prevalence is 27.2% female and 17.4% in male population (1, 2). Approximately 1/3 of acute onset neck aches become chronic. It causes increasing the cost of treatment and also the loss of labor (3, 4).

Does the Cervical Stenosis Affect Hand Function?

The cervical spine is a complex structure that supports the weight of the head and protects the spinal cord and nerve roots. Cervical spinal stenosis (CSS), which develops as a result of degenerative processes, can cause narrowing of the spinal canal and compression of nerve structures, leading to symptoms such as pain, numbness, and weakness. This condition can negatively affect hand function, particularly grip strength and dexterity. However, studies in the literature examining the effect of CSS on grip strength and hand function are limited. Therefore, this study will be conducted to determine the effect of the severity of cervical spinal stenosis, identified in patients who underwent MRI following their presentation with cervical problems at the Physical Medicine and Rehabilitation outpatient clinic of Buca Seyfi Demirsoy Training and Research Hospital, İzmir Democracy University, on hand grip strength and functionality. Grip strength will be assessed using the Jamar hand dynamometer, and fine pinch strength will be evaluated using the Lafayette pinch meter. Additionally, hand functionality will be measured using the Nine-Hole Peg Test. The impact of neck pain on daily life will be assessed using the Neck Disability Index. The data obtained will be compared and analyzed using appropriate statistical methods. This study is expected to fill a significant gap in the current literature by comprehensively elucidating the effects of cervical stenosis on hand function and grip performance, thereby contributing to the individualization of rehabilitation approaches.

The Effect of Osteopathic Treatment on Craniocervico-Mandibular Dysfunction

The goal of this clinical trial is to measure the effects of osteopathic manipulative treatment (OMT) on tissues of the craniocervico-mandibular unit (CCMU) in individuals with neck pain and headaches. The main questions to answer are: 1. How does OMT affect CCMU muscle stiffness 2. How does OMT affect jaw motion 3. How does OMT affect autonomic function 4. Is pain pressure threshold affected by OMT of the CCMU Participants will undergo the following interventions: 1. Photos taken to measure head and neck angles 2. Ultrasound 3. Smooth Pursuit Neck Torsion Test 4. Motion Capture 5. Autonomic Protocol 6. Algometry 7. Surveys

Partners4Pain & Wellbeing: A Randomized Trial of Community Supported Complementary and Integrative Health Self-management for Back Pain

The goal of this clinical trial is to learn how well two community-based self-management programs work in people with chronic back or neck pain. The main question it aims to answer is: How well does a community-based self-management program teaching mind-body skills such as mindfulness and cognitive behavioral approaches (Partners4Pain) work for reducing pain intensity and interference with general activities and enjoyment of life compared to a community-based self-management program focused on general health and wellbeing (Keys to Wellbeing)? Participants will be asked to do the following: * Attend 2 screening visits to learn about the study and see if they meet the requirements to participate. * Be randomly assigned to one of the two community-based self-management programs. * Attend 9 weekly self-management program sessions (90 minutes each) * Complete surveys about their pain and overall health at 2 months (after the programs end), 4 months, and 6 months. Funding for the project is provided through the National Center for Complementary and Integrative Health (NCCIH) and the National Institute of Neurological Disorders and Stroke (NINDS) through the NIH HEAL Initiative (https://heal.nih.gov/), R33AT012309.

Prediction of Outcome of Interventional Pain Management

Interventional pain management for back and neck pain is widely used, but the indications and relative merits of these techniques rest subject to discussion. This study aims to identify prognostic criteria for patients who might specifically benefit from interventional pain management. Specifically, the nociceptive reflex threshold will be investigated, which is a measure of central sensibilisation and thus a potentially important prognostic factor.

Development of STEPPT

This 6-month pilot study aims to assess the feasibility, acceptability, and estimate effect sizes of the pilot STEPPT intervention for addressing ethnic disparities in physical therapy referrals and adherence between Hispanic and Non-Hispanic White patients with spine pain. Feasibility and acceptability will be assessed based on the extent to which the pilot clinic implements all components of the intervention appropriately, feedback from clinic staff during implementation of the intervention, and feedback from patients during post-intervention interviews. The investigators anticipate that the intervention will be both feasible and acceptable. Feedback from patients and clinic staff will be used to inform intervention modifications for a larger clinical trial. Effect sizes for the pilot STEPPT intervention (intervention) in comparison to standard care (control) will be assessed by evaluating changes in ethnic disparities (Hispanic vs. Non-Hispanic White) in physician referral to physical therapy and patient adherence to physical therapy referral for the treatment of spine pain before and after implementation of the pilot STEPPT intervention. In comparison to standard care, the investigators expect STEPPT to reduce ethnic disparities in referral and adherence outcomes.

Forward Head Posture Correction on Cerebral Oxygenation During Dual-task in Symptomatic Subjects

This study aims to investigate the effects of forward head posture correction on neck pain, brain activity, and cognitive-motor performance. Forward head posture is a common postural problem, especially among young adults who spend long hours using smartphones and computers. It is frequently associated with neck pain, reduced mobility, and functional limitations. Emerging evidence also suggests that this postural deviation may influence brain function and increase the mental effort required during tasks that involve both thinking and movement. Participants with forward head posture and neck pain will be recruited and randomly assigned to one of three groups: an intervention group using a cervical traction device (Denneroll), a sham group using a towel roll, or a control group receiving no intervention. The intervention will be performed at home over a six-week period, with sessions conducted five times per week. The duration of each session will gradually increase based on participant tolerance to ensure safety and comfort. All participants will undergo assessments at baseline and after the intervention period. Pain intensity will be measured using a standardized pain scale. Brain activity will be assessed using a non-invasive technique called functional near-infrared spectroscopy (fNIRS), which measures changes in oxygen levels in the brain. Participants will also perform balance tasks under single-task and dual-task conditions, where they will be asked to maintain balance while performing simple cognitive tasks. In addition, cognitive function will be evaluated using standardized tests of attention, memory, and overall cognitive performance. This study will help determine whether correcting forward head posture can reduce pain and improve brain and cognitive function. The findings may provide valuable insights into the relationship between posture, pain, and brain activity, and may contribute to the development of more effective and comprehensive rehabilitation approaches for individuals with forward head posture.

Myofascial Release and Dynamic Cupping in Children

Neck pain is a common musculoskeletal disorder that significantly affects quality of life and daily activities, with an annual prevalence of 30-50% worldwide. This randomized clinical trial aims to compare the effects of myofascial release therapy and dynamic cupping on neck pain and posture in school-based children aged 7-12 years. A total of 40 children with neck pain and postural deviations will be recruited from schools and randomly assigned to either a myofascial release group or a dynamic cupping group (20 participants each) for a 6-week intervention. Children with skin conditions, neurological symptoms, recent analgesic use, or assistive device use will be excluded. Outcomes will be assessed using the Visual Analog Scale, goniometer, and plumb line test, and data will be analyzed using SPSS version 27 to determine the effectiveness of both interventions in reducing pain and improving posture.

Neck Pain in Office Workers

The aim of this study is to evaluate effectiveness of short exercise breaks (2, 5, and 7 minutes) on chronic non-specific neck pain in office workers. It is a 12-week randomized controlled trial assessing pain, disability, and multiple functional and occupational outcomes. We aim to determine the most effective exercise duration for reducing neck pain and improving quality of life, productivity, and job satisfaction.

CARES (Comprehensive Analgesic, Recovery, and Education Support) for Surgery Trial

The goal of this clinical trial is to learn whether a combined behavioral and pharmacologic intervention can help reduce opioid use, improve pain recovery, and prevent opioid misuse after surgery in adults undergoing elective surgery. The study includes adults aged 18 to 75 who have a history of long-term opioid use, defined as having access to opioids for 60 or more days within the 180 days before surgery. The main questions it aims to answer are: * Does Motivational Interviewing with guided opioid tapering plus tizanidine (MI-Opioid Taper + Tizanidine) help participants return to their preoperative opioid use level or stop opioids faster than Enhanced Usual Care (EUC)? * Does the intervention reduce the time to pain resolution and decrease the likelihood of opioid misuse after surgery compared to EUC? Researchers will compare MI-Opioid Taper + Tizanidine to MI-Opioid Taper with placebo and to EUC to see whether the intervention improves postoperative opioid and pain outcomes. Participants will: * Complete a phone assessment and baseline survey before surgery * Be randomly assigned 7-13 days after surgery to one of three groups: * MI-Opioid Taper + tizanidine (MTT) * MI-Opioid Taper + placebo (MTP) * Enhanced Usual Care (EUC) * Complete brief weekly phone or video visits with a study clinician for 6 weeks starting 14 days after surgery * Take a study medication (tizanidine or placebo) three times daily for 5 weeks (MTT and MTP groups only) * Complete weekly online surveys for 6 months, followed by monthly surveys until 12 months after surgery to track pain, opioid use, and related outcomes

The Importance of the Number of Incisions in the Effectiveness of Dry Needling

The dry needling technique is a procedure increasingly used by health professionals. Dry needling consists of the use of a filiform needle to treat musculoskeletal pain. Currently, the mechanisms by which it is an effective technique are not well understood. One of the aspects not yet evaluated is the best dose in terms of the number of times it is necessary to insert the needle into the patient to achieve the best result. This research work aims to assess which treatment obtains the best results in the management of patients with chronic neck pain.

Effectiveness of Massage of the Thoracic Region in Neck Pain

Neck pain is a common disorder in industrialized countries. Manual therapy techniques have been commonly used in the treatment of this problem. Actually, there is no research work that has evaluated the work well of treatment with soft tissue techniques (massage) applied to the dorsal paravertebral muscle in the management of neck pain. The goal of this study (clinical trial) is to compare the efficacy of a massage protocol performed on the dorsal region in subjects with mechanical neck pain. The researchers will compare: A group that will be treated with a local protocol of cervical manual therapy and therapeutic exercise along with the treatment(massage) of the thoracic region. Another group that will be treated only with a local protocol of cervical manual therapy and therapeutic exercise. It is to see if the inclusion of treatment of the thoracic region improves the local intervention in cervical region.

Kinesiophobia in Chronic Neck Pain

In this study, the effect of kinesiophobia on pain, disability, and quality of life in individuals with chronic neck pain will be evaluated. Neck pain is a common musculoskeletal disorder that can become chronic in some individuals. Kinesiophobia may lead to a reduction in physical activity due to fear of movement and re-injury, thereby increasing pain and disability. In this cross-sectional study, 57 participants will be assessed using the Visual Analog Scale (VAS), Tampa Scale for Kinesiophobia (TSK), Neck Disability Index (NDI), and the SF-36 Quality of Life Scale. Participants will be selected from individuals aged 18-59 who have experienced neck pain for at least 3 months, and those with a history of neurological disorders, spinal surgery, or pain treatment in the last 3 months will be excluded. This research aims to determine the effects of kinesiophobia on chronic neck pain, thereby contributing to the development of more effective treatment strategies. Written informed consent will be obtained from all participants.

Predictors of Functional Status in Chronic Neck Pain

Although it has been reported that these problems seen together with neck pain are related to functional limitations and disability, there is still insufficient evidence regarding the relationship between factors affecting functional status and chronic neck pain symptoms in individuals with chronic neck pain. Furthermore, a mixed methodology approach has not been used to comprehensively investigate this relationship. Identifying factors affecting functional status in CNP will help guide the prevention, treatment, and management of neck pain. Therefore, the aim of this study is to investigate the relationships between functional status and psychosocial and bodily functions in CNP.

Chronic Neck Pain and Central Sensizitation

Chronic neck pain is one of the musculoskeletal pain problems that can cause chronic disability. It is emphasised that individuals with chronic neck pain have difficulty during different activities in their daily lives, and that this problem is a very common health problem that can lead to disability. In the case of chronic neck pain, changes in the pain threshold cause central sensitisation and individuals become more sensitive to pain stimuli. This situation can affect the processing of proprioceptive information and lead to deterioration in proprioceptive perception. This situation leads to perceptual problems in body and neck awareness. Therefore, examining the relationship between the relevant parameters is important in the rehabilitation process. In this context, the aim of the study is to examine the relationship between body awareness and pain, central sensitisation, disability and proprioception in patients with chronic non-specific neck pain.

Predictors of Clinical Response After Interlaminar Cervical Epidural Steroid Injection for Cervical Radiculopathy

Cervical epidural steroid injection is a commonly used treatment option for patients with cervical radicular pain who do not improve adequately with conservative treatment. Cervical radicular pain typically radiates from the neck to the shoulder, arm, or hand and may be accompanied by numbness, weakness or changes in reflexes. The most common causes are cervical disc herniation and cervical spondylosis. By reducing inflammation around the affected nerve root, epidural steroid injection may help relieve pain and improve function. Among available techniques, the interlaminar approach is frequently preferred in the cervical region because of its technical feasibility and safety profile. Although interlaminar cervical epidural steroid injection is widely used, treatment response varies among patients, and not all individuals experience the same degree of benefit. Identifying the factors associated with better or poorer clinical response may help improve patient selection and reduce unnecessary procedures. This retrospective cohort study aims to evaluate clinical outcomes after interlaminar cervical epidural steroid injection in patients with cervical radiculopathy and to investigate demographic, clinical, and procedure-related variables which may predict treatment response. By analyzing pain scores before and after the procedure, this study seeks to better define the predictors of clinical outcome following this intervention.