Effect of Integrated Neuromuscular Inhibition Technique on Subjects With Neck Pain and Forward Head Posture
Primary Purpose
Neck Pain and Forward Head Posture
Status
Not yet recruiting
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Integrated Neuromuscular inhibition
traditional treatment
Sponsored by
About this trial
This is an interventional treatment trial for Neck Pain and Forward Head Posture focused on measuring neck pain, Forward head posture
Eligibility Criteria
Inclusion Criteria:
- - Adolescent Female physical therapy students between 18-23 years old
- BMI between 18.5-25 kg/m²
- Symptomatic forward head posture with CVA 49° or less.
- Latent trigger point
- Neck pain more than 3 months
Exclusion Criteria:
- Cervical disc
- Myelopathy or cervical radiculopathy
- Cervical spine surgery in the past
- Having received physical therapy in the three months prior to the study
- Non- rheumatologic diseases as multiple sclerosis, thyroid dysfunction and chronic infection.
- Rheumatologic condition as poly-articular osteoarthritis, rheumatoid arthritis and advanced cervical spine degenerative diseases. -
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Integrated Neuromuscular Inhibition
traditional treatment
Arm Description
Integrated Neuromuscular Inhibition in addition to traditional treatment will be received three times a week for eight weeks. Integrated Neuromuscular Inhibition will be contain three combined manual treatment ( ischemic compression , strain counter strain , Muscle energy technique )
traditional treatment will be received three times a week for eight weeks . traditional treatment in Form of stretching and strenghthening of cervical muscles and postural advices
Outcomes
Primary Outcome Measures
Craniovertebral angle
Craniovertebral angle (CVA): is the angle formed between a horizontal line through the spinous process of C7 and a line from the tragus of the ear
Secondary Outcome Measures
Neck pain intensity level
Neck pain will measured by visual analogue scale ( VAS) .When responding to a VAS item, patients make marks along 100 mm line at the point they feel represents their current pain state .
with 100 mm means high level of pain and 0 means no pain
change in Neck Functional disability
Neck disability will measured by English neck disability index (NDI) Questionnaire is composed of a total of 10 questions.Each question has 6 answer options which pertain to a level of severity (0-5) with total score of 50 ,when NDI is high the neck function is the worst
Cervical Range of motion ROM
Cervical Range of motion will measured by clinometer application
Cervical proprioception
Cervical proprioception will measured by clinometer application
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05439018
Brief Title
Effect of Integrated Neuromuscular Inhibition Technique on Subjects With Neck Pain and Forward Head Posture
Official Title
Effect of Integrated Neuromuscular Inhibition Technique on Subjects With Neck Pain and Forward Head Posture
Study Type
Interventional
2. Study Status
Record Verification Date
July 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
October 2022 (Anticipated)
Primary Completion Date
December 2022 (Anticipated)
Study Completion Date
January 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Cairo University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
To investigate the effects of integrated neuromuscular inhibition technique for upper trapezius and suboccipital muscles on craniovertebral angle in neck pain and forward head posture subjects.
To investigate the effects of integrated neuromuscular inhibition technique for upper trapezius and suboccipital muscles cervical pain intensity level in neck pain and forward head posture subjects.
To investigate the effects of integrated neuromuscular inhibition technique for upper trapezius and suboccipital muscles on cervical range of motion in neck pain and forward head posture subjects.
To investigate the effects of integrated neuromuscular inhibition technique for upper trapezius and suboccipital muscles on cervical proprioception in neck pain and forward head posture subjects.
To investigate the effects of integrated neuromuscular inhibition technique for upper trapezius and suboccipital muscles cervical function in neck pain and forward head posture subjects.
Detailed Description
Forward head posture (FHP) is one of the most common types of postural abnormality, and it is generally described as an anterior position of the head in relation to the vertical line of the body's center of gravity. Many researchers have reported that several factors, including headache, neck pain, and musculoskeletal disorders such as temporomandibular disorders or rounded shoulders, are related to FHP . It is associated with shortening of the upper trapezius, the posterior cervical extensor muscles, the sternocleidomastoid muscle and the levator scapulae muscle Forward head posture (FHP) is a forward inclination of the head with cervical spine hyperextension and is associated with shortening of the upper trapezius, the splenius and semispinalis capitis and crevice's, the cervical erector spinae and the levator scapulae musculature . A significant number of the population experiences neck related musculoskeletal problems caused by abnormal forward head posture. Forward Head Posture (FHP) is a common postural deviation reported in the literature, and has been considered as a risk factor for the development of neck pain. Around 61.3% adults with neck pain, working using computers were reported to have FHP In addition, patients with chronic neck pain demonstrated weakness in their deep neck flexors and presented with FHP when distracted. Neck pain is a common disorder characterized by pain, discomfort or soreness experienced in a region between the inferior margin of the occipital bone and T1. Prevalence of neck pain in employees is not the same all over the world. In western countries it has been reported to be between 34% and 54%.As neck pain could become a chronic and disabling symptom, discovering and controlling risk factors seems to be a reasonable prevention strategy. Improper posture could be improved by education and proper reminders to decrease the prevalence of neck pain and increase the quality of life. It is thought that adolescents or patients with neck pain (NP) have a more forward head posture, thus a smaller craniovertebral (CV) angle than age-matched pain-free participants. It was concluded that the CV angle is negatively correlated with the disability of patients with neck pain. So, patients with small CV angle have a greater forward head posture, and the greater the forward head posture, the greater the disability
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neck Pain and Forward Head Posture
Keywords
neck pain, Forward head posture
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
this trial has two groups ,one experimental and one control
Masking
InvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
40 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Integrated Neuromuscular Inhibition
Arm Type
Experimental
Arm Description
Integrated Neuromuscular Inhibition in addition to traditional treatment will be received three times a week for eight weeks. Integrated Neuromuscular Inhibition will be contain three combined manual treatment ( ischemic compression , strain counter strain , Muscle energy technique )
Arm Title
traditional treatment
Arm Type
Active Comparator
Arm Description
traditional treatment will be received three times a week for eight weeks . traditional treatment in Form of stretching and strenghthening of cervical muscles and postural advices
Intervention Type
Other
Intervention Name(s)
Integrated Neuromuscular inhibition
Other Intervention Name(s)
INMI
Intervention Description
Integrated Neuromuscular Inhibition in addition to traditional treatment will be received three times a week for eight weeks. Integrated Neuromuscular Inhibition will be contain three combined manual treatment ( ischemic compression , strain counter strain , Muscle energy technique ) traditional treatment will be received three times a week for eight weeks . traditional treatment in Form of stretching and strenghthening of cervical muscles and postural advices
Intervention Type
Other
Intervention Name(s)
traditional treatment
Intervention Description
traditional treatment will be received three times a week for eight weeks . traditional treatment in Form of stretching and strenghthening of cervical muscles and postural advices
Primary Outcome Measure Information:
Title
Craniovertebral angle
Description
Craniovertebral angle (CVA): is the angle formed between a horizontal line through the spinous process of C7 and a line from the tragus of the ear
Time Frame
up to eight weeks
Secondary Outcome Measure Information:
Title
Neck pain intensity level
Description
Neck pain will measured by visual analogue scale ( VAS) .When responding to a VAS item, patients make marks along 100 mm line at the point they feel represents their current pain state .
with 100 mm means high level of pain and 0 means no pain
Time Frame
up to eight weeks
Title
change in Neck Functional disability
Description
Neck disability will measured by English neck disability index (NDI) Questionnaire is composed of a total of 10 questions.Each question has 6 answer options which pertain to a level of severity (0-5) with total score of 50 ,when NDI is high the neck function is the worst
Time Frame
up to eight weeks
Title
Cervical Range of motion ROM
Description
Cervical Range of motion will measured by clinometer application
Time Frame
up to eight weeks
Title
Cervical proprioception
Description
Cervical proprioception will measured by clinometer application
Time Frame
up to eight weeks
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
23 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
- Adolescent Female physical therapy students between 18-23 years old
BMI between 18.5-25 kg/m²
Symptomatic forward head posture with CVA 49° or less.
Latent trigger point
Neck pain more than 3 months
Exclusion Criteria:
Cervical disc
Myelopathy or cervical radiculopathy
Cervical spine surgery in the past
Having received physical therapy in the three months prior to the study
Non- rheumatologic diseases as multiple sclerosis, thyroid dysfunction and chronic infection.
Rheumatologic condition as poly-articular osteoarthritis, rheumatoid arthritis and advanced cervical spine degenerative diseases. -
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Somaya Elsayed, Assistant lecturer
Phone
01115593279
Email
somyaowais@gmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Hend Ahmed, lecturer
Phone
01024420121
Email
Hendhamdy110@yahoo.com
12. IPD Sharing Statement
Citations:
PubMed Identifier
34496471
Citation
Mohamed DA, Kamal RM, Gaber MM, Aneis YM. Combined Effects of Extracorporeal Shockwave Therapy and Integrated Neuromuscular Inhibition on Myofascial Trigger Points of Upper Trapezius: A Randomized Controlled Trial. Ann Rehabil Med. 2021 Aug;45(4):284-293. doi: 10.5535/arm.21018. Epub 2021 Aug 30.
Results Reference
background
PubMed Identifier
30368338
Citation
Saadat Z, Hemmati L, Pirouzi S, Ataollahi M, Ali-Mohammadi F. Effects of Integrated Neuromuscular Inhibition Technique on pain threshold and pain intensity in patients with upper trapezius trigger points. J Bodyw Mov Ther. 2018 Oct;22(4):937-940. doi: 10.1016/j.jbmt.2018.01.002. Epub 2018 Jan 17.
Results Reference
background
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Effect of Integrated Neuromuscular Inhibition Technique on Subjects With Neck Pain and Forward Head Posture
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