Scapular Stabilization vs Functional Exercises on Chronic Neck Pain

Comparative Effects of Scapular Stabilization Versus Scapular Functional Exercises on Chronic Neck Pain.

This project is a Randomized clinical trial, will be conducted to check the comparative effects of scapular stabilization versus scapular functional exercises in patients with chronic neck pain. Study duration will be of 8 months, convenient sampling will be done, subject following eligibility criteria from Amina Physical therapy and rehab Centre Lahore, will be randomly allocated in two groups, baseline assessment will be done, Group A participants will be given baseline treatment along with scapular stabilization exercises, Group B participants will be given baseline treatment along with scapular functional exercises. Assessment will be done in 4th week and 8th week via, Visual analogue scale for neck pain, Function of neck will be assessed by Neck disability index and inclinometer measurements of cervical ranges,3 sessions per week will be given, data will be analyzed by using SPSS version 21.

In recent years musculoskeletal related problems are the leading cause of discomfort in people worldwide. Chronic neck pain is among the most commonly reported problems to physicians. Even before reporting to clinics there is long history of using over the counter pain killers. For the duration of rehabilitation in patients who are suffering from chronic neck pain, exercising has been considered one of the maximum proof-based modalities. Rehabilitation exercises that aim to return functionality of the scapular muscles are deemed necessary to render a successful result on chronic neck pain. In previous researches no one explains the specific treatment protocol in scapular exercises. The current study has compared the effects of scapular stabilization exercises and scapular functional exercises protocol and also compare which is more effective for chronic neck pain.

In Scapular stabilization exercise, following treatment protocol will involve. In supine position, for the relaxation of body, patient will take a deep breath. In sitting position, patient will sit on the chair, placed both feet on the floor while bending knee at 90 degree. After this patient will raise his hand overhead with 90 degree flexion and elbow extension and also perform scapular retraction. (10 sec hold, 10 reps, 20 sec break). In quadrupled position with 120 degree flexion and shoulder abduction patient will lifted his hands. (10 sec hold, 10 reps, 20 sec break) TYI exercises will be administered T shape: Place both arms horizontal with thumbs up. (10 times, 5 sec hold, 3 sets) Y-shape: In prone lying place arms in 45 degree. (10 times, 5 sec hold, 3 sets) I-shape: In prone position patients will place his both arms overhead. (10 times, 5 sec hold, 3 sets). These above exercises will perform 3 times a week for eight weeks.

In Scapular functional exercises, following treatment protocol will involve Press-up (in a chair). Push-up plus, Grade 1, in oblique position exercise will be performed with the support of a table. After progression perform this in horizontal plane. Lateral pull down Horizontal pull apart Prone flexion: in prone position on plinth. Both arms placed overhead, and then raise arms towards ceiling. Prone rows: in prone position, with elbow straight, slowly raise arms towards ceiling while bending the elbows. These all above exercises will perform by holding dumbbells in hands (20RM at first week, 10RM at last week) with 3 sets, 3 times a week for eight weeks.

This VAS will be used in this study to measure Pain. Patients will be instructed to assess the severity of neck pain experienced last week on a 0-10 cm horizontal line (0 = painless and 10 = worst pain imaginable).

NDI will be used to measure function of neck. Neck disability index is the first tool to measure the self-reported disability in patients with neck pain. Total score of NDI is 50 and ranges are defined on the level of disability.

Cervical spine range of motion will be assessed by inclinometer. It consists of a circular, fluid-filled disk with a bubble that indicates the number of degrees on the scale of protractor. Bubble inclinometer showed good intrarater and interrater reliability with intraclass Correlation Coefficient

Inclusion Criteria: Patients of both genders.(18-35 years of age) Patients having chronic neck pain(>3 months duration) Patient with restricted ROM of cervical. VAS≥4(16) NDI ≥10 Exclusion Criteria: History of Head, Neck, cervical spine and shoulder injury. History of cervical radiculopathy History of malignancy, scoliosis, torticollis Diagnosed cases of disc prolapse, stenosis, herniation, spondylolisthesis, osteoporosis, and those with current use of any medication or physical therapy treatment were excluded.

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