Neck Pain Clinical Trial
Official title:
Bio-mechanical Reasoning and Lateral Specificity of Upper Cervical Joint Mobilization to Improve Cervical Rotation, Improve Function and Reduce Pain.... Does it Matter?
Participants with limited neck rotation are recruited to determine if manual therapy (joint stretching) techniques applied in a bio-mechanically correct sequence will improve neck motion, function and pain better than if the manual therapy is applied in the opposite direction. Each participant will receive both the correct and the incorrect applications in randomized order with each treatment separated by 2-3 days. Improvement in neck motion, function and pain will be assessed after each session.
Participants are recruited consecutively through referral from provider clinics or through
self referral to physical therapy in the outpatient rehabilitation clinic at Indiana
University Health West Hospital in Avon Indiana. After obtaining informed consent and meeting
study criteria, participants will be randomized into either first receiving atlanto-axial
joint mobilizations in a bio-mechanically correct or incorrect direction with respect to
their loss of cervical rotation. Outcome measures will be completed both pre and post
treatment. The participants will then be given self stretches at home to mimic the same
intervention performed in the clinic three times per day. The participants will then return
to the clinic in two or three days to receive the opposite treatment and opposite home
program. Outcome data will again be collected both pre and post treatment. Participants will
return for a final visit in two or three days and final outcome data will be collected and
the participant will be offered continuation of physical therapy if neck symptoms still
persist.
Planned Statistical Analysis:
- Descriptive statistics of subjects: age, gender, date of onset, Neck Disability Index,
cervical active range of motion rotation, initial numeric pain rating at rest and
rotating to the limited side
- Repeated measures ANOVA effect sizes for comparing differences between:
1. Pre and post treatment comparing with-in treatment change for cervical range of
motion rotation and numeric pain ratings on 1st and 2nd visits. Also comparing post
treatment in cervical range of motion rotation and numeric pain ratings between 2nd
and 3rd visits.
2. Neck disability index change between 1st and 2nd visits and 2nd and 3rd visits
- Power calculation (actual achieved power)
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