Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT05074615 |
Other study ID # |
REC/00945 Laiba Gul |
Secondary ID |
|
Status |
Completed |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
November 2, 2021 |
Est. completion date |
February 17, 2022 |
Study information
Verified date |
March 2022 |
Source |
Riphah International University |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
To determine the effects of cranio-cervical flexion training on the cervical proprioception
and pain in patients with mechanical neck pain.
Description:
Neck pain is a very common health related problem that alters an individual's daily life. In
the over-all population and musculoskeletal training, it happens next to low back pain in its
frequency. Neck pain has a point incidence of approximately 13% and a lifetime incidence of
almost 50%. It is a joint reason for visits in accidents and emergency departments. Neck pain
is said to be more common in females than in males and it crests at the middle age. Sedentary
lifestyles are contributing to the occurrence of neck pain. Chronic neck pain affects a very
significant number when it comes to the adult population. Proprioception involves the body
sensations that helps in the proper orientation of the body relative to the movement of
joints and bones, in rest and in motion. When the joint position sense is disturbed due to
some kind of abnormality, a person adopts an abnormal posture. If this faulty posture
continues, this causes abnormalities in the spine and causes impaired stability. The system
of proprioception in our body is dependent upon different afferent stimulus reaching towards
mechanoreceptors from afferent neurons. Due to the presence of high densities of muscle
spindles in the slow twitch fibers in deep, small intrinsic dorsal and sub-occipital muscles
play very important role in the control of posture. The cervical musculature has a number of
other systems working in congregation including vestibular system, visual as well as central
nervous system feedbacks. All of these systems send the signals according to the body and
head movements. That is why, the involvement of upper cervical region can cause impaired
proprioception and altered afferent stimulus. When many levels of nervous system gets
involved, it can impact a change in the sensitivity of muscle spindle and causes one of the
major proprioception shortages in cervical patients. For the maintenance of motion, posture
and joint position, proprioceptive information has an important role and any factor that
disrupts this information may be considered a major reason of incorrect motion patterns and
symptoms of chronic recurrent pain.
Cranio-Cervical flexion training which aims to enhance activation of the Deep Cervical
flexors (DCFs) and restore coordination between the deep and superficial cervical flexors, is
one form of exercise that has been advocated for addressing impaired neuromuscular control of
the cervical flexors. Clinical trials examining the effectiveness of this exercise regime
have demonstrated positive outcomes in terms of decrease in neck pain and disability,
improvement in sitting posture, enhanced neuromuscular control of the cervical flexors in
patients with chronic neck pain and also improved proprioceptive acuity of the neck,
indicating that proprioception can be enhanced with specific exercise. Cranio-cervical
flexion training will be done using Pressure Biofeedback Device by Chattanooga.
A cervical range of motion (CROM) device will be used to assess cervical proprioception. The
unit of CROM has three inclinometers attached to it and each inclinometer collects degree of
movement in each plane. The CROM device has an advantage over the use of a single
inclinometer that it does not have to be moved again to measure the degree of movements in
other planes. One the CROM device is mounted on the patient's head, instructions are given to
the patient regarding their neutral head movements and target head movements. After that,
patient is blindfolded and all the movements are performed with patient being blindfolded. No
feedback should be given during the ongoing session. This entire procedure takes around 15
minutes for one individual.
In the light of previous research works, the disturbances in the proprioception involving
cervical spine are a very important factor in treating the patients with neck pains. It is
very important for a physical therapist to address these deficits and stop the vicious cycle
of pain as well as improve proprioception. So, this study is aimed at improving the
proprioception and decreasing mechanical neck pain with the help of deep cervical muscles
flexion training using pressure biofeedback device.