Combination of Upper Extremity Proprioceptive Neuromuscular Facilitation and Scapular Stabilization in Nonspecific Chronic Neck Pain with Scapular Dyskinesia

NCT06594809 | Not Yet Recruiting

• 1 other identifier: Upper extremity PNF and SD
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

To study the combination of upper extremity PNF patterns and SS exercises on improving neck pain, function, scapular position, and scapular muscles strength in patients with NSCNP and SD.

Conditions

Scapular Dyskinesis

Outcome Measures

Primary Outcomes (2)

• scapular muscle strength

  Hand-held dynamometer (HHD) (Model 01165, Lafayette Instrument Company, Indiana) is an easy and reliable device to assess isometric muscle strength for shoulder and scapular muscles in both clinical and research settings The patient will be instructed to maintain the midrange position during each muscle test as resistance was gradually applied via the HHD until the examiner matches the subject's effort Assess upper trapezius, middle trapezius, lower trapezius, and serratus anterior

  up to 4 weeks

• Assessment of scapular posture

  Assessment of scapular posture by lateral scapular slide test, It used to determine scapula involves measuring the distance from the inferior angle of the scapula to the nearest vertebral spinous process using a tape measure or goniometer in three positions: shoulder in neutral, shoulder at 45 degrees of coronal plane abduction with hands resting on hips, and the shoulder at 90 degrees abduction with the arms in full internal rotation.

  up to 4 weeks

Study Arms (3)

Group one

PLACEBO COMPARATOR

Neck-focused training consisted of a) cervical stretching, b) craniocervical flexion, and c) cervical retraction exercises d) Manual therapy, for three sessions per week for four weeks (Yildiz et al., 2018).

Other: Traditional neck pain treatment

Group two

ACTIVE COMPARATOR

The patients will receive Traditional treatment of neck pain and Scapular stabilization exercises (Blackburn exercises).

Other: Traditional neck pain treatment + Blackburn scapular stabilization exercises

Group three

EXPERIMENTAL

Patients will receive combination of traditional treatment of neck pain, SS (Blackburn exercises) and upper extremity PNF patterns.

Other: PNF

Interventions

PNF OTHER

Upper extremity PNF exercise is an exercise method that dynamically stabilizes the scapula and affect scapular muscles activity (Witt et al., 2011). Upper extremity PNF patterns consisted of four diagonal patterns (D1 flexion, D2 flexion, D1 extension, and D2 extension) and six key components manual contact, body position, verbal cues pattern of movement, timing of movement and resistance. Patient will be at sitting position with involved side up, head, spine, and scapula in neutral

Group three

Traditional neck pain treatment OTHER

Cervical muscles stretch + Craniocervical retraction ex + Manual therapy

Group one

Traditional neck pain treatment + Blackburn scapular stabilization exercises OTHER

The patients will receive Traditional treatment of neck pain and Scapular stabilization exercises (Blackburn exercises). Blackburn exercises are one of the ways to treat scapular dyskinesia. Perform 2 sets of 20 repetitions of each exercise each session (3 sessions per week) for four weeks (panse et al .,2018). The exercise load will be 60% of the one-repetition maximum (1-RM) during the first week due to their first exposure to the exercises. The evaluation of one-repetition maximum (1-RM) will be every week for all exercises. From the second evaluation, more weight will be added (compare to the previous evaluation) to maintain the overload.

Group two

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Have referred from orthopedic surgeon diagnosed with non specific chronic neck pain (NSCNP) that has been localized to the cervical and periscapular areas for at least three months.
• Aged from 18-40 years. 3- Having a score more than 10 on the Neck disability index (NDI). 4- Having SD according to Kibler's description. 5- BMI from 18.5 to 29.9 kg/m2.

You may not qualify if:

• History of previous neck surgery.
• Recent or old fractures.
• Cognitive impairment and inability to understand the scale.
• Systematic inflammatory disease e.g., rheumatoid arthritis and ankylosing spondylitis, neck pain with radiculopathy or neuropathy.
• Scapular dyskinesia due to other pathology such as shoulder impingement.
• A score of below 10 or above 40 points out of 50 on the NDI.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Faculty of physical therapy Cairo university

Giza, 387722, Egypt

Location

Central Study Contacts

Mohamed Ali ibrahim

CONTACT

002001061759217; mohamed.ibrahim@pt.cu.edu.eg

Enas Fawzy Youssef

CONTACT

002001127867507; Enas.fawzy@pt.cu.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: A triple-blinded randomized controlled trial will be conducted, ensuring that patients, the research assistant (who serves as the examiner for all patients), and the statistician are blinded to the treatment group.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Lecturer orthopedic department faculty of physical therapy Cairo university

Study Record Dates

• First Submitted: September 9, 2024
• First Posted: September 19, 2024
• Study Start: October 1, 2024
• Primary Completion: May 1, 2025
• Study Completion: June 1, 2025
• Last Updated: September 19, 2024

Record last verified: 2024-09

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL

Locations

EG (1)