Effect of Upper Thoracic Manipulation on Neck Pain and Selected Muscle Activities

NCT06926738 | Completed

• 1 other identifier: Upper thoracic manipulation
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 2

Brief Summary

This study will investigate the immediate and short-term effects of upper thoracic manipulation versus sham upper thoracic manipulation on Pain intensity, Cervical ROM, the myoelectric activity of the sternocleidomastoid muscle and upper trapezius muscle during Maximum voluntary isometric contraction.

Conditions

Chronic Neck Pain

Keywords

Neck Pain; Thoracic manipulation; Manual Therapy; Neck pain with Mobility Deficits; Muscle activity

Outcome Measures

Primary Outcomes (1)

• Pain intensity

  A hard copy of the Visual analogue scale will be given to the patient who will be asked to mark a perpendicular line between the two borders of the scale to express his/her pain level. It will be measured pre-treatment, post-treatment, and each week for 2 weeks. The level of pain will be measured at the end range of active extension.

  Pre-intervention, Immediately Post-Intervention, One-week Post-intervention, Two-week post-intervention.

Secondary Outcomes (3)

• Cervical Range of Motion

  Pre-intervention, Immediately Post-Intervention, One-week Post-intervention, Two-week post-intervention.

• Sternocleidomastoid muscle activity

  Pre-intervention, Immediately Post-Intervention, One-week Post-intervention, Two-week post-intervention.

• Upper trapezius muscle activity

  Pre-intervention, Immediately Post-Intervention, One-week Post-intervention, Two-week post-intervention.

Study Arms (2)

Upper thoracic manipulation group

EXPERIMENTAL

The Patients in this group will receive Upper Thoracic Manipulation.

Other: Upper Thoracic Manipulation

Sham Upper Thoracic Manipulation

SHAM COMPARATOR

The patients in this group will receive the sham upper thoracic manipulation.

Other: Sham Comparison

Interventions

Upper Thoracic Manipulation OTHER

Segmental mobility will be assessed using posteroanterior central vertebral pressure and posteroanterior unilateral vertebral pressure. It will be done while the patient lies in a prone position and the examiner stands at the level of the patient's head. Afterwards, the subjects in the thoracic manipulation group will be asked to lie in a prone position on a standard examination table and they were marked on both sides of the zygapophyseal joint of the selected segments including levels from T1- T4. Subjects will then be instructed to perform deep inhalation and exhalation and at the end of exhalation, the Clinician will perform thoracic manipulation (screw thrust technique) at the selected segmental level/s. This maneuver will be repeated for a maximum of two attempts in case of no hearing of a pop sound. It will be performed by an experienced physiotherapist with more than 10-year experience.

Upper thoracic manipulation group

Sham Comparison OTHER

Segmental mobility will be assessed using posteroanterior central vertebral pressure and posteroanterior unilateral vertebral pressure. It will be done while the patient lies in a prone position and the examiner stands at the level of the patient's head. Afterwards, the subjects in the thoracic manipulation group will be asked to lie in a prone position on a standard examination table and they were marked on both sides of the zygapophyseal joint of the selected segments including levels from T1- T4. Subjects will then be instructed to perform deep inhalation and exhalation and at the end of exhalation, the Clinician will just the place the hands on the selected levels in the same hand placement of Thoracic manipulation group (screw thrust technique) without applying the manipulation. It will be performed by an experienced physiotherapist with more than 10-year experience.

Sham Upper Thoracic Manipulation

Eligibility Criteria

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

You may qualify if:

• Male and female subjects diagnosed and classified as having chronic non-specific NP with mobility disorders based on clinical guidelines of NP:
• Having NP for at least 3 months that may be associated with referred shoulder or upper extremity pain (Blanpied et al., 2017; Erdem et al., 2021; Puntumetakul et al., 2015).
• Present with a limitation of cervical ROM and their pain can be provoked by sustained end-range spinal movements or positions will be included (Blanpied et al., 2017).
• Patients present with unilateral or bilateral symptoms will be included (Blanpied et al., 2017; Yang et al., 2015).
• Age between 18-40 (J. Dunning \& Rushton, 2009)
• Negative four tests of the Wainner cluster to exclude NP with radiating pain (Wainner et al., 2003).
• Hypomobility of at least one of the upper thoracic vertebrae (T1-T4) during segmental mobility assessment (Ssavedra-Hernández et al., 2011).

You may not qualify if:

• Subjects diagnosed as cervical radiculopathy or myelopathy (Ssavedra-Hernández et al., 2011).
• A history of whiplash injury, past cervical or thoracic surgery, rheumatoid arthritis, spinal fracture, heart disease, a recent significant trauma, and meningitis (Joshi et al., 2020; Puntumetakul et al., 2015).
• The presence of contraindications of spinal manipulation as spinal infection and spinal osteoporosis(Ssavedra-Hernández et al., 2011).

Sponsors & Collaborators

• Cairo University: lead

Study Sites (2)

CairoU

Giza, 12611, Egypt

Location

Faculty of Physical Therapy, Cairo University

Giza, 12611, Egypt

Location

MeSH Terms

Conditions

Neck Pain

Condition Hierarchy (Ancestors)

Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant lecturer

Study Record Dates

• First Submitted: April 5, 2025
• First Posted: April 15, 2025
• Study Start: April 15, 2025
• Primary Completion: February 1, 2026
• Study Completion: February 1, 2026
• Last Updated: March 3, 2026

Record last verified: 2025-01

Data Sharing

• IPD Sharing: Will not share

Locations

EG (2)