Comparison of the Immediate Effects of Manual Therapy Techniques in Non-Specific Neck Pain

NCT06959160 | Completed

• 1 other identifier: Acetinkaya006
• Study Type: interventional
• Target: 39
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to investigate the effects of manual therapy techniques on joint range of motion, pain tolerance, grip strength, and functionality in individuals with non-specific neck pain. The study is experimental in design. Individuals aged between 18 and 55 who were diagnosed with non-specific neck pain and met the inclusion criteria participated in the study.

Conditions

Manual Therapies; Neck Pain

Keywords

Manual Therapy Techniques; Non-Specific Neck Pain; Immediate Effects

Outcome Measures

Primary Outcomes (4)

• Assessment of Cervical Joint Range of Motion

  The evaluation of cervical flexion, extension, right-left lateral flexion, and right-left rotation range of motion conducted using the CROM device. The CROM device is an inclinometer system affected by magnetic forces and gravity. Validity and reliability studies have been carried out to assess the movements of the cervical region using this device. There are no risks or side effects associated with this assessment method.

  Immediately before and after interventions, assessed within a single session

• Assessment of Grip Strength

  Grip strength of the individuals was measured using the "Jamar Hand Dynamometer" (Takei Scientific Instruments Co., Ltd. - Japan). Measurements were conducted as recommended in the literature, with the patient comfortably seated, shoulder abducted, elbow in 90 degrees of flexion, forearm in a neutral position, and wrist in 0-30 degrees of extension. Measurements were repeated three times with five-second intervals between each trial for both the dominant and non-dominant hands, and the average value was recorded as the result. There are no risks or side effects associated with this assessment method.

  Immediately before and after interventions, assessed within a single session

• Measurement of Pain Tolerance Threshold

  Pain tolerance was measured using the J-tech algometer device. Measurements were taken bilaterally, both on the right and left sides, at the C5 level and at the midpoint of the upper trapezius muscle. The measurements were repeated three times, and the average value was recorded as the result. There are no risks or side effects associated with this assessment method.

  Immediately before and after interventions, assessed within a single session

• Neck Disability Index

  This questionnaire is used for the evaluation of cervical function and has undergone validity and reliability studies. The questionnaire consists of 10 sections, with 6 multiple-choice options for each section. Scoring ranges from 0 to 5 for each section based on the selected response. The total score determines the overall result of the test. There are no risks or side effects associated with this assessment method.

  Immediately before and after interventions, assessed within a single session

Study Arms (3)

Atlanto-occipital Manipulation Group

EXPERIMENTAL

Participants in the first group received atlanto-occipital manipulation.

Other: Atlanto-occipital manipulation

Cervical Mobilization Group

EXPERIMENTAL

Participants in the second group underwent Grade II-III cervical mobilization techniques.

Other: Cervical mobilization

Trigger Point Therapy Group

EXPERIMENTAL

Participants in the third group received trigger point therapy, which included ischemic compression followed by myofascial stretching on the upper trapezius muscle.

Other: Trigger point therapy

Interventions

Atlanto-occipital manipulation OTHER

Participants in the first group received atlanto-occipital manipulation. The patient was positioned in a supine position, with the head rotated to one side. The therapist placed the middle and ring fingers of one hand on the patient's mastoid process, while the palm of the other hand made contact with the patient's jawline and cheek. A gentle traction force was applied to the cranial region using both hands. When the therapist sensed joint tension, a high-velocity, low-amplitude thrust was delivered in the direction of the traction with a slight rotational force. The procedure was performed bilaterally and lasted approximately 5 minutes.

Atlanto-occipital Manipulation Group

Cervical mobilization OTHER

Participants in the second group underwent Grade II-III cervical mobilization techniques, administered over a period of 10 minutes. The patient was positioned in a supine position, and the physiotherapist performed 10 minutes of Grade II-III mobilizations with an upward and downward incline (postero-anterior and antero-posterior mobilizations following the movement plane of the cervical zygapophyseal joints).

Cervical Mobilization Group

Trigger point therapy OTHER

Participants in the third group received trigger point therapy, which included ischemic compression followed by myofascial stretching on the upper trapezius muscle. The patient was positioned in a supine position, and the physiotherapist performed 10 minutes of Grade II-III mobilizations with an upward and downward incline (postero-anterior and antero-posterior mobilizations following the movement plane of the cervical zygapophyseal joints).

Trigger Point Therapy Group

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Be between the ages of 18 and 55
• Have been diagnosed with non-specific neck pain by a specialized physician
• Have been experiencing neck pain for less than 3 months
• Have a neck pain level of at least 3 on the Visual Analog Scale
• Have bilateral active trigger points in the upper trapezius muscle
• Have restricted active cervical range of motion

You may not qualify if:

• Presence of neurological deficit or radicular pain
• History of pathology or surgery in the cranio-cervical region
• Positive response in the extension-rotation test
• Use of anticoagulants or corticosteroids
• Presence of one or more red flags defined for non-specific neck pain

Sponsors & Collaborators

• Halic University: lead

Study Sites (1)

Halic University

Istanbul, Eyupsultan, 2022, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Neck Pain

Condition Hierarchy (Ancestors)

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

Study Officials

• Seda Saka, assoc. prof.

  Halic University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 28, 2025
• First Posted: May 6, 2025
• Study Start: September 15, 2023
• Primary Completion: December 30, 2024
• Study Completion: January 10, 2025
• Last Updated: August 3, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)