Active Release Versus Strain-Counter-strain Technique in Patients With Non-Specific Neck Pain

NCT07026006 | Recruiting DMC

• 1 other identifier: Junad- REC/RCR&AHS 24/0141
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

The study design will be a randomized clinical trial (RCT) aims to compare the effects of Active Release Technique and Strain-Counterstrain on pain, range of motion, cranio-vertebral angle, and disability in patients with non-specific neck pain. Data will be collected from Safi Teaching Hospital, Faisalabad, Pakistan. Using a non-probability purposive sampling method, participants aged 18-45 years with localized cervical pain and stiffness will be selected based on inclusion and exclusion criteria. The inclusion and exclusion criteria will be; Participants aged 18-45, both male and female, experiencing neck pain for at least 2 months, with palpable taut bands in upper trapezius and SCM, active trigger points in upper trapezius, levator scapulae, and SCM, NPRS score \>3/10 for neck region, and localized pain/stiffness in cervical spine (C3-C7) without upper limb radiculopathy, confirmed by negative Spurling's test, upper limb tension test, and shoulder abduction test. Subjects will be excluded if presented with a history of Participants who received myofascial treatment in the preceding month or have a diagnosis of fibromyalgia, KNGF Clinical Practice Guideline Grade III or IV, or neurological deficits. Participants will be equally divided into 2 groups using a random number generator table. Group A will receive Active Release Technique, while Group B will receive Strain-Counterstrain. Both groups will also receive hot packs, superficial neck muscles stretching, and neck isometrics. Outcome measures, including the Numerical Pain Rating Scale for pain, goniometer for range of motion, cranio-vertebral angle measurement, Neck Disability Index, will be assessed at baseline and after four weeks. Ethical approval will be obtained from the Ethical Committee of Riphah International University, and informed consent will be secured from all participants. The outcomes will focus on pain intensity, cervical range of motion, cranio-vertebral angle, and disability, Data analysis will be performed using SPSS version 25. The findings are expected to provide valuable insights into the comparative efficacy of these manual therapy techniques, informing clinical practice and improving patient outcomes in the management of non-specific neck pain.

Conditions

Neck Pain

Keywords

Neck Pain; Soft Tissue Therapy; Trigger points; Cervicalgia; Posterior Cervical Pain

Outcome Measures

Primary Outcomes (4)

• Numeric Pain rating Scale

  Baseline, 4th Week

• Neck Disability Index

  Baseline, 4th Week

• Craniovertebral Angle

  Baseline, 4th Week

• Cervical Range of Motion

  Baseline, 4th Week

Study Arms (2)

Treatment Group A

EXPERIMENTAL

Active Release Technique

Other: Active Release Technique

Treatment Group B

ACTIVE COMPARATOR

Strain-counterstrain

Other: Strain-counterstrain

Interventions

Active Release Technique OTHER

Patients will receive Active Release Technique (ART) protocol will be applied to 4 muscles Including; trapezius, levator scapulae, sternocleidomastoid (SCM), and suboccipital muscles (for 15 minutes)

Treatment Group A

Strain-counterstrain OTHER

Patients will receive Strain-counterstrain (SCS) protocol will be applied to 4 muscles Including the trapezius, levator scapulae, sternocleidomastoid (SCM), and suboccipital muscles for 15 minutes.

Treatment Group B

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age 18-45 years
• Both male and female
• Patients with neck pain for at least 2 months
• Palpable taut bands in upper trapezius, SCM
• ATrPs in upper trapezius, levator scapulae, SCM
• NPRS score is \>3/10 on NPRS for neck region
• Individuals with a Craniovertebral angle less than 53
• Individuals having grade 2 severity of neck pain according to KNGF Guidelines
• Localized pain/stiffness in cervical spine (C3-C7) without upper limb radiculopathy
• Diagnostic Tests: Negative Spurling's test, upper limb tension test, and shoulder abduction test

You may not qualify if:

• Myofascial treatment in the preceding month
• Diagnosis of fibromyalgia
• Congenital problems
• Trigger point injections
• Individuals with KNGF Clinical Practice Guideline Grade III and IV severity of neck pain
• Respiratory disease and joint disease
• Neurological deficit

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Riphah Rehabilitation Clinic

Lahore, Punjab Province, 54000, Pakistan

RECRUITING

Related Publications (2)

• de Campos TF, Maher CG, Steffens D, Fuller JT, Hancock MJ. Exercise programs may be effective in preventing a new episode of neck pain: a systematic review and meta-analysis. J Physiother. 2018 Jul;64(3):159-165. doi: 10.1016/j.jphys.2018.05.003. Epub 2018 Jun 19.

  PMID: 29908853 BACKGROUND

• Cabrera-Martos I, Rodriguez-Torres J, Lopez-Lopez L, Prados-Roman E, Granados-Santiago M, Valenza MC. Effects of an active intervention based on myofascial release and neurodynamics in patients with chronic neck pain: a randomized controlled trial. Physiother Theory Pract. 2022 Sep;38(9):1145-1152. doi: 10.1080/09593985.2020.1821418. Epub 2020 Sep 15.

  PMID: 32930638 BACKGROUND

MeSH Terms

Conditions

Neck Pain

Condition Hierarchy (Ancestors)

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

Study Officials

• Syed Shakil ur Rehman, PhD

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Syed Shakil ur Rehman, PhD

CONTACT

+92 320 786661; shakil.urrehman@riphah.edu.pk

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: June 11, 2025
• First Posted: June 18, 2025
• Study Start: May 1, 2025
• Primary Completion: August 30, 2025
• Study Completion: September 28, 2025
• Last Updated: June 18, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)