Deep Cervical Flexor and Sensorimotor Training for Chronic Neck Pain

NCT07040605 | Recruiting

• 1 other identifier: P.T.REC/012/005888
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial aims to investigate the effectiveness of deep cervical flexor muscle training combined with sensorimotor (proprioception) training in patients with chronic mechanical neck pain. The study will be conducted in outpatient clinic of the faculty of physical therapy- Cairo University, involving 60 participants aged 20-40 years with neck pain persisting for more than three months. Participants will be randomly allocated into an experimental group receiving conventional physical therapy plus deep flexor and sensorimotor training, and a control group receiving conventional treatment alone. Outcome measures will include pain intensity, craniovertebral angle (CVA), cervical range of motion (ROM), segmental mobility, neuromotor control, proprioception (head repositioning accuracy), and respiratory function (FEV1 and PEF). Assessments will be performed at baseline and after four weeks of intervention. The study seeks to provide evidence-based recommendations for physiotherapy management of mechanical neck pain, particularly addressing the gaps in literature within the regional context.

Conditions

Mechanical Neck Pain

Keywords

mechanical neck pain; sensorimotor training; Deep cervical flexors muscles

Outcome Measures

Primary Outcomes (1)

• Change in Pain Intensity Score on the Numeric Pain Rating Scale (NPRS) from Baseline to 4 Weeks

  which will be measured using the Numeric Pain Rating Scale (NPRS), a validated 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain).

  4 weeks

Secondary Outcomes (5)

• Change in Cervical Range of Motion (ROM) in Degrees Measured by Digital Inclinometer from Baseline to 4 Weeks

  4 weeks

• Change in Neuromotor Control of the Deep Cervical Flexor Muscles Assessed by Craniocervical Flexion Test (CCFT) from Baseline to 4 Weeks

  4 weeks

• Change in Craniovertebral Angle (CVA) Measured by AI Posture Evaluation and Correction System (APECS) from Baseline to 4 Weeks

  4 weeks

• Change in Cervical Proprioceptive Function Assessed by Head Repositioning Accuracy (HRA) Test in centimetre from Baseline to 4 Weeks

  4 weeks

• Change in Respiratory Function Parameters (FEV1 and PEF) Measured by Spirometer from Baseline to 4 Weeks

  4 weeks

Study Arms (2)

core stability exercise and proprioception training

EXPERIMENTAL

Participants in the experimental group will receive a structured four-week physiotherapy intervention consisting of conventional physical therapy treatment combined with deep cervical flexor muscle training and proprioception (sensorimotor) training.

Other: Deep cervical flexors muscle training and sensorimotor training

conventional physical therapy exercise

ACTIVE COMPARATOR

. Conventional physiotherapy will include stretching exercises targeting the sternocleidomastoid, upper trapezius, levator scapulae, scalene, Rhomboids and pectoralis muscles, performed in three repetitions, holding each stretch for thirty seconds, strengthening exercises will be provided Isometrically for the cervical flexors, extensors and at sides using a prescription of three sets of ten repetitions with a ten-second hold and two minutes of rest between sets. TENS for 15 min. hot back for 15 min.

Other: conventional physical therapy exercise

Interventions

Deep cervical flexors muscle training and sensorimotor training OTHER

deep cervical flexor muscle training will be performed according to the protocol of Jull and Falla using a pressure biofeedback unit. Participants will be positioned in a supine crook-lying posture with the neck in a neutral position, and the air bag of the pressure biofeedback unit will be placed beneath the cervical lordosis and inflated to a baseline of 20 mmHg. Patients will be instructed to perform a gentle nodding action, increasing the pressure by 2 mmHg increments up to 30 mmHg. Each increment will be held for ten seconds, repeated in three sets of ten repetitions, with a two-minute rest between sets. To enhance activation of the deep flexors, patients will be instructed to keep their mouth open during the exercise. Proprioception training will include head relocation practice, oculomotor exercises, and eye-head coordination exercises.

core stability exercise and proprioception training

conventional physical therapy exercise OTHER

will include stretching exercises targeting the sternocleidomastoid, upper trapezius, levator scapulae, scalene, Rhomboids and pectoralis muscles, performed in three repetitions, holding each stretch for thirty seconds, strengthening exercises will be provided Isometrically for the cervical flexors, extensors and at sides using a prescription of three sets of ten repetitions with a ten-second hold and two minutes of rest between sets. TENS and Hot back.

conventional physical therapy exercise

Eligibility Criteria

• Age: 20 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Participants aged between 20-40 years.
• participant having neck pain report more than 4 in NPRS, and at least within the last three months known as chronic pain.
• participant with CVA more than 45 degrees and less than 50.
• Participant with poor cervical muscle endurance.

You may not qualify if:

• Participant with acute neck pain (less than three month).
• Participant with radiated neck pain.
• Participant who undergone recent surgeries within the thoracic, shoulder girdle, and cervical spine regions.
• Participants who were already undergoing treatment for neck pain.
• Participant with fixed spinal deformity.
• Pregnant women.

Sponsors & Collaborators

• Al-Neelain University: lead

Study Sites (1)

Out-patient clinic- Faculty of physical therapy

Cairo, Giza Governorate, 12111, Egypt

RECRUITING

Study Officials

• Khaled A Ayad, Professor

  Cairo University

  STUDY CHAIR

• Karima A Mohamed, PhD

  Cairo University

  STUDY DIRECTOR

Central Study Contacts

Halla T Ahmed, MSc

CONTACT

+966545277073; htajelsir@ju.edu.sa

Karima A Mohamed, PhD

CONTACT

+201114032967; karima_hassan2008@yahoo.com

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: lecturer of orthopaedic physical therapy, faculty of physical therapy

Study Record Dates

• First Submitted: June 19, 2025
• First Posted: June 27, 2025
• Study Start: June 19, 2025
• Primary Completion: November 1, 2025
• Study Completion: December 1, 2025
• Last Updated: June 29, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ICF
• Time Frame: 6 months after publication
• Access Criteria: study protocol

Locations

EG (1)