Combined Effects of Bruegger's Exercises and Upper Thoracic Mobilizations in Patients With Non-specific Neck Pain

NCT07063004 | Not Yet Recruiting

• 1 other identifier: REC/RCR &AHS/24/0159 Maryam
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

Neck pain is a multifactorial disease, and is a major problem in modern society. Patients with NCNP usually have alterations in cervical proprioception and PS. They may also develop symptoms such as dizziness or vertigo. A recently published study shows that patients with NCNP suffer greater sensations of stunning and lack of proprioception than patients with benign paroxysmal vertigo.

Conditions

Neck Pain

Keywords

Pain; Disability; Manual therapy

Outcome Measures

Primary Outcomes (3)

• Numerical Pain Rating Scale (NPRS)

  Patient level of pain will be assessed using the NPRS scale. The NPRS was used to capture the patient's level of pain. Patients were asked to indicate the intensity of their current pain level using an 11-point scale, ranging from 0 (no pain) to 10 (worst pain imaginable).

  upto 4 weeks

• Neck Disability Index (NDI)

  Patient level of Disability will be assessed using NDI. The NDI is a self-report questionnaire with 10-items: pain intensity, personal care, lifting work, headaches, concentration, sleeping, driving, reading, and recreation. The response to each item is rated on a 6-point scale from 0 (no disability) to 5 (complete disability). The numeric responses for each item are summed for a total score ranging between 0 and 50; however, some evaluators have chosen to multiply the raw score by 2 and then report the NDI on a 0-100% Higher scores represent increased levels of disability.

  upto 4 weeks

• Universal Goniometer (UG)

  A large UG having 12-inch arms and full-circle plastic body will be used for measuring ACROM..It will be used to measure cervical AROM: flexion, extension, lateral flexion, and rotation.

  upto 4 weeks

Study Arms (2)

Bruegger's Exercise and Upper Thoracic Mobilization

EXPERIMENTAL

Bruegger's Exercise: The position will be held for 10 second at first session and then there will be an increment of 2 seconds during each session. Upper Thoracic Mobilization: Upper thoracic (T1-T6) mobilization (Maitland mobilization (Grade I, II and III; PA glide) applied in prone lying position from via spinous process. Amount of treatment will be 3-4 mobilizations for a vertebra for 30 seconds approximately.

Other: Bruegger's Exercise and Upper Thoracic Mobilization

Standard Physical Therapy

ACTIVE COMPARATOR

* Isometric exercises will be done for flexors, extensors, rotators, and lateral flexors of the neck. Isometrically contracting working muscle for 5 seconds against patients own hand, which was placed in compliance with the working muscles, with a total of 10 repetitions. * Passive stretching will apply to Upper trapezius, Levator scapulae, Sternocleidomastoid, Scalene, Pectoralis major and minor muscle for 3-5 repetition 10 with 20-30 second hold. Intensity of exercise will be prescribed according to patient's tolerance level. Duration of stretch will 15 to 30 seconds, 3-5repetition and for 10 minutes. * Postero-anterior Maitland mobilization (Grade I \& II) for C1-C2, Maitland lateral PA glide (Grade-III \& IV) for C3-C6. Time of oscillations will be two or three oscillations in a second for one to two minutes.

Other: Standard Physical Therapy

Interventions

Bruegger's Exercise and Upper Thoracic Mobilization OTHER

Bruegger's Exercise: The position will be held for 10 second at first session and then there will be an increment of 2 seconds during each session. Upper Thoracic Mobilization: Upper thoracic (T1-T6) mobilization (Maitland mobilization (Grade I, II and III; PA glide) applied in prone lying position from via spinous process. Amount of treatment will be 3-4 mobilizations for a vertebra for 30 seconds approximately.

Bruegger's Exercise and Upper Thoracic Mobilization

Standard Physical Therapy OTHER

Isometric exercises will be done for flexors, extensors, rotators, and lateral flexors of the neck. Isometrically contracting working muscle for 5 seconds against patients own hand, which was placed in compliance with the working muscles, with a total of 10 repetitions. Passive stretching will apply to Upper trapezius, Levator scapulae, Sternocleidomastoid, Scalene, Pectoralis major and minor muscle for 3-5 repetition 10 with 20-30 second hold. Intensity of exercise will be prescribed according to patient's tolerance level. Duration of stretch will 15 to 30 seconds, 3-5repetition and for 10 minutes. Postero-anterior Maitland mobilization (Grade I \& II) for C1-C2, Maitland lateral PA glide (Grade-III \& IV) for C3-C6. Time of oscillations will be two or three oscillations in a second for one to two minutes.

Standard Physical Therapy

Eligibility Criteria

• Age: 25 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Males and Females between 25 and 45 years of age with nonspecific neck pain, and Current neck pain of at least 3 months duration.

You may not qualify if:

• Cervical radiculopathy, History of whiplash injury and surgery

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Medical and Rehabilitation Center, Gujrat

Gujrat, Punjab Province, 50700, Pakistan

Location

Related Publications (7)

• Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, Kolahi AA, Safiri S. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord. 2022 Jan 3;23(1):26. doi: 10.1186/s12891-021-04957-4.

  PMID: 34980079 BACKGROUND

• Bernal-Utrera C, Gonzalez-Gerez JJ, Anarte-Lazo E, Rodriguez-Blanco C. Manual therapy versus therapeutic exercise in non-specific chronic neck pain: a randomized controlled trial. Trials. 2020 Jul 28;21(1):682. doi: 10.1186/s13063-020-04610-w.

  PMID: 32723399 BACKGROUND

• Fandim JV, Nitzsche R, Michaleff ZA, Pena Costa LO, Saragiotto B. The contemporary management of neck pain in adults. Pain Manag. 2021 Jan;11(1):75-87. doi: 10.2217/pmt-2020-0046. Epub 2020 Nov 25.

  PMID: 33234017 BACKGROUND

• Joshi S, Balthillaya G, Neelapala YVR. Thoracic Posture and Mobility in Mechanical Neck Pain Population: A Review of the Literature. Asian Spine J. 2019 Jun 3;13(5):849-860. doi: 10.31616/asj.2018.0302. Print 2019 Oct.

  PMID: 31154701 BACKGROUND

• Arsh A, Darain H, Iqbal M, Rahman MU, Ullah I, Khalid S. Effectiveness of manual therapy to the cervical spine with and without manual therapy to the upper thoracic spine in the management of non-specific neck pain; a randomized controlled trial. J Pak Med Assoc. 2020 Mar;70(3):399-403. doi: 10.5455/JPMA.300523.

  PMID: 32207414 BACKGROUND

• SALWA SHENDY PD, EL-KHOZAMY PD. Effect of Upper Thoracic Mobilization on Chronic Mechanical Neck Pain. The Medical Journal of Cairo University. 2019;87(June):1449-57.

  BACKGROUND

• Hidalgo B, Hall T, Bossert J, Dugeny A, Cagnie B, Pitance L. The efficacy of manual therapy and exercise for treating non-specific neck pain: A systematic review. J Back Musculoskelet Rehabil. 2017 Nov 6;30(6):1149-1169. doi: 10.3233/BMR-169615.

  PMID: 28826164 BACKGROUND

MeSH Terms

Conditions

Neck Pain; Pain

Condition Hierarchy (Ancestors)

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

Central Study Contacts

Samrood Akram, PhD Scholar

CONTACT

03324806143; samrood.akram@riphah.edu.pk.com

Study Design

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

Study Record Dates

• First Submitted: July 3, 2025
• First Posted: July 14, 2025
• Study Start: July 1, 2025
• Primary Completion: September 1, 2025
• Study Completion: October 1, 2025
• Last Updated: July 14, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)