Effect of Rib Mobilization and Diaphragm Release Techniques in Patients With Non-Specific Neck Pain

NCT07133646 | Completed

• 1 other identifier: IRB # 28/7/2024-2025
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

Rib mobilization is a therapeutic technique aimed at enhancing the mobility of the ribcage, which can have a significant impact on neck pain, even when the pain is classified as non-specific. The ribcage plays a crucial role in maintaining the alignment and posture of the upper body, including the neck. When the ribs are restricted or misaligned, it can lead to compensatory movements and increased strain on the cervical spine, contributing to neck pain. By mobilizing the ribs, we can restore their natural movement, which in turn can release tension in the surrounding musculature and improve the overall biomechanics of the thoracic and cervical regions. This approach not only addresses the immediate symptoms of neck pain but also targets the underlying structural issues that may perpetuate discomfort.

Conditions

Neck Pain

Outcome Measures

Primary Outcomes (2)

• Numerical Pain Rating Scale (NPRS)

  The Numerical Pain Rating Scale (NPRS) is a subjective measure used to assess the intensity of neck pain in individuals. Patients are asked to rate their pain on a scale from 0 to 10, where 0 represents "no pain" and 10 signifies "the worst possible pain." This simple tool provides a quantitative measure of pain, enabling healthcare providers to evaluate the severity of the patient's condition and monitor changes over time. The NPRS is widely used due to its ease of application and effectiveness in capturing patient-reported pain intensity

  at baseline and at 8 weeks

• Neck range of motion (ROM)

  A goniometer is an instrument used to measure the range of motion (ROM) of the neck. It is an essential tool for evaluating the flexibility and mobility of the cervical spine. During the assessment, the goniometer is aligned with specific anatomical landmarks to measure the angles of neck flexion, extension, lateral flexion, and rotation. This objective data is crucial for identifying limitations in neck movement, which could contribute to pain and functional impairment. The goniometer is considered reliable and valid for assessing cervical ROM in clinical settings

  at baseline and at 8 weeks

Secondary Outcomes (2)

• Neck flexor Muscle Endurance Test

  at baseline and at 8 weeks

• Neck Disability Index

  at baseline and at 8 weeks

Study Arms (3)

RMT and DRT(Rib Mobilization Technique and Diaphragm Release Technique)

EXPERIMENTAL

Rib Mobilization Technique and Diaphragm Release Technique(In the seated position, the participants remained seated on the stretcher, keeping the feet on the floor, while the therapist stood in front of him or her. The participant's head (frontal region) was positioned over his or her overlapping arms, which were placed on the therapist's trunk )

Other: Rib Mobilization Technique and Diaphragm Release Technique; Other: Diaphragm Release Technique

DRT(Diaphragm Release Technique)

EXPERIMENTAL

Diaphragm Release Technique:The DRT was performed according to the protocol described by Rocha et al.13 In this protocol, the participant remains in the supine position so that the therapist is able to maintain manual contact with the bottom edge of the rib cage

Other: Diaphragm Release Technique

control

NO INTERVENTION

No intervention

Interventions

Rib Mobilization Technique and Diaphragm Release Technique OTHER

The RMT, adapted from Henderson et al10 and Abdelaal et al,15 was carried out in 2 different participant positions: supine and seated. In the supine position, the therapist was placed next to the participant and positioned the last 4 fingertips of both hands at the rib angles. The therapist mobilized the costal angles in the postero anterior direction accompanying the participant's normal inspiration The movement was performed in 2 series of 10 respiratory cycles in each hemi thorax, with a 1-minute interval between sets.

RMT and DRT(Rib Mobilization Technique and Diaphragm Release Technique)

Diaphragm Release Technique OTHER

The DRT was performed according to the protocol described by Rocha et al.13 In this protocol, the participant remains in the supine position so that the therapist is able to maintain manual contact with the bottom edge of the rib cage. During inspiration, the therapist exerts traction after the natural rib-cage movement, then deepens the manual contact and maintains the resistance exerted in the previous phase throughout exhalation. The technique was applied in 2 series of 10 deep respiratory cycles, with a 1-minute interval between the series, under the therapist's verbal command.

DRT(Diaphragm Release Technique); RMT and DRT(Rib Mobilization Technique and Diaphragm Release Technique)

Eligibility Criteria

• Age: 20 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Neurological tests will be negative
• Both genders having age between 20 to 45 years
• Participants should have primary complaint of neck pain
• Neck Disability Index (NDI) score of 20% or greater (i.e. 10 points or greater on a 0 to 50 scale)
• A pain intensity of ≥4 on the 10-point Numerical Pain Rating Scale (NPRS)

You may not qualify if:

• First and second rib fracture and dislocation
• Past surgical history of cervical and thoracic region
• Thoracic Outlet syndrome and cervical radiculopathy
• Congenital anomalies of spine and ribs

Sponsors & Collaborators

• MTI University: lead

Study Sites (1)

faculty of physical therapy ,Cairo University

Cairo, 11311, 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: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assisstant professor

Model Details: Randomized clinical trial

Study Record Dates

• First Submitted: August 14, 2025
• First Posted: August 21, 2025
• Study Start: October 1, 2025
• Primary Completion: December 1, 2025
• Study Completion: December 1, 2025
• Last Updated: December 2, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)