Symmetrical Scapula-pelvis Proprioceptive Neuromuscular Facilitation and Superficial Back Line in Chronic Neck Pain With Hamstring Tightness

NCT07332845 | Recruiting DMC

• 1 other identifier: IBC KU-544/2025
• Study Type: interventional
• Target: 156
• Locations: 1 country
• Sites: 1

Brief Summary

A research study will be conducted at Physiotherapy department of the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan. Overall 156 patients with 18-40 years old individuals with neck pain will be eligible and they will be included through non-probability, purposive sampling technique. The written informed consent will be taken from all the patients. They will be divided through Simple random sampling (computer generated software) method into two groups, 78 in each group. Group A (experimental group) will receive PNF Symmetrical Scapula-Pelvis Patterns (PNF-SSPP), group B (control group) will receive sub occipital muscle inhibition technique (SMI) and static stretching (SS) of hamstring muscle. All participants will be assessed using assessment form. Outcome measures will be Pain, disability, disability, neck range of motions, hamstring tightness, head posture, and levator scapulae index. An independent assessor blinded to the treatment will assess all the patients for treatment outcome assessment at baseline, after first session and post treatment. Treatment sessions will be given thrice a week for 6 weeks.

Conditions

Hamstring Muscle Tightness; Neck Pain; Chronic Neck Pain

Keywords

neck ache; Exercise; Muscle Stretching; Muscle Inhibition; PNF

Outcome Measures

Primary Outcomes (8)

• Change in pain intensity with visual analogue scale for pain at Day 1

  The Visual Analogue Scale is a 10 cm line used to measure pain intensity, where the patient marks a point on the line to indicate their pain level, with 0 representing "no pain" and 10 representing "pain as bad as it could possibly be". A score is obtained by measuring the distance from the "no pain" end to the patient's mark, which can be done in centimeters (0-10) or millimeters (0-100). Higher scores indicate greater pain intensity, and this score helps healthcare providers assess severity, which can be categorized as mild (1-3), moderate (4-6), or severe (7-10)

  From enrolment to the end of the first treatment session at Day 1.

• Change in pain intensity with visual analogue scale for pain at 6 weeks

  The Visual Analogue Scale (VAS) is a 10 cm line used to measure pain intensity, where the patient marks a point on the line to indicate their pain level, with 0 representing "no pain" and 10 representing "pain as bad as it could possibly be". A score is obtained by measuring the distance from the "no pain" end to the patient's mark, which can be done in centimeters (0-10) or millimeters (0-100). Higher scores indicate greater pain intensity, and this score helps healthcare providers assess severity, which can be categorized as mild (1-3), moderate (4-6), or severe (7-10).

  From enrolment to the end of 18 treatment session at 6 weeks

• Change in range of motion with goniometry at Day 1

  Goniometry measures the change in range of motion of a joint in degrees by using a goniometer to calculate the joint's angle. The increase in degrees suggests increase in range of motion and decrease suggests decrease in range of motion.

  From enrolment to the end of first treatment at Day 1

• Change in range of motion with goniometry at 6 weeks

  Goniometry measures the change in range of motion of a joint in degrees by using a goniometer to calculate the joint's angle. The increase in degrees suggests increase in range of motion and decrease suggests decrease in range of motion.

  From enrolment to the end of 18 treatment sessions at 6 weeks.

• Change in neck disability with Neck Disability Index at day 1

  A change in the Neck Disability Index score indicates a change in a patient's self-reported neck disability. A higher score means greater disability.The NDI is scored from 0 to 50, or 0% to 100%. A score of 0 indicates no limitation, while a score of 50 represents complete limitation.

  From enrolment to the end of first treatment session at Day 1.

• Change in neck disability with Neck Disability Index at 6 weeks

  A change in the Neck Disability Index score indicates a change in a patient's self-reported neck disability. A higher score means greater disability.The NDI is scored from 0 to 50, or 0% to 100%. A score of 0 indicates no limitation, while a score of 50 represents complete limitation.

  From enrolment to the end of 18 treatment sessions at 6 weeks.

• Change in hamstring tightness with Sit and Reach (SR) test at Day 1

  A low Sit and Reach test score in centimetre indicates tight hamstrings, while a higher score shows better hamstring flexibility. When a person with tight hamstrings performs the Sit and Reach test, the muscles pull the pelvis into a posterior tilt, which limits the ability to reach as far and can cause the lower back to round instead of the spine flexing naturally. As hamstring tightness decreases through stretching, the SR score increases, signifying greater flexibility and improved superficial back line.

  From enrolment to the end of first treatment session at Day 1.

• Change in hamstring tightness with Sit and Reach (SR) test at 6 weeks

  A low Sit and Reach test score in centimetre indicates tight hamstrings, while a higher score shows better hamstring flexibility. When a person with tight hamstrings performs the Sit and Reach test, the muscles pull the pelvis into a posterior tilt, which limits the ability to reach as far and can cause the lower back to round instead of the spine flexing naturally. As hamstring tightness decreases through stretching, the SR score increases, signifying greater flexibility and improved superficial back line.

  From enrolment to the end of 18 treatment sessions at 6 weeks.

Secondary Outcomes (4)

• Change in head posture with goniometry at Day 1

  From enrolment to the end of first treatment session at Day 1

• Change in head posture with goniometry at 6 weeks

  From enrolment to the end of 18 treatment sessions at 6 weeks

• Change in levator scapulae index with vernier caliper at Day 1

  From enrolment to the end of first treatment session at Day 1

• Change in levator scapulae index with vernier caliper at 6 weeks

  Time Frame: From enrolment to the end of 18 treatment sessions at 6 weeks

Study Arms (2)

Symmetrical Scapula-Pelvis Pattern Exercises

EXPERIMENTAL

This arm will receive PNF Dynamic Reversal of Antagonists using Symmetrical Scapula-Pelvis Patterns

Other: Symmetrical Scapula-Pelvis Patterns Exercises

Control Treatment

ACTIVE COMPARATOR

This arm will receive evidence based treatment, the suboccipital muscle inhibition with static stretching of the hamstrings.

Other: Suboccipital muscle inhibition technique; Other: Static stretching of hamstring muscle

Interventions

Symmetrical Scapula-Pelvis Patterns Exercises OTHER

Symmetrical scapula-pelvis patterns refer to a balanced, aligned posture and movement of the shoulder blades and pelvis which is often a therapeutic goal in physical rehabilitation with proprioceptive neuromuscular facilitation.

Symmetrical Scapula-Pelvis Pattern Exercises

Suboccipital muscle inhibition technique OTHER

The Suboccipital Muscle Inhibition technique is a manual therapy method used by practitioners to relieve tension in the suboccipital muscles, which are located at the base of the skull.

Control Treatment

Static stretching of hamstring muscle OTHER

Static stretching for hamstrings involves holding a position that creates tension in the back of the thigh for 30 seconds.

Control Treatment

Eligibility Criteria

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

You may qualify if:

• Individual with both male and female gender
• Individuals with chronic neck pain (pain for \> 3 month) with hamstring tightness

You may not qualify if:

• Any history related to spinal surgery
• Previous administration of epidural injections
• Neck pain due to specific pathology
• Patients with radiculopathy or myelopathy
• Traumatic spinal cord injury
• Neck pain associated with progressive neurological deficit or loss of strength

Sponsors & Collaborators

• University of Karachi: lead
• Sindh Institute of Physical Medicine and Rehabilitation: collaborator

Study Sites (1)

Sindh Institute of Physical Medicine and Rehabilitation

Karachi, Sindh, 75300, Pakistan

RECRUITING

MeSH Terms

Conditions

Neck Pain; Motor Activity

Condition Hierarchy (Ancestors)

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

Study Officials

• Aftab Ahmed Mirza Baig, PhD

  University of Karach

  PRINCIPAL INVESTIGATOR

• Basit Ansari, PhD

  University of Karachi

  STUDY DIRECTOR

Central Study Contacts

Aftab Ahmed Mirza Baig, PhD

CONTACT

+923002739920; ab.dptrm@gmail.com

Basit Ansari, PhD

CONTACT

+923222279221; basitansari@hotmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Data analyst was also blinded.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: December 30, 2025
• First Posted: January 12, 2026
• Study Start: January 16, 2026
• Primary Completion (Estimated): October 26, 2026
• Study Completion (Estimated): November 26, 2026
• Last Updated: March 10, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)