Comparative Effects of Nerve Flossing and Deep Neck Flexor Muscle Strengthening on Pain, Range of Motion and Functional Disability on Cervical Spinal Stenosis

NCT07604935 | Completed

• 1 other identifier: GIU/REC/26-34
• Study Type: interventional
• Target: 62
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this randomized clinical trial is to compare the effectiveness of Nerve Flossing and Deep Neck Flexor strengthening exercises in individuals with cervical spinal stenosis. The study aims to determine which treatment is more effective in reducing neck pain, improving cervical range of motion, and enhancing the ability to perform daily activities. Participants will be randomly assigned to receive either Nerve Flossing or Deep Neck Flexor exercises for specified duration. Both groups will attend physiotherapy sessions 3 times per week as assigned. Outcomes such as pain intensity, neck disability, and range of motion will be measured before and after the intervention using standard assessment tools. This study will help identify a more effective physiotherapy approach for managing symptoms of cervical spinal stenosis.

Conditions

Cervical Spinal Stenosis

Keywords

Cervical Spinal Stenosis; Nerve Flossing; Neural Mobilization; Deep Neck Flexor; Neck Pain; Cervical Spine; Physiotherapy; Physical Therapy; Neck Disability; Range of Motion

Outcome Measures

Primary Outcomes (1)

• Pain Intensity

  Pain intensity will be measured using the Visual Analogue Scale (VAS), where participants mark their pain level on 100mm line ranging from "no pain" (0) to "worst imaginable pain (100). Higher scores indicate greater pain intensity.

  Baseline and 12 weeks post-intervention

Secondary Outcomes (2)

• Change in Neck Disability Index Score

  Baseline and 12 weeks post-intervention

• Change in Cervical Range of Motion

  Baseline and 12 weeks post-intervention

Study Arms (2)

Nerve Flossing Group

EXPERIMENTAL

Participants in this arm will receive Nerve Flossing techniques targeting the cervical and upper limb neural tissues. The intervention involves controlled, low-amplitude movements of the neck and upper limb to improve neural mobility. Sessions will be conducted as per the study protocol.

Behavioral: Nerve Flossing

Deep Neck Flexor Strengthening Group

EXPERIMENTAL

Participants in this arm will receive Deep Neck Flexor strengthening exercises using low-load, targeted movements to improve activation and strength of the deep cervical flexor muscles. The exercises focus on enhancing cervical stability and posture. Sessions will be conducted as per the study protocol.

Behavioral: Deep Neck Flexor Strengthening

Interventions

Deep Neck Flexor Strengthening BEHAVIORAL

Low-load, targeted exercises to improve activation and endurance of the deep cervical flexor muscles. Focuses on enhancing cervical stability and posture. Frequency, duration, and repetitions will follow the study protocol.

Also known as: Group B

Deep Neck Flexor Strengthening Group

Nerve Flossing BEHAVIORAL

This intervention involves controlled, low-amplitude movements of the neck and upper limb to mobilize the cervical and upper limb neural tissues. The technique aims to reduce mechanical sensitivity of the nerves, improve neural mobility, and alleviate nerve-related pain in patients with cervical spinal stenosis. The specific dosage, frequency, and duration will be applied as per the study protocol.

Also known as: Group A

Nerve Flossing Group

Eligibility Criteria

• Age: 20 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Adults aged 20-50 years, both male and female.
• Clinical and radiological (MRI) diagnosis of cervical spinal stenosis.
• Cervical pain with or without radiating to the upper limb.
• At least one neurological sign, such as sensory disturbance, muscle weakness or diminished reflexes.
• Symptoms present for more than 4 weeks but less than 6 months.
• Ability to understand and follow exercise instructions.
• VAS pain score ≥ 3/10 at baseline.

You may not qualify if:

• History of cervical spine surgery
• Recent trauma, fracture, or cervical instability.
• History of disc herniation involving surgery.
• Other neurological or musculoskeletal conditions, including peripheral neuropathy, thoracic outlet syndrome, and rheumatoid arthritis.
• Pregnancy.
• Recent medication use that may impact nerve function (e.g., systemic steroids).

Sponsors & Collaborators

• Green International University: lead

Study Sites (1)

Green International University

Lahore, Punjab Province, Pakistan

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: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
• Masking Details: This study uses single masking in which the outcome assessor is blinded to group allocation. Participants will be assigned to either the nerve flossing group or the deep neck flexor muscle strengthening group by an independent researcher who is not involved in assessment. The assessor responsible for recording baseline and post intervention outcomes (VAS, Range of motion and NDI scores) will not be informed of the participants intervention group. To maintain blinding, participants will be instructed not to disclose their group assignment during assessments.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: This is a randomized, parallel-group interventional study with two arms. Participants diagnosed with cervical spinal stenosis will be randomly assigned to either Arm 1, receiving Nerve Flossing techniques, or Arm 2, receiving Deep Neck Flexor strengthening exercises. Each group will follow their assigned intervention for the specified duration. Outcomes will be assessed at baseline and post-intervention to compare the effectiveness between the two treatment arms.

Study Record Dates

• First Submitted: May 17, 2026
• First Posted: May 22, 2026
• Study Start: April 6, 2026
• Primary Completion: April 29, 2026
• Study Completion: May 6, 2026
• Last Updated: May 22, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR
• Time Frame: It will be available after the completion of the study.
• Access Criteria: Through the corresponding author.

Locations

PA (1)