Reciprocal Inhibition vs PNF for Cervical Spondylitis

NCT07637812 | Active Not Recruiting

• 1 other identifier: TUF/EIRB/ 207 /26
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Cervical spondylitis is a common cause of chronic neck pain and limited function. Physiotherapists often use two manual techniques: Reciprocal Inhibition (RI) and Passive Proprioceptive Neuromuscular Facilitation (PNF) stretching. However, no previous study has directly compared these two techniques in patients with confirmed cervical spondylitis. This randomized controlled trial will include 60 patients diagnosed with cervical spondylitis based on clinical and imaging findings. Participants will be randomly divided into two equal groups. Group A will receive Reciprocal Inhibition Technique. Group B will receive Passive PNF Stretching. Both groups will receive 12 sessions over 4 weeks, with three sessions per week on alternate days. Pain will be measured using the Visual Analog Scale (VAS). Functional disability will be measured using the Neck Disability Index (NDI). Cervical range of motion will be measured using a standard goniometer. All measurements will be taken at baseline and after 4 weeks of treatment. The goal is to determine which technique is more effective for reducing pain, improving function, and increasing neck mobility in cervical spondylitis patients

Conditions

Cervical Spondylitis

Keywords

Reciprocal Inhibition; PNF Stretching; Cervical Spondylitis; Neck Pain; Physical Therapy; Randomized Controlled Trial

Outcome Measures

Primary Outcomes (3)

• Change in Pain Intensity

  Pain intensity measured using the Visual Analog Scale (VAS), a 0 to 10 cm line where 0 means no pain and 10 means worst possible pain. Higher score indicates worse pain.

  Baseline and after 4 weeks of intervention

• Change in Neck Disability Index Score

  Neck Disability Index (NDI) is a 10-item questionnaire. Each item scores 0 to 5. Total score ranges from 0 to 50, converted to a percentage. Higher percentage indicates greater disability. Minimum detectable change is 5 points.

  Baseline and after 4 weeks of intervention

• Change in Cervical Range of Motion

  Active cervical range of motion measured using a standard universal goniometer. Movements measured: flexion, extension, right lateral flexion, left lateral flexion, right rotation, left rotation. Measured in degrees. Three trials performed per movement; average recorded.

  Baseline and after 4 weeks of intervention

Study Arms (2)

Reciprocal Inhibition Group

EXPERIMENTAL

Participants receive Reciprocal Inhibition Technique for cervical spine.

Procedure: Reciprocal Inhibition Technique; Procedure: Passive PNF Stretching

Passive PNF Stretching Group

ACTIVE COMPARATOR

Participants receive Passive Proprioceptive Neuromuscular Facilitation stretching for cervical spine.

Procedure: Passive PNF Stretching

Interventions

Passive PNF Stretching PROCEDURE

Patient sits comfortably. Therapist applies one stretch per cervical muscle group. Each stretch: 30-second passive hold, followed by 10-second push (patient gently pushes against therapist), then 10 seconds relaxation. Two sets performed for cervical flexion, extension, lateral flexion, and rotation. Recovery period between sets. Total 12 sessions over 4 weeks (3 sessions/week, alternate days). Performed by a licensed physiotherapist.

Passive PNF Stretching Group; Reciprocal Inhibition Group

Reciprocal Inhibition Technique PROCEDURE

Patient sits upright with back support. Therapist stands behind and passively moves the patient's neck until first resistance. Patient then performs a pain-free isometric contraction against therapist's resistance for 10 seconds. After relaxation, therapist moves neck into greater range of motion. Three repetitions performed for cervical flexion, extension, lateral flexion, and rotation. Total 12 sessions over 4 weeks (3 sessions/week, alternate days). Performed by a licensed physiotherapist.

Reciprocal Inhibition Group

Eligibility Criteria

• Age: 25 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Confirmed diagnosis of cervical spondylitis by MRI or radiograph.
• Chronic neck pain lasting more than 4 months.
• Visual Analog Scale (VAS) score of 7 or higher.
• Age between 25 and 65 years.
• Willing to provide written informed consent.
• Bacteriological or histological confirmation where available.

You may not qualify if:

• Upper limb fracture or recent injury.
• Cervical radiculopathy with neurological deficit.
• Systemic diseases (e.g., rheumatoid arthritis, diabetes with neuropathy).
• Congenital cervical deformity.
• Cognitive impairment preventing cooperation.
• Previous cervical spine surgery.

Sponsors & Collaborators

• University of Faisalabad: lead

Study Sites (1)

The University of Faisalabad

Faisalābad, Punjab Province, 3800, Pakistan

Location

MeSH Terms

Conditions

Neck Pain

Interventions

Muscle Stretching Exercises

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

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: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor, Department of Rehabilitation Sciences

Study Record Dates

• First Submitted: June 1, 2026
• First Posted: June 10, 2026
• Study Start: January 1, 2026
• Primary Completion: May 24, 2026
• Study Completion: June 15, 2026
• Last Updated: June 10, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)