Targeted Cervical Versus Integrated Trunk and Diaphragmatic Muscle Retraining for Chronic Mechanical Neck Pain

NCT07691151 | Completed

• 2 other identifiers: COHSSTD32Jan2026RB-COHS-STD-32-Jan-2026
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Persistent pain, functional disability, cervical motor control deficit, and abnormal posture are associated with chronic mechanical neck pain. This study aimed to evaluate the efficacy of an integrated physiotherapy program of cervical motor control training, lumbopelvic stabilization, diaphragmatic breathing exercises, and pressure biofeedback versus conventional cervical physiotherapy in patients with chronic mechanical neck pain through a randomized controlled trial. 40 eligible participants were randomly assigned to the experimental or control group. The two groups were all given supervised physiotherapy three times a week for 6 weeks plus a standardized home exercise program. The main aim was to investigate the efficacy of the interventions on pain intensity and neck related disability. Secondary outcomes were CROM, DCFE, head position, and patient perceived recovery. Outcome measures were conducted at both baseline and the end of the six-week intervention.

Conditions

Neck Pain; Chronic Mechanical Neck Pain

Keywords

Chronic Mechanical Neck Pain; Physiotherapy; Randomized Controlled Trial; Cervical Motor Control; Pressure Biofeedback; Deep Cervical Flexor Training; Neck Disability; Pain; Cervical Range of Motion; Rehabilitation

Outcome Measures

Primary Outcomes (2)

• Neck Disability

  Neck-related disability will be assessed using the NDI. Higher scores indicate greater disability.

  Baseline and 6 weeks

• Pain Intensity

  Pain intensity will be assessed using the NPRS. The NPRS is an 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain). Lower scores indicate reduced pain intensity.

  Baseline and 6 weeks

Secondary Outcomes (4)

• Cervical Range of Motion

  Baseline and 6 weeks

• Deep Cervical Flexor Endurance

  Baseline and 6 weeks

• Head Posture

  Baseline and 6 weeks

• Global Rating of Change

  6 weeks

Study Arms (2)

Integrated Physiotherapy

EXPERIMENTAL

Participants were treated with a comprehensive physiotherapy intervention that included cervical motor control exercises with pressure biofeedback, lumbopelvic stabilization exercises, diaphragmatic breathing exercises, and additional physiotherapy interventions as clinically necessary. Three times per week for 6 weeks. In addition, a standardized home exercise program was performed during the intervention.

Behavioral: Integrated Physiotherapy

Conventional Physiotherapy

ACTIVE COMPARATOR

All participants underwent conventional cervical physio, which included cervical range of motion exercises, cervical isometric strengthening, upper trapezius and levator scapulae and pectoral muscles stretching, scapulothoracic strengthening, proprioceptive training, postural correction exercises and intermittent cervical traction as clinically indicated. Treatment was given three times a week for 6 weeks. A standardized home exercise program was also performed by the participants during the intervention period.

Behavioral: Conventional Physiotherapy

Interventions

Integrated Physiotherapy BEHAVIORAL

Participants were given an integrated physiotherapy program which comprised motor control training for the cervical spine with pressure biofeedback, lumbopelvic stabilization exercises, diaphragmatic breathing exercises, and a standardized home exercise program. Three treatment sessions per week for six weeks were conducted under supervision.

Integrated Physiotherapy

Conventional Physiotherapy BEHAVIORAL

Conventional cervical physiotherapy included cervical range-of-motion exercises, isometric strengthening, stretching, scapulothoracic strengthening, proprioceptive training, postural exercises, and a standardized home exercise program. Supervised treatment was provided three times per week for six weeks.

Conventional Physiotherapy

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age in the range 18-60 years.
• CNMP (lasting more than 3 months).
• NPRS score ≥ 3.
• Head Impact Test (HIT-6) score \< 50.
• Absence of clinical signs of cervical radiculopathy.
• Capacity to comprehend study procedures, follow directions for exercising and sign informed consent in writing.
• Diaphragmatic function impairment by the DNS diaphragm test with asymmetric or inadequate rib expansion laterally, high elevation of upper chest or shoulder girdle and diminished truncal stabilization during inhalation.

You may not qualify if:

• Participants were excluded if they had cervical radiculopathy, cervical myelopathy, previous cervical spine surgery, spinal fracture, inflammatory arthritis, malignancy, neurological disorders, pregnancy, or any other serious spinal pathology that would make it difficult for the participant to participate in the rehabilitation programme. People with cognitive deficits or any medical condition which hampered their safe involvement in the exercise programme were also excluded.

Sponsors & Collaborators

• Gulf Medical University: lead

Study Sites (1)

Thumbay Physical Therapy & Rehabilitation Hospital

Ajman, Ajman Emirate, United Arab Emirates

Location

MeSH Terms

Conditions

Neck Pain; Pain

Condition Hierarchy (Ancestors)

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

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: This is a single-blind randomized control trial. An independent assessor, blinded to treatment allocation, conducted outcome assessments. Due to the type of intervention (exercises), participants and physiotherapists were not blinded.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: The participants were randomly assigned in a 1:1 ratio to two parallel study arms. The integrated physiotherapy program for the experimental group included cervical motor control training, lumbopelvic stabilization, diaphragmatic breathing exercises, and pressure biofeedback. Conventional cervical physiotherapy was given to the control group. Each group received three supervised treatments per week for 6 weeks and a standard home exercise program.

Study Record Dates

• First Submitted: July 1, 2026
• First Posted: July 8, 2026
• Study Start: May 2, 2026
• Primary Completion: June 26, 2026
• Study Completion: June 30, 2026
• Last Updated: July 8, 2026

Record last verified: 2026-07

Locations

AE (1)