Core Stability vs Scapular Stabilization on Hand Grip Strength in Chronic Myofascial Neck Pain

NCT07692126 | Recruiting DMC

• 1 other identifier: P.T.REC/012/006550
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Chronic myofascial neck pain (CMNP) is a painful non-articular musculoskeletal neck syndrome that is a persistent and prevalent with a high incidence of recurrence rate range 30-93%.Management of myofascial trigger points were directed at its deactivation, and prevention of its recurrence. Based on mechanical kinetic chain, the upper extremity functions as a unique system of connected segments those collaborated in a harmony in order to perform daily life activities. Core stability exercises maximize motor pathways mechanoreceptors' activities, as well scapular stabilization exercises are generally recommended based on reported benefits in terms of chronic neck pain. The relationship between chronic myofascial neck pain, and hand disability is quite strong. From mechanical point of view, core stability exercises improve trunk stability in line to enhance upper extremity efficiency that facilitates hand, and pinch grasping. In addition, scapular stabilization exercises could improve both hand, and pinch grasp strength and dexterity. Therefore, this randomized clinical trial will be conducted in line to clarify the superiority of the therapeutic effects between core stability exercises, scapular stabilization exercises, and conventional physical therapy program on hand grip strength, pinch grip strength, neck pain intensity level, pain pressure threshold, and whole upper extremity functional level in patients with chronic myofascial neck pain.

Conditions

Hand Grip Strength; Trigger Point in Trapezius Muscle; Neck Pain Musculoskeletal; Myofascial Neck Pain; Pressure Pain Threshold; Core Muscle Weakness; Scapular Muscle Endurance; Disability of the Arm, Shoulder, and Hand Questionnaire

Keywords

Core Stability Exercise; Scapular Stabilization Exercises; Hand Grip Strength; Chronic Myofascial neck syndrome; Trigger Points; Upper Trapezius; Pinch Grip Strength; Hand Held Dynamometer; Pressure Pain Threshold; Pressure Algometer; Diability of the Arm, Shoulder, and Hand Questionnaire (Arabic version), (Arabic-Q-DASH)

Outcome Measures

Primary Outcomes (2)

• Hand Grip Strength

  Hand-held Dynamometer (SAMMONS PRESTON, INC. Bolingbrook, IL604404989) will be used to measure it. The patient will sit on a standard height chair with no armrest with his/ her forearm in a neutral position, and shoulder in adducted and neutral rotation, with elbow flexed 90 degrees (°). The patient will be requested to squeeze the ipsilateral hand on the hand grip dynamometer handle accordingly to the ordered verbs 'i.e., one, two, three, squeeze…harder, harder'. Three measures will be conducted with one minute a break in between, then the average will be recorded in value score.

  1. At Baseline (Pre-procedure), 2. Post-treatment (Post 6 weeks of treatment program).

• Pinch Grip Strength

  The pinch gauge (FEI, White plains, NY 10602, USA) will be used to measure the pinch grip strength, it is a valid and reliable tool. The patient will sit on a standard height chair with no armrest with his/ her shoulder, elbow, forearm, and wrist in a neutral position. The patient will be requested to squeeze the thumb pad as firm as possible against the lateral aspect of index fingers' middle phalanx, while the examiner will hold the distal end of the pinch gauge. Three measures will be conducted with one minute a break in between, then the average will be recorded in a score value.

  1. At Baseline (Pre-procedure), 2. Post-treatment (Post 6 weeks of treatment program).

Secondary Outcomes (3)

• Chronic Myofascial Neck Pain Intensity assessment using Numerical Pain Rating Scale:

  1. At Baseline (Pre-procedure), 2. Post-treatment (Post 6 weeks of treatment program).

• Pressure Pain Threshold using electronic pressure algometer

  1. At Baseline (Pre-procedure), 2. Post-treatment (Post 6 weeks of treatment program).

• Whole Upper Extremity Functional Level using Arabic-Q-DASH scale

  1. At Baseline (Pre-procedure), 2. Post-treatment (Post 6 weeks of treatment program).

Study Arms (3)

Experimental Group A (Core Stability)

EXPERIMENTAL

consists of 20 participants who receive core stability exercises, plus the traditional physical therapy program in the form of ischemic compression of upper trapezius muscle, strain-counter strain of upper trapezius muscle, and muscle energy technique of upper trapezius muscle, three sessions per week for 6 weeks.

Other: Core Stability Exercise Protocol; Other: Traditional Physical Therapy Protocol

Experimental Group B (Scapular Stabilization)

EXPERIMENTAL

consists of 20 participants who receive scapular stabilization exercise, plus the traditional physical therapy program, three sessions per week for 6 weeks.

Other: Scapular stabilization Exercise Protocol; Other: Traditional Physical Therapy Protocol

Control Group C (Traditional Physical Therapy Program)

ACTIVE COMPARATOR

consists of 20 participants who receive the traditional physical therapy program, three sessions per week for 6 weeks, only

Other: Traditional Physical Therapy Protocol

Interventions

Core Stability Exercise Protocol OTHER

The core stability exercise protocol will be conducted to experimental group (A), only. The core stability exercise protocol will be conducted for 40-45 minutes (10 minutes worm-up 'stretch exercises', 25 minutes core stabilization exercises, and 5-10 minutes cool down exercises 'stretch exercises') 3 sections/ week for six weeks 1\. Diaphragm Core '';360 degree expansion breathing, weighted breathing 2. Transverse abdominis 'Abdominal drawing in maneuver, supine vacuum, pelvic tilt'; 3. Multifidus 'quadruped altered leg/arm, bridge with leg extension'; 4. Pelvic Floor muscles/Kegel, bridging, and bridging dog, and squat Core stability exercise.

Experimental Group A (Core Stability)

Scapular stabilization Exercise Protocol OTHER

The scapular stabilization exercise protocol will be conducted to experimental group (B), only. The core scapular stabilization exercise protocol will be conducted for 40-45 minutes (10 minutes worm-up 'stretch exercises', 25 minutes scapular stabilization exercises, and 5-10 minutes cool down exercises 'stretch exercises') 3 sections/ week for six weeks a. Open chain stabilization exercises 'scapular elevation/depression, upward/downward rotation', b. Static closed chain stabilization exercises 'Protected weight bearing through both hands leaning against wall', c. Dynamic closed chain stabilization exercises 'scapular retraction'

Experimental Group B (Scapular Stabilization)

Traditional Physical Therapy Protocol OTHER

1. Ischemic compression; apply an intermittent ischemic compression on the identified MTrPs within upper trapezius via the researcher thumb for ninety seconds. 2. Strain-counter strain; apply pressure at MTrPs within stretched upper trapezius, with patient will move the affected shoulder passively to 90° of abduction and external rotation for ninety seconds. 3. Muscle Energy Technique; patient will do lateral neck flexion to opposite side, and will maintained for 10 seconds, will apply thirty seconds of stretch for ipsilateral affected upper trapezius

Control Group C (Traditional Physical Therapy Program); Experimental Group A (Core Stability); Experimental Group B (Scapular Stabilization)

Eligibility Criteria

• Age: 25 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients diagnosed with chronic myofascial neck pain depending on referral, and physical examination.
• Sixty patients diagnosed with chronic myofascial neck pain for more than six months.
• Patients age range will 25-45 years
• Patients body mass index (BMI) will be 18.5-24.9 kg/m2
• Each patient suffering from all active MTrPs in the upper trapezius muscle with painful/ tender nodule.
• Patients have a constant neck pain with positive jump sign when palpating the upper trapezius muscle.
• Patients have referred pain, and symptoms of ipsilateral hand muscle weakness.
• No history of undergoing physiotherapy modalities or corticosteroid injection therapies in the past six months before the study

You may not qualify if:

• Presence of signs of severe pathology such as malignancies, mainly of the cervical region.
• Fracture of the cervical spine.
• Cervical radiculopathy or myelopathy.
• Diabetes mellitus.
• Trauma, cognitive anomalies, and surgery around neck, shoulders, or hand.
• Fibromyalgia or vascular syndromes such as vertebral basilar insufficiency.
• Pregnancy.
• Having undergone physical therapy within the past three months before the study.
• Having corticosteroid injection therapies in the past 3 months before the study.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Cairo University

Giza, Giza Governorate, 11432, Egypt

RECRUITING

Study Officials

• Sohair Shehata Rezkallah, Professor

  Cairo University; Faculty of Physical Therapy

  STUDY DIRECTOR

Central Study Contacts

Adnan AA Gharib, PHD

CONTACT

+201065798861; dradnanpts@gmail.com

Magda Ramadan Zahran, Assistant Professor

CONTACT

01065798861; dradnanpts@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: Subjects will be included diagnosed with chronic myofascial neck pain depending on certified referral, and physical examination. Subjects will be randomly assigned into three equal groups. Each group consisted of 20 subjects. Simple randomization will be done as the following a double, blinded randomization using opaque, sealed envelopes, containing the name of one of each group (groups A, B and C). The second supervisor, who is not participating in recruiting, treating or evaluating participants selected the envelopes. After the initial assessment that conducted by the third supervisor 'who will be completely blinded regarded the participants ' distribution on the three groups', but before first therapy session, group allocation will be carried out; finally papers will be picked and assigned to three groups.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Physical Therapy Specialist

Model Details: A double- blind, pretest-posttest randomized clinical controlled

Study Record Dates

• First Submitted: June 29, 2026
• First Posted: July 9, 2026
• Study Start: June 1, 2026
• Primary Completion (Estimated): January 1, 2027
• Study Completion (Estimated): June 30, 2027
• Last Updated: July 10, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)