Effect of Integrated Neuromuscular Inhibition Technique on Patients With Non-Specific Neck Pain

NCT07694102 | Completed DMC

• 1 other identifier: Ref: USKT/RERC/ADT/2026/09/115
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

Non-specific mechanical neck pain (NSNP) is a common musculoskeletal condition that causes neck pain, reduced movement, and difficulty performing daily activities. Manual therapy techniques are frequently used to manage this condition; however, evidence regarding the combined use of Integrated Neuromuscular Inhibition Technique (INIT) and cervical mobilization remains limited. This randomized controlled trial aims to compare the effectiveness of INIT combined with cervical mobilization versus cervical mobilization with conventional physiotherapy in adults with non-specific mechanical neck pain. Forty-two participants aged 30-60 years will be allocated to one of two treatment groups. The experimental group will receive INIT, consisting of muscle energy technique, strain-counterstrain, and ischemic compression, in addition to cervical mobilization. The control group will receive cervical mobilization with conventional physiotherapy modalities. Both groups will receive five treatment sessions. The primary outcomes are pain intensity, neck-related disability, and cervical range of motion. Outcomes will be assessed before treatment and after completion of the intervention using the Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), and cervical range of motion measurements. The findings of this study are expected to determine whether adding INIT to cervical mobilization provides greater improvements in pain, cervical mobility, and functional ability than conventional physiotherapy alone, thereby supporting evidence-based management of non-specific mechanical neck pain.

Conditions

Non-specific Mechanical Neck Pain

Keywords

Integrated Neuromuscular Inhibition Technique; Cervical Mobilization; Muscle Energy Technique; Strain Counterstrain; Ischemic Compression

Outcome Measures

Primary Outcomes (3)

• Pain Intensity

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

  Baseline and immediately after completion of five treatment sessions (approximately 1 week).

• Neck-Related Disability

  Neck-related disability will be evaluated using the Neck Disability Index (NDI), a validated 10-item questionnaire with total scores ranging from 0 to 50. Higher scores indicate greater disability, while lower scores indicate improvement in functional status.

  Baseline and immediately after completion of five treatment sessions (approximately 1 week).

• Cervical Range of Motion

  Active cervical extension and rotation will be measured using a universal goniometer. Changes in cervical range of motion will be compared between groups to evaluate improvements in cervical mobility following the intervention.

  Baseline and immediately after completion of five treatment sessions (approximately 1 week).

Study Arms (2)

Integrated Neuromuscular Inhibition Technique + Cervical Mobilization

EXPERIMENTAL

Participants receive the Integrated Neuromuscular Inhibition Technique (muscle energy technique, strain-counterstrain, and ischemic compression) combined with cervical mobilization and conventional physiotherapy for five treatment sessions.

Procedure: Integrated Neuromuscular Inhibition Technique (INIT); Procedure: Cervical Mobilization

Conventional Physiotherapy + Cervical Mobilization

ACTIVE COMPARATOR

Participants receive cervical mobilization together with conventional physiotherapy, including TENS and hot pack therapy, for five treatment sessions.

Procedure: Conventional Physiotherapy; Procedure: Cervical Mobilization

Interventions

Integrated Neuromuscular Inhibition Technique (INIT) PROCEDURE

Integrated Neuromuscular Inhibition Technique (INIT) is a multimodal manual therapy consisting of Muscle Energy Technique (MET), Strain-Counterstrain (SCS), and Ischemic Compression (IC). The intervention targets myofascial trigger points, muscle tightness, and neuromuscular dysfunction to reduce pain, improve cervical range of motion, and decrease functional disability. Participants received INIT in combination with cervical mobilization during five treatment sessions.

Integrated Neuromuscular Inhibition Technique + Cervical Mobilization

Conventional Physiotherapy PROCEDURE

Conventional physiotherapy consisted of transcutaneous electrical nerve stimulation (TENS) applied for 15 minutes and hot pack therapy applied to the cervical and upper back region for 10-15 minutes. These modalities were provided together with cervical mobilization during each of the five treatment sessions.

Conventional Physiotherapy + Cervical Mobilization

Cervical Mobilization PROCEDURE

Cervical mobilization was performed using Maitland mobilization techniques applied to the cervical spine (C1-C7) to improve joint mobility, reduce pain, and restore cervical range of motion. Mobilization was administered in three sets of ten repetitions during each of the five treatment sessions. This intervention was provided to participants in both study groups.

Conventional Physiotherapy + Cervical Mobilization; Integrated Neuromuscular Inhibition Technique + Cervical Mobilization

Eligibility Criteria

• Age: 30 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Adults aged 30 to 60 years.
• Clinical diagnosis of non-specific mechanical neck pain.
• Neck pain duration of less than 6 months.
• Painful cervical extension and rotation.
• Negative Sharp-Purser test.
• Negative vertebral artery insufficiency test.
• No history of whiplash injury.
• Able and willing to provide written informed consent and comply with the study protocol

You may not qualify if:

• Specific causes of neck pain (e.g., fracture, infection, tumor, inflammatory disease, or cervical myelopathy).
• History of cervical spine surgery.
• Positive Sharp-Purser test or vertebral artery insufficiency test.
• History of whiplash injury.
• Neurological disorders affecting the cervical spine or upper extremities.
• Pregnancy.
• Receipt of physiotherapy or manual therapy for neck pain within the previous 4 weeks.
• Any medical condition that would prevent safe participation in the intervention or outcome assessment.

Sponsors & Collaborators

• Ibadat International University, Islamabad: lead

Study Sites (1)

Physiotherapy Outpatient Department, Fauji Foundation Hospital

Islamabad, 44800, Pakistan

Location

Study Officials

• Zahid Mehmood, DPT, MSPT

  Ibadat International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: This was an open-label randomized controlled trial. Blinding of participants and treating physiotherapists was not feasible because of the manual therapy interventions. Outcome measures were collected using standardized assessment tools at baseline and after completion of the intervention.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Participants are assigned to one of two groups and remain in that group for the duration of the study. This is the standard definition of a parallel-group randomized controlled trial.

Study Record Dates

• First Submitted: July 3, 2026
• First Posted: July 9, 2026
• Study Start: January 10, 2026
• Primary Completion: July 1, 2026
• Study Completion: July 2, 2026
• Last Updated: July 10, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)