Effect of Cervical Force Control Training on Force Sense and Steadiness in Chronic Non-Specific Neck Pain

NCT07813871 | Not Yet Recruiting

• 1 other identifier: P.T.REC/012/006579
• Study Type: interventional
• Target: 32
• Locations: 1 country
• Sites: 1

Brief Summary

Chronic non-specific neck pain (CNSNP) is a very common issue among young adults, often linked to poor posture, prolonged screen time, and sedentary habits. This persistent pain can change how the neck muscles work and control movement. The purpose of this study is to investigate whether a specific type of rehabilitation-called "cervical force control training"-can help improve how well people can feel and control their neck muscle strength, and whether this reduces their pain and improves their daily function. Researchers will invite young adults (18 to 24 years old) who have had neck pain for at least 3 months to participate. Participants will be randomly divided into two groups: Force Control Training Group: Will receive a new training program that uses a handheld dynamometer with a screen to help them practice holding steady, precise neck muscle contractions with visual feedback. Conventional Exercise Group: Will receive a standard physical therapy program consisting of neck muscle stretches and shoulder-blade strengthening exercises. Both groups will perform their exercises 3 times a week for 8 weeks. Researchers will measure participants' neck muscle steadiness, pain levels, and neck disability before the program starts, right after the 8-week program ends, and again at a 3-month follow-up to evaluate the long-lasting effects.

Conditions

Chronic Non-specific Neck Pain; Neck Pain

Keywords

Cervical Force Control; Force Steadiness; Force Sense; Sensorimotor Control; Proprioception; Handheld Dynamometer; Physical Therapy

Outcome Measures

Primary Outcomes (2)

• Cervical Force Sense

  Assessed using a Handheld Dynamometer (HHD) during force reproduction tasks. It is measured by calculating the absolute error between a target submaximal force and the reproduced force without visual feedback. Lower error values indicate better force sense and proprioception.

  Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up

• Cervical Force Steadiness

  Evaluated by calculating the Coefficient of Variation (CoV) of force during submaximal isometric cervical contractions using a Handheld Dynamometer (HHD). Lower CoV percentages indicate better force steadiness and neuromuscular control.

  Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up

Secondary Outcomes (2)

• Neck Functional Disability (Neck Disability Index - NDI)

  Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up

• Pain Intensity (Visual Analogue Scale - VAS)

  Baseline, 8 weeks (immediately post-intervention), and 3-month follow-up

Study Arms (2)

Experimental Group: Force Control Training

EXPERIMENTAL

Patients in this group will receive an 8-week cervical force control training program (3 sessions/week). The training involves submaximal isometric neck contractions using visual feedback via a Handheld Dynamometer, progressing from simple feedback-assisted holds to complex dual-task exercises.

Behavioral: Cervical Force Control Training

Active Comparator: Conventional Exercise Training

ACTIVE COMPARATOR

Patients in this group will receive an 8-week conventional exercise program (3 sessions/week). The program includes standard cervical stretching (upper trapezius and levator scapulae) and scapular strengthening and stabilization exercises.

Behavioral: Conventional Exercise Training

Interventions

Cervical Force Control Training BEHAVIORAL

An 8-week program (3 sessions/week, 30-40 mins each) utilizing submaximal isometric neck contractions with visual feedback via a Handheld Dynamometer. The protocol progresses through three phases: initial calibration, acquisition using descending target intensities (25% to 10% MVIC) with continuous visual tracking, and retention/transfer using faded or no feedback combined with dual-tasking (e.g., auditory monitoring or arithmetic).

Experimental Group: Force Control Training

Conventional Exercise Training BEHAVIORAL

An 8-week program (3 sessions/week, 30 mins each) consisting of standard cervical stretching for the upper trapezius and levator scapulae muscles, alongside scapular strengthening and stabilization exercises (e.g., side-lying external rotation, side-lying forward flexion, prone extension, and push-up plus). Resistance is tailored based on patient gender and body weight.

Active Comparator: Conventional Exercise Training

Eligibility Criteria

• Age: 18 Years - 24 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients diagnosed with Chronic Non-Specific Neck Pain (CNSNP) lasting \>= 3 months.
• Body mass index (BMI) between 18.5 and 29.9 kg/m² (non-obese).
• Pain intensity \>= 30 mm on the Visual Analogue Scale (VAS).
• Neck disability ranging from mild to moderate (10% to 48%) on the Neck Disability Index (NDI).
• Able to perform isometric contractions with visual feedback.

You may not qualify if:

• Shoulder/upper limb fractures or replacement (\<12 months), or moderate-severe shoulder osteoarthritis (OA).
• Cervical radiculopathy/myelopathy, peripheral neuropathy, vestibular disorders, or history of stroke/Transient Ischemic Attack (TIA).
• Upper limb pathology (tendinopathy, capsulitis), thoracic outlet syndrome, or fibromyalgia.
• Received neck-specific physiotherapy within the last 3 months.
• Severe osteoporosis, uncontrolled diabetes (HbA1c \>9%), or active infection/inflammation.
• Cervical injections or surgery within the last 6 months.
• Inability to follow 2-step instructions.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Faculty of Physical Therapy

Kafr ash Shaykh, Kafr el-Sheikh Governorate, Egypt

Location

Related Publications (6)

• Vaillancourt DE, Slifkin AB, Newell KM. Inter-digit individuation and force variability in the precision grip of young, elderly, and Parkinson's disease participants. Motor Control. 2002 Apr;6(2):113-28. doi: 10.1123/mcj.6.2.113.

  PMID: 12122222 BACKGROUND

• Arvanitidis M, Falla D, Sanderson A, Martinez-Valdes E. Does pain influence control of muscle force? A systematic review and meta-analysis. Eur J Pain. 2025 Feb;29(2):e4716. doi: 10.1002/ejp.4716. Epub 2024 Aug 23.

  PMID: 39176440 BACKGROUND

• Vannebo KT, Iversen VM, Fimland MS, Mork PJ. Test-retest reliability of a handheld dynamometer for measurement of isometric cervical muscle strength. J Back Musculoskelet Rehabil. 2018;31(3):557-565. doi: 10.3233/BMR-170829.

  PMID: 29526841 BACKGROUND

• Zaidi, S., Khan, S. A., Zaki, S., Sundus, H., Alam, M. F., & Nuhmani, S. (2025). Effectiveness of sensorimotor training on pain, cervical joint position sense, range of motion, balance, and disability in chronic neck pain: A systematic review. Heliyon, 11(10), Article e43409.

  BACKGROUND

• Peng B, Yang L, Li Y, Liu T, Liu Y. Cervical Proprioception Impairment in Neck Pain-Pathophysiology, Clinical Evaluation, and Management: A Narrative Review. Pain Ther. 2021 Jun;10(1):143-164. doi: 10.1007/s40122-020-00230-z. Epub 2021 Jan 12.

  PMID: 33464539 BACKGROUND

• Muceli S, Farina D, Kirkesola G, Katch F, Falla D. Reduced force steadiness in women with neck pain and the effect of short term vibration. J Electromyogr Kinesiol. 2011 Apr;21(2):283-90. doi: 10.1016/j.jelekin.2010.11.011. Epub 2010 Dec 30.

  PMID: 21195628 BACKGROUND

MeSH Terms

Conditions

Neck Pain

Condition Hierarchy (Ancestors)

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

Central Study Contacts

Mohamed M Refaey, M.Sc.

CONTACT

00201030290667; mohamed_salama@pt.kfs.edu.eg

Refaey

CONTACT

mohamed_salama@pt.kfs.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The assessors responsible for outcome measurements will be blinded to the treatment allocation of the participants to minimize bias.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Lecturer

Model Details: Participants will be randomly assigned to one of two parallel groups: an experimental group receiving cervical force control training, and a control group receiving conventional neck exercises

Study Record Dates

• First Submitted: September 6, 2026
• First Posted: September 10, 2026
• Study Start: September 1, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: September 11, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)