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The purpose of this study is to investigate the effect of motor control training using scapular PNF exercise on neck pain, function, proprioception, and scapular muscle strength in patients with chronic mechanical neck pain.
Chronic mechanical neck pain (CMNP) is defined as generalized neck and/ or shoulder pain for more than 3 months with symptoms provoked by neck movement, neck postures, or palpation of the cervical muscles .
regional interdependence (RI) is defined as the concept that a patient's primary musculoskeletal symptom(s) may be directly or indirectly related or influenced by impairments from various body regions and systems regardless of proximity to the primary symptom(s)'.
Changes in scapular posture and alteration of muscle activation patterns of scapulothoracic muscles are cited as potential risk factors for neck pain the structural connectivity of the cervical spine and scaopulothorathic muscles . The bones and muscles of the cervical spine and the shoulders are connected to each other mechanically, thus a continuously applied mechanical load on the shoulders directly increases the load on the cervical region, which may cause joint and ligament pain Scapular malalignment can contribute to prolonged compressive loading of the posterior cervical structures .
It has been suggested that abnormal joint stress affects the firing of cervical afferents, leading to changes in proprioceptive function. Moreover, pain leads to changes in motor control . we believe that scapular motor control exercises using PNF technique may help to restore normal alignment and reverse this vicious circle PNF Technique is based on movement patterns to facilitate and correct sensory-motor function it has been suggested that PNF correct the impaired impulses emerging from proprioceptive receptors in the muscle. Therefore, it decreases pain and desires to improve the strength of muscles. PNF position renders a greater amount of sensory input coming from the periphery than that in the neutral position .The purpose of this study is to investigate the effect of motor control training using scapular PNF exercise on neck pain, function, proprioception, and scapular muscle strength in patients with chronic mechanical neck pain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| interventinal group | Experimental | 28 subject will receive a program of scapular motor control exercises using PNF technique in addition to the conventional treatment for 18 sessions (3 sessions per week for six weeks) |
|
| control group | No Intervention | 28 subject will receive conventional physical therapy program (heat-TENS) for 18 sessions (3 sessions per week for six weeks) |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| scapular PNF technique | Other | PNF Technique is based on movement patterns to facilitate and correct sensory-motor function,then correct the impaired impulses emerging from proprioceptive receptors in the muscle. Therefore, it decreases pain and improve the strength of muscles. PNF position renders a greater amount of sensory input coming from the periphery than that in the neutral position . |
| Measure | Description | Time Frame |
|---|---|---|
| change in cervical pain | by using the Arabic version of Numeric pain rating scale , ranging from 0 ("no pain") to 10 ("worst pain imaginable") | one week after end of treatment |
| change in neck function | by using the Arabic version of neck disability index that consists of 10 questions: pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, and recreation. Each item is scored from 0 (no disability) to 5 (total disability). The maximum possible score is 50. | one week after end of treatment |
| change in proprioceptive inputs of cervical | Bubble Inclinometer will be used to assess proprioceptive inputs of cervical
| one week after end of treatment |
| change in muscle strength | Hand-held dynamometer will be used to assess muscle strength
| one week after end of treatment |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Aisha said, master | Contact | 01061157728 | aishasaid1960@gmail.com | |
| mohammed abdelmaged | Contact | +1 (909) 583-4966 |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tala Central Hospital | Recruiting | Tala | Munofia | Egypt |
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| Label | URL |
|---|---|
| Bansal, R., \& Paul, M. (2020). Effectiveness of Motor Control Therapeutic Exercise Vs. Proprioceptive Neuromuscular Facilitation in Subjects With Cervical Spondylosis on Pain and Functional Disability. International Journal of Physiotherapy and Researc | View source |
| Celenay, S. T., Kaya, D. O., \& Akbayrak, T. (2016). Cervical and scapulothoracic stabilization exercises with and without connective tissue massage for chronic mechanical neck pain: A prospective, randomised controlled trial. Manual Therapy, 21, 144-150. | View source |
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This will be a double blinded, randomized, controlled, pre-post test clinical trial
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Patients will be randomly assigned into one of the two groups. We will use a simple randomization method to allocate participants to the groups. A random number generator available online from www.randomization.com will be used.
|
| Tala Central Hospital | Not yet recruiting | Tala | Egypt |
| Ha, S. min, Kwon, O. yun, Yi, C. hwi, Jeon, H. seon, \& Lee, W. hwee. (2011). Effects of passive correction of scapular position on pain, proprioception, and range of motion in neck-pain patients with bilateral scapular downward-rotation syndrome. Manu | View source |
| 25\. Ijspeert, J., Kerstens, H. C. J. W., Janssen, R. M. J., Geurts, A. C. H., Van Alfen, N., \& Groothuis, J. T. (2019). Validity and reliability of serratus anterior hand held dynamometry. BMC Musculoskeletal Disorders, 20(1), 1-8. | View source |