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The effectiveness of neuroscience-based pain education, myofascial induction technique, and home exercise programs will be compared in patients with chronic neck pain.
The study aims to present the immediate and long-term effects of Neuroscience-based Pain Education (NPE) and Myofascial Induction Therapy (MIT). It will evaluate parameters such as pain, quality of life, pain catastrophizing, and neck disability after treatment completion and at the 6-month follow-up.
The investigators aim to illuminate future studies concerning neuroscience-based pain education, which has gained prominence in recent years and continues to increase in importance annually.
The participants will be randomly assigned to one of three groups:
1 Group: Neuroscience-Based Pain Education Combined with Home Exercise Program Participants in this group will receive Neuroscience-Based Pain Education (NPE) treatment in addition to the home exercise program. Training sessions will be organized as one-on-one conversation sessions focusing on the neurophysiology of pain, and participants will be reinforced through PowerPoint presentations and visual aids such as pictures, templates, and metaphors.
Group: Myofascial Induction Techniques Combined with Home Exercise Program In addition to the home exercise program, Myofascial Induction Techniques (MIT) group participants will have MIT applied to the cervical and upper thoracic regions.
Group: Home Exercise Program After undergoing general training, participants in this group will be taught an exercise program. The program will include neck muscle stretching, strengthening, and posture exercises.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Neuroscience-Based Pain Education Combined with Home Exercise Program | Active Comparator | Patients in this group will receive Neuroscience-Based Pain Education (NPE) treatment in addition to the home exercise program. Training sessions are planned once a week for an average of 35-45 minutes and 8 sessions. NPE will be performed by a physiotherapist who has an internationally recognized certificate in this regard. Training sessions will be organized as one-on-one conversation sessions focusing on the neurophysiology of pain, and patients will be reinforced through PowerPoint presentations and visual pictures, templates, and metaphors. |
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| Myofascial Induction Techniques Combined with Home Exercise Program | Active Comparator | In addition to the home exercise program, Myofascial Induction Techniques (MIT) group patients will have MIT applied to the cervical and upper thoracic regions by a physiotherapist trained and experienced in myofascial treatments. The application will be once a week for 8 weeks, with an average duration of 35-45 minutes. |
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| Home Exercise Program | Active Comparator | Patients in this group will be taught an exercise program after undergoing general training. Exercises will include stretching and strengthening exercises for neck muscles and posture exercises. Patients are asked to take 35-45 minutes once a day, five days a week, for 8 weeks. They will be asked to do the given home exercises and fill out follow-up charts. The continuity of the exercises will be ensured by sending reminder messages to this group of patients once a week by the physiotherapist about doing their exercises. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Neuroscience-Based Pain Education Combined with Home Exercise Program | Other | Neuroscience-Based Pain Education and Home Exercises will be applied. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Short Form McGill Pain Questionnaire | A short form of the McGill Pain Questionnaire (SF-MPQ) used in pain assessment consists of four sections. In the first section, participants are asked to mark the location of pain on a body diagram. In the second section, participants are asked to select the word that best describes their pain from twenty subgroups. The third section investigates the relationship of pain over time, while the fourth and final section requires participants to indicate the intensity of pain on a scale of 1 to 5 and provide written responses to six questions. The questionnaire is scored from 0 to 112. The higher the pain score, the greater the pain. | Baseline,8 weeks, 6 months |
| Algometric Digital Measurement | It is a digital device used to evaluate trigger point sensitivity. | Baseline,8 weeks, 6 months |
| Central Sensitization Inventory | The scale, which can be applied in chronic pain, is used in central sensitization syndromes. It consists of two parts. Section A questions health-related symptoms, and part B questions whether any central sensitization syndromes have been diagnosed before. | Baseline,8 weeks, 6 months |
| Head Posture Evaluation | Forward head posture is measured with a goniometer, which measures the angle between the horizontal plane and the seventh cervical vertebra and ear line. | Baseline,8 weeks, 6 months |
| Neck Disability Index | The scale consists of ten headings in total. It includes neck pain intensity, personal care, lifting, reading, headaches, concentration, driving, sleep, and leisure activities. | Baseline,8 weeks, 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Aysenur Tuncer, Assoc. Prof. | Hasan Kalyoncu University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Türkoğlu Dr. Kemal Beyazıt State Hospital | Kahramanmaraş | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33466426 | Background | Bernetti A, Agostini F, de Sire A, Mangone M, Tognolo L, Di Cesare A, Ruiu P, Paolucci T, Invernizzi M, Paoloni M. Neuropathic Pain and Rehabilitation: A Systematic Review of International Guidelines. Diagnostics (Basel). 2021 Jan 5;11(1):74. doi: 10.3390/diagnostics11010074. | |
| 34062143 | Background | Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. Lancet. 2021 May 29;397(10289):2082-2097. doi: 10.1016/S0140-6736(21)00393-7. |
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| Myofascial Induction Techniques Combined with Home Exercise Program | Other | Myofascial Induction Techniques and Home Exercises will be applied. |
|
| Home Exercises Group | Other | Home Exercises wiil be applied |
|
| Pittsburgh Sleep Quality Index |
This survey contains 24 questions about sleep status, both during the day and at night. Nineteen of these are to be answered personally, and five are to be answered by a spouse or roommate. |
| Baseline,8 weeks, 6 months |
| 36-Item Short Form Health Survey Questionnaire | 36-Item Short Form Health Survey (SF-36) questionnaire consists of eight subscales: physical functioning, social functioning, role limitations due to physical problems, pain, vitality, mental health, and general health perception. Each subscale is scored from 0 to 100, and the scores from these subscales are not summed. A high score indicates good health status. | Baseline,8 weeks, 6 months |
| Pain Catastrophizing Scale | The Pain Catastrophizing Scale (PCS) is a 13-item self-report measure of catastrophizing in the context of actual or anticipated pain. The PCS measures catastrophizing as a multidimensional construct with three subscales: rumination, magnification, and helplessness. Rumination focuses on thoughts related to pain, helplessness reflects feelings of helplessness in coping with a painful situation, and magnification is a general view of the threat of pain. High PCS scores are associated with greater pain and more functional impairment. A total score above 30 represents clinically significant levels of pain catastrophizing. | Baseline,8 weeks, 6 months |
| 34444594 | Background | Javdaneh N, Saeterbakken AH, Shams A, Barati AH. Pain Neuroscience Education Combined with Therapeutic Exercises Provides Added Benefit in the Treatment of Chronic Neck Pain. Int J Environ Res Public Health. 2021 Aug 22;18(16):8848. doi: 10.3390/ijerph18168848. |
| ID | Term |
|---|---|
| D010146 | Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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