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The purpose of this study is to examine effect of cervical stabilization exercises on hand grip strength, key pinch strength, pain intensity, pain pressure threshold and hand function in chronic myofascial neck pain patients.
Myofascial pain of the trapezius is considered one of the main causes of neck pain and characterized by deep, intense pain of the skeletal muscles and their fascia and by the presence of one or more MTrPs, Although MTrPs can be formed in any muscle or muscle group, previous studies concluded that the upper trapezius(UT) muscle is the most commonly affected muscle.
Considering the role of synergistic function of the UT muscle in scapula-humeral rhythm during shoulder movement, it is not surprising that MTrPs in UT muscle can result in shoulder dysfunction and disability. Muscle activity of proximal parts is necessary for activation of distal parts. In fact, the stable activity of distal parts needs controlling the proximal parts. Thus, the stability of shoulder girdle is required for activity of distal parts such as fingers, wrists and elbows. In addition, trigger points in the UT can affect grip strength, which depends on shoulder joint and scapular stability. Thus, UT muscle dysfunction can reduce grip strength.
However, little research has been carried out to determine the therapeutic effects of cervical stabilization exercises on chronic neck pain, and up till now, there is a gap in literature to explore efficacy of cervical stabilization exercises on chronic neck pain and hand grip strength. Therefore, this study aims to investigate whether cervical stabilization exercises has an effect on hand grip strength in chronic myofascial neck pain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| cervical stabilization exercises and integrated neuromuscular inhibition technique | Experimental | patients received cervical stabilization exercises and integrated neuromuscular inhibition technique for 3 sessions / week for 4 weeks. Cervical stabilization included chin tucks, isometric holds, ball squeeze. Integrated neuromuscular inhibition technique included:
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| Integrated neuromuscular inhibition technique | Active Comparator | patients received integrated neuromuscular inhibition technique for 3 sessions / week for 4 weeks.it included Ischemic compression, Strain counter-strain and muscle energy technique.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| cervical stabilization exercises and integrated neuromuscular technique. | Procedure | Patients received cervical stabilization exercises and integrated neuromuscular inhibition technique. Cervical stabilization protocol included strengthening exercises of deep cervical flexors muscles which included chin tucks, isometric holds, ball squeeze, as well as deep cervical extensors muscles which included cranio-cervical flexion from neutral, upper cervical rotation and extension of cervical spine. integrated technique includes ischemic compression, muscle energy technique and strain counter strain. |
| Measure | Description | Time Frame |
|---|---|---|
| primary outcome measure | hand grip strength was measured by hand held dynamometer. | up to four weeks |
| Measure | Description | Time Frame |
|---|---|---|
| secondary outcome measures | pain pressure threshold was measured by pressure algometer. | up to four weeks |
| secondary outcome measure | hand function was measured by michigan quesstionaire.The Michigan Hand Outcomes Measure comprises 37 items with rating scale ranging 1 to 5. Every single domain was scored and converted to values that range from 0-100. A high score indicates better results, with the exception of pain in which a high score indicates a more intense pain. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Fatma Alzahraa M Ali, Master | Contact | 01028371924 | fatmaalzahraa@pt.bsu.edu.eg |
| Name | Affiliation | Role |
|---|---|---|
| soheir sh Rezkallah, PHD | professor of physaical therapy | Study Director |
| Ghada Abd Elmoneim, PHD | assistant professor of physical therapy | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cairo University | Completed | Giza | 11251 | Egypt | ||
| Faculty of physical therapy |
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cervical stabilization exercises
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double (investigator, outcome assessor)
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| up to four weeks |
| secondary outcome measure | pain intensity was measured by visual analogue scale.The level of pain on the VAS was recorded on a 10 cm line distinct at one end 'no pain' and marked at the other end 'the worst pain. Subjects were asked to state their pain level by placing a mark on this horizontal line | up to 4 weeks |
| secondary outcome measure | pinch strength was measured by pinch gauge | up to four weeks |
| Haidy S Roshdy, PHD |
| lecturer of physical therapy |
| Study Director |
| Recruiting |
| Giza |
| 11251 |
| Egypt |