Hot pack along with Neck isometrics and muscle energy technique protocol

MCTE included cranio-cervical flexion, cranio-cervical extension, co-contraction of flexion and extension and synergistic exercise of neck flexor along with hot pack, neck isometrics and muscle energy technique protocol

• Hot pack for 10 minutes.
• Neck isometrics with 10 second hold.
• Each series of neck isometrics strengthening exercises had three movements including cervical flexion, cervical extension and cervical side flexion.
• Muscle energy technique protocol: The individual was in a position of supine. The therapist was at the edge of bed, near the participants head. the therapist positioned the joint at the point of beginning range of motion resistance when performing a given movement. When the therapist felt restriction, positioned the cervical spine in that region and apply the resistive force. Patient was instructed to contract isometrically for five seconds without exceeding the therapist force. thereafter, therapist counterforce gradually reduced and patient was asked to relaxed. Therapist move the joint into new point of barrier and same protocol repeated three times.

Patient came thrice per week for a total of 4 weeks.

Changes from base line Pain intensity was assessed by Numeric Rating Scale (NRS). NRPS has fair to moderate reliability of test-retest in patients with Mechanical Neck Pain. The patient was required to indicate the number that represent his intensity of pain, in which 0 represents "no pain" and 10 represents "the worst pain imaginable". Numeric Pain Rating Scale is widely used subjective pain measure that has good test-retest reliability r = 0.79 - 0.96

Changes from base line NDI is self-assessment tool for the specific functional status of patients with neck pain, consisting of ten components pain, personal hygiene, obesity, reading, headache, focus, work, travelling, sleeping, and leisure, each part is scored on an index of 0 to 5, with 0 representing "painless" and 5 representing the "worst pain imaginable". These points earned are added to the total score. The questionnaire was determined in percentage. The NDI disability categories are: 0-8% without disability, 10-28% mild, 30-48% moderate, 50-64% serious, and 70-100% complete. NDI has fair to moderate reliability of test-retest in patients, with inter-class correlation coefficient ranging from 0.50-0.98.