Effect of Kendall and Scapulothoracic Exercises in Treatment of Chronic Non-specific Neck Pain

Combined Effect of Kendall and Scapulothoracic Exercises on Brachial Plexus Mechanoreceptors in Chronic Non-specific Neck Pain

The purpose of the clinical trial is to investigate the effect of the combined Kendall and scapulothoracic exercises program on mechanosensitivity of brachial plexus, cervical range of motion, neck functional ability, and craniovertebral angle in patients with chronic non-specific neck pain.

we have 3 groups to compare between traditional treatment, scapulothoracic and kendall exercises in treatment of chronic non-specific neck pain.

Non-specific neck pain is a generalized pain in the neck and/or shoulder that has mechanical characteristics, such as symptoms brought on by holding a certain neck position, moving the neck, or palpating the cervical muscles (Fernández-de-las-Penas et al., 2007). Minor injuries to the neck caused by poor posture and abrupt muscle contractions might further cause the muscles that are not frequently utilized to shrink, which can result in mechanical dysfunction and chronic pain (Boyd-Clark et al., 2002).

Kendall exercise is generally used as physical therapy for forward head posture and induces proper neck alignment generally using strengthening methods for two muscles (deep cervical flexors and retractors of the scapula) and stretching methods for two muscles (neck extensor muscles and pectoralis) to help with forward head posture, which is a state of imbalance of muscles) (Kendall et al., 2005).

Scapulothoracic strength training may have positive impacts across subjective and objective parameters including pain, and sequentially, activities of daily living, neck range of motion, and strength (Anna-Maria et al., 2020)

PURPOSE:

The purpose of study is to investigate the effect of the combined Kendall and scapulothoracic exercises program on mechanosensitivity of brachial plexus, cervical range of motion, neck functional ability, and craniovertebral angle in patients with chronic non-specific neck pain.

• The mechanosensitivity of brachial plexus will be measured with strength duration curve
• CROM will be used to measure cervical range of motion
• Neck disability index will be used to evaluate and document neck functional ability in patients with neck pain.
• Kinovea software program will be used to measure the craniovertebral angle of the cervical spine by still photography The subjects will receive treatment for four weeks all variables wil be measured pre-treatment and post treatment

Inclusion Criteria:

• Sixty patients of both genders were recruited in the study.
• The age of the recruited subjects were ranging from 25 to 50 years old
• Patients having neck pain symptoms provoked by neck postures, neck movement, or palpation of the cervical musculature, for at least the last 3 months
• Patients with a craniovertebral angle of less than 54º
• Subjects with a BMI 25-30

Exclusion Criteria:

• History of previous injury of the neck
• History of surgical intervention at the neck
• History of inflammatory joint disease affecting facet joints
• Neurological disorders such as cervical spondylosis, spondylolisthesis or disc prolapse (Kim et al., 2012).
• Rheumatic diseases.
• Cancer patients
• Patients who received pain medication or physical therapy for their neck pain during the last 3 months
• Patients who are unable to perform the exercises.