To investigate the effect of body mind exercise and specific neck exercises in chronic mechanical neck pain on neck pain severity, functional disability, neck flexion range of motion, isometric neck muscle strength and quality of life.

Chronic mechanical neck pain is one of the most common musculoskeletal disorders affecting middle-aged and older adults and is associated with pain, reduced cervical mobility, functional disability, and decreased quality of life. Exercise therapy is widely recommended as a first-line conservative treatment for chronic neck pain. Previous studies have shown that both specific neck exercises and general physical activity can reduce pain and improve functional outcomes.

Body-mind exercises, which combine physical movement with focused attention and breathing control, may provide additional benefits by improving both physical and psychological aspects of chronic pain. However, the comparative effectiveness of body-mind exercises and specific neck exercises when combined with conventional physical therapy remains unclear.

The aim of this randomized controlled trial is to investigate the effect of body-mind exercises and specific neck exercises on pain intensity, functional disability, cervical range of motion, isometric neck muscle strength, and quality of life in individuals with chronic mechanical neck pain.

A total of 80 participants aged 50 to 65 years with chronic mechanical neck pain will be recruited and randomly allocated into four groups using a parallel-group design. Group A will receive conventional physical therapy alone. Group B will receive conventional physical therapy combined with body-mind exercises in the form of mindful aerobic treadmill walking. Group C will receive conventional physical therapy combined with specific cervical and scapular stabilization exercises. Group D will receive a combination of conventional physical therapy, body-mind exercises, and specific neck exercises.

All interventions will be performed over a treatment period of six weeks. Outcome measures will include pain intensity measured by the Numeric Pain Rating Scale (NPRS), functional disability assessed by the Neck Disability Index (NDI), cervical range of motion measured using a Cervical Range of Motion (CROM) device, isometric neck muscle strength measured using a handheld dynamometer, and quality of life assessed using the RAND-36 Health Survey. Measurements will be taken before the intervention and after completion of the six-week treatment period.

The results of this study will help determine the most effective exercise approach for improving clinical outcomes in patients with chronic mechanical neck pain and may provide evidence to guide physical therapy practice.

Inclusion Criteria:

• Adults aged between 50-65 years
• Diagnosis of chronic mechanical neck pain (pain duration ≥ 3 months)
• Pain intensity of at least 3/10 on the NPRS

Exclusion Criteria:

• History of cervical surgery
• Specific neck conditions (fractures, neoplasm, infection)
• Pregnancy
• Severe cardiopulmonary disease or other systemic illness affecting participation

sensitive patient data.

Due to the nature of the exercise interventions, participants and treating therapists cannot be blinded. However, the outcome assessor responsible for measuring pain, cervical range of motion, and neck muscle strength will be blinded to group allocation to reduce measurement bias.