Objective: To compare the effects craniocervical and cervicothoracic extension training versus deep cervical flexor training, both combined with conventional treatment, on disability, perceived pain, Health-related quality of life (HRQoL), endurance, active range of motion (AROM) of the cervical spine, joint position sense (JPS) and intake of drugs in subjects with non-specific chronic neck pain, referenced by the control group. Methods: The research will be done from December 2019 to August 2020 at the Recoletas Burgos Hospital. Fifty-four volunteers with non-specific chronic neck pain, recruited at the hospital, will be randomly assigned, using sealed envelopes, to 1 of the three groups. The first two experimental groups will be named Group A and Group B and each of them will go to the Rehabilitation Service for 4 weeks to perform the exercises under the supervision of the physiotherapist. This process will occur along with the conventional treatment (infrared heat, massage and transcutaneous electrical nerve stimulation). These groups will differ between them in the muscles they will mainly train through training. The group A will perform a neck extensor muscles training and group B a deep cervical flexor muscles training. After these 4 weeks, these exercises will be performed by them on a daily routine which will be prescribed for 6 months at home. On the control group (group C), no intervention will be performed due to the fact that they will be still on the waiting list. Disability, pain, HRQoL and drug intake will be measured in pre-treatment, at 4 weeks (post-treatment) and at 6 months follow-up; endurance, AROM and JPS will be measured in pre-treatment and at 4 weeks (post-treatment); while demographic variables (height, weight and age) will only be measured at the baseline.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
54
During the first month, the participants of the experimental groups will come at Rehabilitation Service to do the exercises individually and supervised by the physiotherapist and to received the conventional treatment (10 minutes of infrared heat, 10 minutes of massage and 15 minutes of TENS). The last six months, they will perform daily home exercises. * A-group: the degrees respect to the floor in wich each participant can hold the craniocervical extension and the cervicothoracic extension during 5 seconds will bo measured with the BDI. * B-group: Using an air-filled pressure sensor placed behind the neck, the physiotherapist will identify the target level that the patient can hold steadily a craniocervical flexion (CCF) for 5 seconds in a controlled manner. They will train following the protocol described by Jull et al. Of each of this exercises, they will perform 10 isometric contractions, at the corresponding degrees or target level, of 10 seconds with a rest of 3-5 seconds.
Recoletas Burgos Hospital
Burgos, Spain
Change in Pain related disability
using the Neck Disability Index (NDI) Questionnaire
Time frame: Baseline, 1 month (primary timepoint) and 6 months after intervention.
Change in Neck pain
Using a Numeric Rating Scale (NPRS) from 0 to 10
Time frame: Baseline, 1 month (primary timepoint) and 6 months after intervention.
Change in Health-related quality of life (HRQoL)
using the SF-36 quality of life questionnaire.
Time frame: Baseline, 1 month (primary timepoint) and 6 months after intervention.
Change in Neck muscles endurance
Using the modified Neck Extensor Endurance test (NEE test) proposed by Lee el al. (2005) or the Neck Flexor Muscle Endurance Test (NFME test) with a chronometer and a BDI
Time frame: Baseline and 1 month (primary timepoint).
Change in Active Range of cervical Motion (AROM)
Using a digital inclinometer
Time frame: Baseline and 1 month (primary timepoint).
Change in Joint Position Sense (JPS)
Using a target and a rule
Time frame: Baseline and 1 month (primary timepoint).
Change in Frequency of use of drugs
Using a shelf-completed drug registration document
Time frame: Baseline, 1 month (primary timepoint) and 6 months after intervention.
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