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
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
Ultrasound, hot packs, cervical postural stretching and strengthening exercise will be done for all groups. Stretching Exercises Posture correction exercises training will include stretching of tight muscles such as Pectoralis major, levator scapulae, upper trapezius, suboccipital muscles and, sternocleidomastoid. Strengthening Exercises Exercises will include Chin Tucks exercise and Neck isometric exercises
Scapulothoracic exercises It is a strengthening exercises of the serratus anterior muscle, as well as the middle and inferior fibres of the trapezius muscle
The exercise techniques used by Kendell were as follows: 1\. Stretching of the Cervical Extensors: By sitting with the head down and putting both hands across the occipital area, the cervical extensors can be stretched by adopting a flex neck position 2- Strengthening of the Deep Cervical Flexors Positioning supine with the chin tucked in and lifting the head for 2 to 8 s 3- Strengthening the Shoulder Retraction Maintaining an upright posture, keep the resistance band circling with strong support and stretching it with the upper limbs of both sides so that there is full retraction of the scapula 4-Stretching the Pectorals muscle Assigning both hands on the occipital area and pulling the elbows back up (bilateral) and performance arm abduction and external rotation (unilateral).
Physical therapy College - Cairo university
Cairo, Egypt
RECRUITINGThe strength-duration curve to assess the change in mechanosensitivity of brachial plexus
The mechanosensitivity of brachial plexus will be measured with strength duration curve by EMG. Assessment will be before and after treatment
Time frame: at first week and after 4 weeks of treatment
Change in Cervical range of motion
Cervical range of motion will assessed by Cervical Range of Motion (CROM) device . Assessment will be before and after treatment
Time frame: at first week and after 4 weeks of treatment
Change in Functional performance will be measured by Neck disability index
Neck functional ability assessed by Neck disability index. Assessment will be before and after treatment
Time frame: at first week and after 4 weeks of treatment
Change in Craniovertebral angle
Craniovertebral angle assessd by Kinovea software program. Assessment will be before and after treatment
Time frame: at first week and after 4 weeks of treatment
Doaa Rafat Assistant professor of physical therapy - Cairo university, Assistant professor
CONTACT
Rania Reda Assistant professor of physical therapy - Cairo university, Assistant professor
CONTACT
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TREATMENT
Masking
SINGLE
Enrollment
60