This study aims to investigate the effects of different exercise approaches on physical status, cognitive functions, brain structures, and blood biomarkers in individuals with chronic neck pain.
Chronic neck pain is a common musculoskeletal disorder. It has been stated in the literature that in addition to physical disabilities, cognitive problems may also be observed in these individuals. Still, the neurophysiological and biochemical mechanisms related to these disabilities are not yet sufficiently clear. Previous studies conducted on individuals with chronic neck pain are mostly evaluation studies aimed at existing disabilities, and our planned study seeks to achieve positive improvements in these disabilities by applying a treatment approach known to be effective on physical and cognitive health, such as exercise. Within the scope of the project, neuropsychological tests will be applied to the participants to evaluate attention, memory, visual and spatial structuring, language skills, and executive functions. Participants' brain structural changes will be evaluated with T1-weighted imaging, and brain perfusion changes will be evaluated with Arterial Spin Labeling imaging. Within the scope of physical condition and pain-related evaluations, participants' pain intensity, neck disability levels, muscle strength, functional capacities, pain catastrophizing level, kinesiophobia, central sensitization, and sleep quality will be evaluated. Finally, blood samples of the participants will be collected and serum concentrations of Cortisol, Interleukin 1-Beta, Tumor Necrosis Factor-Alpha, Insulin-Like Growth Factor-1, Interleukin-10, Irisin, Brain-Derived Neurotrophic Factor, Nerve Growth Factor and Cathepsin-B will be examined. All these assessments will be applied both before and after the exercise applications, and only muscle strength and functional capacities will be measured again at the end of the 6th week so that the exercise program can progress according to the gains in physical condition. Individuals whose initial assessments are completed will be assigned to aerobic exercise, strength exercises, or home exercise control group by stratified randomization method. Exercise applications will be applied 3 days a week for 3 months and each participant will participate in a total of 36 exercise sessions individually. It is anticipated that revealing the cognitive, physical, neurophysiological, and biochemical effects of aerobic, strengthening, and home exercise practices in individuals with chronic neck pain and explaining the similarities and superiorities of different exercise practices will pave the way for planning targeted health services.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
21
Participants will receive a total of 36 sessions of treatment, 3 sessions per week for 12 weeks. Aerobic exercise training will be performed with a bicycle ergometer, and a 5-minute warm-up (pedaling without resistance) program will be applied before the exercise training, finished by a 5-minute cool-down program (pedaling without resistance). Details of the intervention is described below: 60% of maximum heart rate, for 30 minutes (1-2nd weeks), 60% of maximum heart rate, for 45 minutes (3-4th weeks), 60% of maximum heart rate, for 60 minutes (5-6th weeks), mid-examination (at the end of the 6th week), 75% of maximum heart rate, for 30 minutes (7-8th weeks), 75% of maximum heart rate, for 45 minutes (9-10th weeks), 75% of maximum heart rate, for 60 minutes (11-12th weeks)
A 5-minute warm-up (neck and upper extremity range of motion exercises) will be applied before the exercise training, and finished by a 5-minute cool-down program (neck and upper extremity range of motion exercises). Details of the intervention is described below: Isometric neck exercise (MVC 80%,2x10) and Theraband resistive neck and upper body exercises 10 RM-2x10 (1-2nd weeks), Isometric neck exercise (MVC 80%,3x10) and Theraband resistive neck and upper body exercises 10 RM-3x10 (3-4th weeks), Isometric neck exercise (MVC 80%,3x15) and Theraband resistive neck and upper body exercises 10 RM-3x15 (5-6th weeks) , mid-examination (6th week), Isometric neck exercise (MVC 80%,2x10) Theraband resistive neck and upper body exercises 10 RM-2x10 (7-8th weeks), Isometric neck exercise (MVC 80%,3x10) Theraband resistive neck and upper body exercises 10 RM-3x10 (9-10th weeks), Isometric neck exercise (MVC 80%,3x15) Theraband resistive neck and upper body exercises 10 RM-3x15 (11-12th weeks)
Hacettepe University Faculty of Physical Therapy and Rehabilitation
Ankara, Altindag, Turkey (Türkiye)
RECRUITINGPain Intensity
Numerical scales are among the frequently used one-dimensional pain intensity scales because they are easy to use and effective. In the application, volunteers are asked to choose the number that best describes their pain intensity. Zero indicates no pain, while 10 represents the worst pain imaginable.
Time frame: Baseline, 6th week, and 12th week
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Posture and stretching exercises and stretching exercises will be applied as a control treatment to volunteers with chronic neck pain included in the control group, and at the end of the study, these people will be included in the training program according to the exercise approach that is effective.