The goal of this randomized clinical trial is to compare the effectiveness of Nerve Flossing and Deep Neck Flexor strengthening exercises in individuals with cervical spinal stenosis. The study aims to determine which treatment is more effective in reducing neck pain, improving cervical range of motion, and enhancing the ability to perform daily activities. Participants will be randomly assigned to receive either Nerve Flossing or Deep Neck Flexor exercises for specified duration. Both groups will attend physiotherapy sessions 3 times per week as assigned. Outcomes such as pain intensity, neck disability, and range of motion will be measured before and after the intervention using standard assessment tools. This study will help identify a more effective physiotherapy approach for managing symptoms of cervical spinal stenosis.
Cervical spinal stenosis is a condition characterized by narrowing of the spinal canal in the cervical region, leading to compression of neural structures. This often results in neck pain, reduced cervical range of motion, and functional disability that affects daily activities and quality of life. Conservative management through physiotherapy is the preferred initial approach before considering surgical intervention. Among conservative techniques, Nerve Flossing and Deep Neck Flexor strengthening are commonly used but their comparative effectiveness remains unclear. Nerve Flossing involves controlled, low-amplitude movements of the neck and upper limb to mobilize neural tissues and reduce nerve-related pain and sensitivity. Deep Neck Flexor strengthening uses specific low-load exercises to improve the activation and endurance of the deep cervical flexors that support head and neck posture. This study is conducted to address the gap in evidence by directly comparing these two interventions in patients with cervical spinal stenosis. The findings will help physiotherapists and clinicians select the most effective treatment approach for reducing pain and improving function in this population.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
62
This intervention involves controlled, low-amplitude movements of the neck and upper limb to mobilize the cervical and upper limb neural tissues. The technique aims to reduce mechanical sensitivity of the nerves, improve neural mobility, and alleviate nerve-related pain in patients with cervical spinal stenosis. The specific dosage, frequency, and duration will be applied as per the study protocol.
Low-load, targeted exercises to improve activation and endurance of the deep cervical flexor muscles. Focuses on enhancing cervical stability and posture. Frequency, duration, and repetitions will follow the study protocol.
Green International University
Lahore, Punjab Province, Pakistan
Pain Intensity
Pain intensity will be measured using the Visual Analogue Scale (VAS), where participants mark their pain level on 100mm line ranging from "no pain" (0) to "worst imaginable pain (100). Higher scores indicate greater pain intensity.
Time frame: Baseline and 12 weeks post-intervention
Change in Neck Disability Index Score
Change in neck-related disability from baseline to 6 weeks and post-intervention, measured using the Neck Disability Index (NDI) on a scale of 0-50. Higher scores indicate greater disability.
Time frame: Baseline and 12 weeks post-intervention
Change in Cervical Range of Motion
Change in cervical flexion, extension, and rotation range of motion from baseline to 6 weeks and 12 weeks, measured by using inclinometer.
Time frame: Baseline and 12 weeks post-intervention
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