Longitudinal Stripping Massage vs. Percussion Device for Neck Pain: Ultrasound Study.

Neck pain-related disability on Neck Disability Index (NDI)

Neck pain-related disability measured with the Neck Disability Index (score range 0-50 points, where higher scores indicate greater disability). Unit of Measure: points

Time frame: Baseline, 2 days post-therapy (follow-up), immediately before next therapy session, and 2 days post-second therapy (final follow-up)

Shear-wave elastography of upper trapezius muscle: mean stiffness

Ultrasound shear-wave elastography of the upper trapezius muscle at the midpoint (foramen magnum-acromion line) to evaluate the mean stiffness value. Measurements performed supine with head stabilized, arms alongside body, cervical spine neutral. Probe placed at the midpoint of the trapezius. Ultrasound gel applied for optimal contact. The measurement is performed 3 times and the average value is used; repeated if discrepancies. Same researcher throughout. Unit of Measure: kilopascals (kPa)

Time frame: Baseline, 20 minutes post-therapy, 2 days post-therapy (follow-up), immediately before next therapy session, 20 minutes post-second therapy, and 2 days post-second therapy (final follow-up)

Myotonometry of upper trapezius muscle: oscillation frequency

Assessment of myofascial tissue tone (oscillation frequency) of the upper trapezius at the midpoint (foramen magnum-acromion line) using MyotonPRO device. Measurements performed supine with head stabilized, arms alongside body, cervical spine neutral. Probe placed perpendicular to the muscle surface at the midpoint of the trapezius. Same researcher throughout. Unit of Measure: hertz (Hz)

Time frame: Baseline, 20 minutes post-therapy, 2 days post-therapy (follow-up), immediately before next therapy session, 20 minutes post-second therapy, and 2 days post-second therapy (final follow-up)

Myotonometry of upper trapezius muscle: dynamic stiffness

Assessment of biomechanical properties (dynamic stiffness) of the upper trapezius at the midpoint (foramen magnum-acromion line) using MyotonPRO device. Measurements performed supine with head stabilized, arms alongside body, cervical spine neutral. Probe placed perpendicular to the muscle surface at the midpoint of the trapezius. Same researcher throughout. Unit of Measure: newtons per meter (N/m)

Time frame: Baseline, 20 minutes post-therapy, 2 days post-therapy (follow-up), immediately before next therapy session, 20 minutes post-second therapy, and 2 days post-second therapy (final follow-up)

Myotonometry of upper trapezius muscle: decrement

Assessment of viscoelastic properties (logarithmic decrement of oscillation, reflecting elasticity) of the upper trapezius at the midpoint (foramen magnum-acromion line) using MyotonPRO device. Measurements performed supine with head stabilized, arms alongside body, cervical spine neutral. Probe placed perpendicular to the muscle surface at the midpoint of the trapezius. Same researcher throughout. Unit of Measure: dimensionless

Time frame: Baseline, 20 minutes post-therapy, 2 days post-therapy (follow-up), immediately before next therapy session, 20 minutes post-second therapy, and 2 days post-second therapy (final follow-up)

Active cervical range of motion: flexion

Active cervical range of motion (flexion) measured using EasyAngle goniometer mounted on the patient's head with an elastic band. The patient is seated upright with feet flat on the floor, head in neutral position. The movement is performed 3 times from neutral (goniometer recalibrated to 0° between trials) and the mean value is recorded. All measurements performed by the same researcher. Unit of Measure: degrees

Time frame: Baseline, 20 minutes post-therapy, 2 days post-therapy (follow-up), immediately before next therapy session, 20 minutes post-second therapy, and 2 days post-second therapy (final follow-up)

Active cervical range of motion: extension

Active cervical range of motion (extension) measured using EasyAngle goniometer mounted on the patient's head with an elastic band. The patient is seated upright with feet flat on the floor, head in neutral position. The movement is performed 3 times from neutral (goniometer recalibrated to 0° between trials) and the mean value is recorded. All measurements performed by the same researcher. Unit of Measure: degrees

Time frame: Baseline, 20 minutes post-therapy, 2 days post-therapy (follow-up), immediately before next therapy session, 20 minutes post-second therapy, and 2 days post-second therapy (final follow-up)

Active cervical range of motion: right lateral flexion

Active cervical range of motion (right lateral flexion) measured using EasyAngle goniometer mounted on the patient's head with an elastic band. The patient is seated upright with feet flat on the floor, head in neutral position. The movement is performed 3 times from neutral (goniometer recalibrated to 0° between trials) and the mean value is recorded. All measurements performed by the same researcher. Unit of Measure: degrees

Time frame: Baseline, 20 minutes post-therapy, 2 days post-therapy (follow-up), immediately before next therapy session, 20 minutes post-second therapy, and 2 days post-second therapy (final follow-up)

Active cervical range of motion: left lateral flexion

Active cervical range of motion (left lateral flexion) measured using EasyAngle goniometer mounted on the patient's head with an elastic band. The patient is seated upright with feet flat on the floor, head in neutral position. The movement is performed 3 times from neutral (goniometer recalibrated to 0° between trials) and the mean value is recorded. All measurements performed by the same researcher. Unit of Measure: degrees

Time frame: Baseline, 20 minutes post-therapy, 2 days post-therapy (follow-up), immediately before next therapy session, 20 minutes post-second therapy, and 2 days post-second therapy (final follow-up)

Active cervical range of motion: right rotation

Active cervical range of motion (right rotation) measured using EasyAngle goniometer mounted on the patient's head with an elastic band. The patient is seated upright with feet flat on the floor, head in neutral position. The movement is performed 3 times from neutral (goniometer recalibrated to 0° between trials) and the mean value is recorded. All measurements performed by the same researcher. Unit of Measure: degrees

Time frame: Baseline, 20 minutes post-therapy, 2 days post-therapy (follow-up), immediately before next therapy session, 20 minutes post-second therapy, and 2 days post-second therapy (final follow-up)

Active cervical range of motion: left rotation

Active cervical range of motion (left rotation) measured using EasyAngle goniometer mounted on the patient's head with an elastic band. The patient is seated upright with feet flat on the floor, head in neutral position. The movement is performed 3 times from neutral (goniometer recalibrated to 0° between trials) and the mean value is recorded. All measurements performed by the same researcher. Unit of Measure: degrees

Time frame: Baseline, 20 minutes post-therapy, 2 days post-therapy (follow-up), immediately before next therapy session, 20 minutes post-second therapy, and 2 days post-second therapy (final follow-up)