Effectiveness of Mckenzie neck exercise and conventional physical therapy in patients with chronic non-specific neck pain: A randomized controlled trial
To find out the effectiveness of McKenzie exercises compared to conventional physical therapy in patients with chronic non-specific neck pain.
Design
Randomised, superiority, parallel group trial with blinded outcome assessment. Randomisation was centralised and computerised with concealed randomisation sequence carried out at an external site
Settings and conduct
Physical therapy department of Hayatabad Medical Complex (HMC).
Participants/Inclusion and exclusion criteria
Inclusion Criteria:
• Male and female individuals
• Age 18 to 65 years
• Having localized chronic non-specific neck pain from ≥ 3 months
Exclusion Criteria:
• Cervical radiating pain
• History of the neck surgery in the past 12 months
• History of spinal cord lesion
• Diagnosed cases of serious pathologies like infection, inflammation or malignancy
Intervention groups
Control Group: The conventional physical therapy protocol will include active neck exercises, which consists of functional exercises, postural exercises, stretching, relaxation exercises and isometric neck exercises to increase strength or range of motion. Exercise therapy may also be preceded by massage (such as soft tissue release for 5 minutes), stretching, or physical therapy techniques like heat applications (such as hot pack for 10-15 minutes), interferential current, and transcutaneous electrical nerve stimulation (TENS) application.
Experimental Group: The patient will be asked to keep their head as forward-facing as possible while moving it backward as much as they can. Making the movement as large as possible is crucial. After finishing, the patient goes back to their neutral rest position.
Main outcome variables
Numerical Pain Rating Scale (NPRS) for neck pain, Copenhagen neck functional disability scale (CNFDS) to measure neck functional activity and goniometer to measure cervical ROM.
General information
Reason for update
Acronym
IRCT registration information
IRCT registration number:IRCT20230907059376N5
Registration date:2024-06-08, 1403/03/19
Registration timing:prospective
Last update:2024-06-08, 1403/03/19
Update count:0
Registration date
2024-06-08, 1403/03/19
Registrant information
Name
Sarmad Khattak
Name of organization / entity
Rehman Medical Institute, Peshawar
Country
Pakistan
Phone
+92 91 5838666
Email address
sarmadkhattak007@gmail.com
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2024-06-15, 1403/03/26
Expected recruitment end date
2024-09-15, 1403/06/25
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Effectiveness of Mckenzie neck exercise and conventional physical therapy in patients with chronic non-specific neck pain: A randomized controlled trial
Public title
Effectiveness of Mckenzie neck exercise and conventional physical therapy in patients with chronic non-specific neck pain
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Male and female individuals•
Age 18 to 65 years
Having localized chronic, non-specific neck pain from ≥ 3 months
Exclusion criteria:
Cervical radiating pain
History of the neck surgery in the past 12 months
History of spinal cord lesion
Diagnosed cases of serious pathologies like infection, inflammation or malignancy
Individuals who have been clinically diagnosed with psychological disorders
Age
From 18 years old to 65 years old
Gender
Both
Phase
N/A
Groups that have been masked
Outcome assessor
Sample size
Target sample size:
26
Randomization (investigator's opinion)
Randomized
Randomization description
The participants will be randomly allocated to groups using the sealed envelope method. This technique ensures that the assignment is unbiased and that neither the participants nor the researchers can influence the group allocation. Each participant will draw an envelope containing their group assignment, maintaining the randomness and confidentiality of the process. This method is commonly used in clinical trials and research studies to ensure the integrity of the experimental design.
Blinding (investigator's opinion)
Single blinded
Blinding description
Only the assessor, who will assess pre and post scores, will be blind in current study
Outcome measures will be used/measured at baseline and after the intervention
Method of measurement
Numeric Pain rating scale
Secondary outcomes
empty
Intervention groups
1
Description
Control group: Participants in this group will receive conventional therapy. Conventional physical therapy protocol will include active neck exercises, which consists of functional exercises, postural exercises, stretching, relaxation exercises and isometric neck exercises to increase strength or range of motion. Exercise therapy may also be preceded by massage (such as soft tissue release for 5 minutes), stretching, or physical therapy techniques like heat applications (such as hot pack for 10-15 minutes), interferential current, and transcutaneous electrical nerve stimulation (TENS) application. This protocol will be done thrice a week, with thirty-minute therapy sessions, with an overall of maximum of twelve sessions.
Category
Rehabilitation
2
Description
Intervention group: This group will receive McKenzie exercise for neck pain. The patient will be asked to keep their head as forward-facing as possible while moving it backward as much as they can. Making the movement as large as possible is crucial. After finishing, the patient goes back to their neutral rest position. Four sets of ten to fifteen repetitions of the exercise are to be performed, with a one-to-two-minute break in between.First Week of applying McKenzie Protocol:The patient will be supine with their head retracted or their chin thrust in. Under the occiput, a tiny pillow will be positioned to sustain a small amount of flexion. The patient will be instructed to position their head so that it was squarely over the girdle of their shoulders by pulling the neck and head posteriorly. After holding the final position for a brief moment, the subject will be free to settle into a resting position. Frequency: Four sets of ten to fifteen repetitions of this procedure will be performed, with one to three minutes of rest in between.Second Week of applying McKenzie Protocol:The therapist will progress the patient while they were seated by adding neck extension and applying overpressure with their chin at the end of the range of motion. Frequency: Four sets of this procedure will be performed, with a one to two minute break in between.Third Week of applying McKenzie Protocol:The patient will be positioned in such a way that their head will keep off the couch while lying supine. The therapist will apply the traction exercise of retraction and extension. All along the range of motion, the traction and extension will be maintained. Fourth Week of applying McKenzie Protocol:The patient will be instructed to get into short sitting. The therapist will then apply retraction with lateral flexion, neck rotation, and then pair the retraction and flexion of the neck with overpressure. Frequency: Four sets of 10 to 15 repetitions of this procedure will be performed, with a 1- to 2-minute rest period in between.
Category
Rehabilitation
Recruitment centers
1
Recruitment center
Name of recruitment center
Physical Therapy Department, Hayatabad Medical Complex, Peshawar