Comparative Effects of Nerve Flossing and Deep Neck Flexor Muscle Strengthening on Pain, Range of Motion and Functional Disability on Cervical Spinal Stenosis (NF-DNF)

Green International University

Status: Completed

Conditions: Cervical Spinal Stenosis

Treatments: Behavioral: Deep Neck Flexor Strengthening; Behavioral: Nerve Flossing

Study type: Interventional

Funder types: Other

Identifiers

NCT07604935

GIU/REC/26-34

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 62 patients

Sex: All

Ages: 20 to 50 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adults aged 20-50 years, both male and female.
• Clinical and radiological (MRI) diagnosis of cervical spinal stenosis.
• Cervical pain with or without radiating to the upper limb.
• At least one neurological sign, such as sensory disturbance, muscle weakness or diminished reflexes.
• Symptoms present for more than 4 weeks but less than 6 months.
• Ability to understand and follow exercise instructions.
• VAS pain score ≥ 3/10 at baseline.

Exclusion criteria

• History of cervical spine surgery
• Recent trauma, fracture, or cervical instability.
• History of disc herniation involving surgery.
• Other neurological or musculoskeletal conditions, including peripheral neuropathy, thoracic outlet syndrome, and rheumatoid arthritis.
• Pregnancy.
• Recent medication use that may impact nerve function (e.g., systemic steroids).

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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62 participants in 2 patient groups

Nerve Flossing Group

Experimental group

Description:

Participants in this arm will receive Nerve Flossing techniques targeting the cervical and upper limb neural tissues. The intervention involves controlled, low-amplitude movements of the neck and upper limb to improve neural mobility. Sessions will be conducted as per the study protocol.

Treatment:

Behavioral: Nerve Flossing

Deep Neck Flexor Strengthening Group

Experimental group

Description:

Participants in this arm will receive Deep Neck Flexor strengthening exercises using low-load, targeted movements to improve activation and strength of the deep cervical flexor muscles. The exercises focus on enhancing cervical stability and posture. Sessions will be conducted as per the study protocol.

Treatment:

Behavioral: Deep Neck Flexor Strengthening