Investigation of the Efficacy of Thoracic Mobilization Exercises Performed in Addition to Core Stabilization Exercises in Individuals With Chronic Non-Specific Neck Pain

Kirsehir Ahi Evran Universitesi

Status: Completed

Conditions: Neck Pain

Treatments: Other: Core Stabilization Exercises; Other: Thorocal Mobilization Exercises

Study type: Interventional

Funder types: Other

Identifiers

NCT06991140

43834581758)

Details and patient eligibility

About

Neck pain is one of the most common musculoskeletal complaints worldwide and is an important health problem that restricts the daily life activities of individuals. In particular, chronic non-specific neck pain (CNSNP) describes pain that persists for at least 12 weeks without an underlying specific pathological cause and affects a large segment of the population. CNSNP leads not only to pain but also to functional limitations, postural disorders and decreased quality of life.

In recent years, exercise-based approaches, especially core stabilisation exercises, have become prominent in the treatment of CNSNP. Core stabilisation exercises aim to increase postural control, improve segmental stability and thus reduce pain by activating deep muscle groups around the spine. However, it has been reported that exercises targeting only local muscle groups may be insufficient to meet the high-level biomechanical and neuromuscular needs of the cervical spine.

In this context, the effect of the mobility of the thoracic spine on neck function is noteworthy. Hypomobility in the thoracic region may contribute to pain and dysfunction by increasing the load on the cervical spine. Therefore, it is thought that adding thoracic mobilisation exercises to core stabilisation exercises may be more effective in improving neck pain and postural disorders.

The aim of this study was to investigate the effects of adding thoracic mobilisation to a core stabilisation exercise programme in individuals with chronic non-specific neck pain.

Full description

Neck pain is one of the most common musculoskeletal problems on a global scale and causes a significant decrease in the quality of life by negatively affecting the social, occupational and physical functionality of individuals. It is reported that approximately 30-50% of individuals experience neck pain every year and a significant proportion of these complaints become chronic. Chronic non-specific neck pain (CNSNP) is defined as neck pain that persists for more than three months without an underlying anatomical or pathological cause and is the most common type of neck pain encountered in clinical practice. In the treatment of CNSNP, both symptom relief and correction of underlying mechanical disorders are important.

In rehabilitation programmes for neck pain, core stabilisation exercises are widely used to strengthen spinal stability and improve postural control by increasing activation of the deep muscles supporting the cervical and thoracic spine. The core consists of a large number of muscles and connective tissues surrounding the lumbar, thoracic and cervical spine and the coordinated functioning of these structures is critical for the functional integrity of the spine. Various studies have shown that core stabilisation exercises are effective in reducing pain and increasing functional capacity.

However, the functional and mechanical health of the cervical spine is closely related not only to the local stabilising muscles but also to the mobility of the thoracic spine. Hypomobility of the thoracic spine can lead to increased compensatory motion in the cervical segments, muscle spasm, postural distortion and increased pain. There is increasing evidence in the literature that improving thoracic mobility can reduce cervical pain and dysfunction. In this context, integrating thoracic mobilisation exercises into core stabilisation programmes may provide not only symptomatic relief, but also better postural alignment and more effective functional recovery.

The aim of this study is to comparatively examine the effects of adding thoracic mobilisation exercises to core stabilisation exercises in individuals with chronic non-specific neck pain. In this direction, it is aimed to evaluate the extent to which the applications for the mobility of the thoracic spine affect the clinical symptoms in the cervical region and to obtain data that will contribute to clinical rehabilitation programmes.

Enrollment: 54 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• To be between the ages of 18-65,
• 3 months of persistent neck pain,
• Being sedentary,
• Not being involved in any physiotherapy programme in the last 6 months

Exclusion criteria

• History of previous spinal surgery or trauma,
• Neurological deficit, vestibular pathology, neurological, cardiopulmonary, musculoskeletal problems affecting physical performance, any pathology in the shoulder joint, any pathology in the jaw joint and pregnancy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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54 participants in 2 patient groups

Control Group

Experimental group

Description:

Core stabilisation exercises applied to both groups of the study were structured to target the activation of deep muscle groups supporting the stability of the cervical and thoracic spine. The exercise programme was performed 3 days a week for a total of 6 weeks under the supervision of a physiotherapist. The programme included exercises to improve head and neck control (chin tuck, head lift in supine position), exercises to improve scapular stability (scapular retraction, wall slide, serratus anterior activation) and exercises to improve trunk control in neutral spine position (arm and leg extension in four-point position, plank variations). The exercises were gradually made more difficult according to the tolerance of the individuals and each session lasted approximately 40-45 minutes. By ensuring that the exercises were performed in the correct form and in a controlled manner, overloading of the musculoskeletal system was prevented.

Treatment:

Other: Core Stabilization Exercises

Thorocal mobilization group

Experimental group

Description:

Thoracic mobilisation exercises were performed 3 days a week for a total of 6 weeks under the supervision of a physiotherapist. Thoracic mobilisation programme consisted of active self-mobilisation techniques, mobilisation exercises with foam rollers, stretching exercises including thoracic rotation and extension movements and dynamic postural exercises. Especially 'thread the needle' exercise in sitting or quadruped position, 'thoracic extension press-up' in prone position and 'extension on foam rollers' were preferred to increase the mobility of thoracic vertebral segments. The exercises were gradually made more difficult according to the tolerance of the individuals. Each exercise was performed as 10-15 repetitions and 2-3 sets. Exercise safety was ensured by informing the patients about the correct posture and movement patterns before all applications. The main aim of the exercises was to alleviate the mechanical load of the cervicothoracic transition by reducing thoracic hypomobi

Treatment:

Other: Thorocal Mobilization Exercises

Other: Core Stabilization Exercises