Upper Cervical Mobilization Versus Integrated Neuromuscular Inhibition Technique in Patients With Levator Scapulae Syndrome (LSS)

Cairo University (CU)

Status: Not yet enrolling

Conditions: Levator Scapulae Syndrome

Treatments: Other: Conventional treatment; Other: Upper cervical mobilization; Other: Integrated neuromuscular inhibition technique

Study type: Interventional

Funder types: Other

Identifiers

NCT07208396

P.T.REC/012/005854

Details and patient eligibility

About

the study will be conducted to answer the following research question: is there a difference between the effect of upper cervical mobilization and integrated neuromuscular inhibition technique of levator scapulae muscle in patients with levator scapulae syndrome?

Full description

Neck pain might be usually provoked by TrPs in the upper trapezius and levator scapulae muscles The differentiation in levator scapulae MTrPs prevalence between the right and left sides may also indicate potential asymmetries in muscle use or stress, which could be relevant for diagnosis and treatment strategies.

Integrated treatment approach (INIT) for neck pain provides greater pain relief, reduces disability, improves functional ability, and improves quality of life than other treatments Cervical Spine Mobilization (CSM) by oscillatory movements and traction to the cervical segments helps to break adhesion and stretch the hypo-mobile shortened structures.

There is a gap in the available literature about the comparative effect of upper cervical mobilization and integrated neuromuscular inhibition technique (INIT) of levator scapulae muscle on neck pain, neck disability, range of motion, and cervical proprioception in levator scapulae syndrome.

60 Participants recruited from both genders will be assigned randomly into 3 equal groups Group A : will receive upper cervical mobilization plus conventional treatment .

Group B : will receive integrated neuromuscular technique, It is a technique which combines three methods (Ischemic compression- muscle energy technique- strain counter strain) plus conventional treatment .

Group C : will receive conventional physical therapy only in the form of: (superficial heat using hot pack for 10 minutes ,Isometric Neck Exercises and Dynamic Neck) .

Enrollment: 60 estimated patients

Sex: All

Ages: 18 to 45 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Patients with a primary complaint of chronic neck pain (assessed by VAS) for more than 3 months.
2. Subjects with pain provocation and reduced mobility at the upper cervical segment (assessed by passive accessory intervertebral movements (PAIVMs) and reduced mobility at cervical spine (assessed by CROM) will be included in the study.
3. Participants will be recruited from both genders with age ranged from 18 to 45 years old, and BMI from 18 to 30kg/m2

Exclusion criteria

• 1) Previous spine surgery 2) Pregnant and breast feeding women 3) Diabetic patients 4) Hypertensive patients 5) Neck pain associated with cervical radiculopathy 6) Whiplash injuries 7) Cervical spine fracture 8) Vertebrobasilar insufficiency. 9) Red flags suggesting of cancer, infection, vascular insufficiency

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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60 participants in 3 patient groups

UPPER CERVICAL MOBILIZATION

Experimental group

Description:

All patients in group A will receive Grades I and II mobilizations and conventional physical therapy program in the form of :( hot pack, Dynamic and Isometric Neck Exercises) for four weeks.

Treatment:

Other: Upper cervical mobilization

Integrated neuromuscular inhibition technique

Experimental group

Description:

Group B will receive integrated neuromuscular inhibition Technique and conventional physical therapy program as in group A in the form of :( hot pack, Dynamic and Isometric Neck Exercises) for four weeks.

Treatment:

Other: Integrated neuromuscular inhibition technique

conventional treatment

Active Comparator group

Description:

Participants in group C will receive conventional physical therapy only in the form of: (superficial heat using hot pack for 10 minutes, Dynamic Neck Exercises and Isometric Neck Exercises) for four weeks

Treatment:

Other: Conventional treatment