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Completed

NCT Number: NCT06960525

Joint Mobilization vs. Strengthening Exercises on Cervical Proprioception for Nonspecific Neck Pain

This clinical trial aims to compare the effects of cervical joint mobilization versus cervical strengthening exercises in patients with chronic neck pain. The study will assess neck proprioception, pain intensity, cervical muscle strength, range of motion, and neck disability.

The main question it aims to answer is:

Which treatment is superior, or do they have equal effects after the first session and after the 12th session?

Participants will:

Receive either cervical joint mobilization or cervical strengthening exercises for 12 sessions.

Do not perform any physical therapy treatment outside the trial. Visit the clinic three times per week for treatment.

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Key information

Conditions

Chronic Neck Pain Neurologic Manifestations Nonspecific Neck Pain Pain Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

18 year–50 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Armed Forces Hospital - Al Hada

Ta'if, Mecca Region, Saudi Arabia

About this study

Neck pain refers to a type of generalized neck discomfort characterized by mechanical features. This condition is a widespread issue, causing significant levels of pain, disability, and can lead to economical strain. Patients suffering from neck pain often experience functional impairments, including weak neck muscles and impaired proprioception. Strengthening exercises and cervical joint mobilization offer effective relief of pain and improve disability. Exploring the superiority of these techniques in improving cervical proprioception to prevent recurrence is still a vague topic. Therefore, this study will investigate the effect of Maitland joint mobilization versus cervical strengthening exercises in patients with nonspecific chronic neck pain on neck proprioception, pain intensity, cervical muscles strength, range of motion and neck disability. This is a double-blinded randomized clinical trial with a parallel-group design. Twenty-six participants will be allocated randomly to one of two groups. Group one (Mobilization) will have cervical joint mobilization according to Maitland approach. Group two (Exercises) will perform craniocervical, cervical and axioscapular muscles strengthening exercises. Treatment will be provided for 12 sessions. Both groups will receive standardized care, including patient education and transcutaneous electrical nerve stimulation.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 18 to 50 years
  • Pain ≥ 3 months
  • Neck pain on VAS ≥ 3/10
  • NDI ≥ 5/50 points
  • ZZ Errors ≥ 9 or the time to complete the task ≥ 28s

Exclusion criteria

  • Unilateral headache aggravated by neck movement.
  • Upper extremity symptoms beyond the elbow.
  • Any history of neck trauma including whiplash
  • Recent fractures (last 8 weeks)
  • Cervical surgery (last 3 months)
  • Current neck-related dizziness
  • Known or suspected ves3bular pathology
  • Internal fixation of the cervical spine
  • Physical therapy for the neck (last 3 months)

Treatment and study plan

Cervical joint mobilization

Other

Passive cervical joint mobilization following Maitland's approach for 3 sets of 1 minute on the most painful segment with one minute rest between sets.

cervical strengthening exercises

Other

concentric and eccentric training of the craniocervical, cervical flexors, extensors, muscles involved in cervical spine rotation and axioscapular muscles.

Primary outcomes

  1. Active cervical movement sense

    Time frame: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4

    Participants will be comfortably seated upright on a chair with a backrest, positioned 1 meter away from a board displaying a zigzag pattern (ZZ). They will wear a headband with a laser pointer attached. The pattern is affixed to the board in a manner that directs the laser beam to the pattern's centre.

  2. Cervical joint position error

    Time frame: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4

    Participants were comfortably seated upright on a chair with a backrest, positioned 0.9 meters away from a wall. Using a distance laser meter, for accurate measurement, the distance between the forehead of the participant and the wall was measured after the participant wore a headband with a laser pointer attached. A point on the wall was located as the patient was in a self-neutral position. A warm-up session was given as the patient with open eyes was instructed to perform flexion, extension, and rotation on both sides and return to the selected point after each movement. After that, the patient was asked to perform the movement for three trials in each movement direction with their eyes closed.

Secondary outcomes

  1. Visual Analogue Scale

    Time frame: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4

    Pain intensity was assessed using the Visual Analogue Scale (VAS) which a ruler with 100 mm measured. The 0 mm indicates 'No pain" and 100 mm indicates " worse pain". Patient were asked to mark their level of pain.

  2. Cervical muscles strength

    Time frame: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4

    Measure the cervical muscles using a hand-held dynamometer. The patient was asked to perform flexion, extension, lateral flexion and rotation to both sides.

  3. Cervical range of motion

    Time frame: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4

    The range of motion was measured three times in flexion, extension, left-right lateral flexion and rotation using a therapeutic range of motion inclinometer.

  4. Neck Disability Index

    Time frame: Three points: 1) baseline, 2) week 4

    Neck Disability Index (NDI) was used to evaluate the score of self-rated disability linked to neck pain experienced during the preceding week. This assessment consists of 10 questions, each question rated from 0 (indicating no disability) to 5 (representing total disability), with a maximum score of 50 points (see Appendix D.). Disability can be categorized as no disability (0-4 points), mild disability (5-14 points), moderate disability (15-24 points), severe disability (25-34 points), and (35-50 points) present complete disability.

Sponsors and collaborators

Lead sponsor

Imam Abdulrahman Bin Faisal University

Other

Collaborators

  • Al Hada Military Hospital

Registry information

Official study title

Comparison of Joint Mobilization vs. Strengthening Exercises for Improving Cervical Proprioception in Individuals With Nonspecific Neck Pain: A Randomized Clinical Trial

Acronym: CervPro-RCT

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
May 7, 2025
Registry last updated
Dec 30, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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