Evaluation of the effect of scapulothorasic joint mobilization on pain intensity, pinch strength and upper limb function in patients with mechanical neck pain
Evidences show a strong association between chronic neck and shoulder pain and scapular dysfunction. The objective of this study is evaluation of the effect of scapulothorasic joint mobilization on pain intensity, maximal pinch and grip strength and upper limb function in patients with mechanical neck pain. Inclusion criteria are: neck disability index between 10 to 45 percent; duration of the involvement more than three months; the scapular dyskinesia. Exclusion criteria are: History of whiplash injury; Surgery in the neck or upper limb and cervical Radiculopathy. This study is a single blinded randomized clinical trial. The sample size is 46 (23 patients in each group). The Patients who referred to the physiotherapy clinic of Shiraz school of rehabilitation sciences, recruited by convenience sampling method. The subjects in the control group receive routine physiotherapy and the subjects in the intervention group receive scapulothorasic joint mobilization beside routine physiotherapy. Both groups receive 5 treatment sessions in a week. Pain intensity, maximal fingers and grip strength before and immediately after the first session and at the end of the course of treatment measured by Pain Numeric Rating Scale, the Pinch Gage and dynamometer. Also functional disability of neck and upper extremity respectively will be measured with the Neck Disability Index and Disabilities of Arm, Shoulder and Hand questionnaire in two groups before and at the end of the course of treatment.
General information
Acronym
IRCT registration information
IRCT registration number:IRCT2014100119358N1
Registration date:2014-12-08, 1393/09/17
Registration timing:registered_while_recruiting
Last update:
Update count:0
Registration date
2014-12-08, 1393/09/17
Registrant information
Name
Zeinab Shirzadi
Name of organization / entity
Shiraz University Of Medical Scienses
Country
Iran (Islamic Republic of)
Phone
+98 71 3628 2700
Email address
shirzadize@sums.ac.ir
Recruitment status
Recruitment complete
Funding source
Shiraz University of Medical Sciences
Expected recruitment start date
2014-09-23, 1393/07/01
Expected recruitment end date
2014-12-21, 1393/09/30
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Evaluation of the effect of scapulothorasic joint mobilization on pain intensity, pinch strength and upper limb function in patients with mechanical neck pain
Public title
The effect of scapulothorasic joint mobilization on treatment of patients with neck pain
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria: Complaint of mechanical neck pain (general pain in the neck that induced with movement or constant holding of neck and palpation of the neck muscles); age between 20-50 years; neck disability index between 10 to 45 percent; duration of the involvement more than three months; incorrect position of scapula and scapular dyskinesia. Exclusion criteria: History of whiplash injury; Surgery in the neck or upper limb; serious pathology (eg malignant tumor, infection, inflammatory disorders or fracture); any disease or disorder of the central nervous system including: stroke, MS and ...; any disease of peripheral nervous system which may affect the study results such as: neuropathies, carpal tunnel syndrome, Guyan tunnel syndrome and cervical radiculopathy.
Age
From 20 years old to 50 years old
Gender
Both
Phase
N/A
Groups that have been masked
No information
Sample size
Target sample size:
46
Randomization (investigator's opinion)
Randomized
Randomization description
Blinding (investigator's opinion)
Single blinded
Blinding description
Placebo
Not used
Assignment
Parallel
Other design features
Secondary Ids
empty
Ethics committees
1
Ethics committee
Name of ethics committee
Shiraz University of Medical Sciences
Street address
Central building of Shiraz University of Medical Sciences, Zand avenue, Shiraz
City
Shiraz
Postal code
Approval date
2014-08-26, 1393/06/04
Ethics committee reference number
CT-9373-7113
Health conditions studied
1
Description of health condition studied
Mechanical neck pain
ICD-10 code
M95.3
ICD-10 code description
Acquired deformity of neck
Primary outcomes
1
Description
pain intensity
Timepoint
before and immediately after the first session and at the end of the course of treatment
Method of measurement
Pain Numeric Rating Scale
2
Description
maximum grip strength
Timepoint
before and immediately after the first session and at the end of the course of treatment
Method of measurement
Newton scale with digital dynamometer
3
Description
pinch strength
Timepoint
before and immediately after the first session and at the end of the course of treatment
Method of measurement
Newton scale with Pinch Gage
4
Description
Disability of upper limb
Timepoint
before and after intervention
Method of measurement
Disabilities of Arm, Shoulder and Hand questionnaire
5
Description
Disability of neck
Timepoint
before and after intervention
Method of measurement
Neck Disability Index
Secondary outcomes
empty
Intervention groups
1
Description
Intervention group: In the intervention group patients receive routine physical therapy treatment protocol for neck pain for 5 sessions over a week. The routine physical therapy treatment protocol contained: Transcutaneous electrical nerve stimulation: conventional mode, frequency 100 Hz, tolerable intensity for 20 min over the pain site; Hot pack: for 20 minutes on the neck; exercise therapy: - the patient place both hands on the forehead and press the forehead into the palms while not moving. - The patient press the back of the head into both hands. - the patient press one hand against the side of the head and attempt to side-bend, as if trying to bring the ear toward the shoulder but not allowing motion, this exercise done for both left and right side. Each patient does exercises 20 times in a day and holds contraction to 6 seconds. The intensity of the contraction must be maximum; scapulothorasic joint mobilization: In intervention group, mobilization techniques applied in the direction of the limited movements of scapula (Retraction, Depression, Elevation, Upward Rotation and Downward Rotation). Patient sleeps on the sound side, close to the edge of the bed. Her head is on the pillow and hips and knees are bent. The therapist stands in front of the patient's hip and bends on it, so that the patient's ileum taken by therapist's axilla. Then each of the techniques done on the intervention group. These techniques applied Sustained with grade 4. Each technique consists of 10 sets of 10 repetitions with 30 seconds rest between each set. Each movement hold 5 seconds and there are 3 seconds rest between each movement in each set. Patients in intervention group receive 5 sessions scapulothorasic joint mobilization in a week.
Category
Rehabilitation
2
Description
Control group: In the control group patients receive routine physical therapy treatment protocol for neck pain for 10 sessions over a week. The routine physical therapy treatment protocol contained: Transcutaneous electrical nerve stimulation: conventional mode, frequency 100 Hz, tolerable intensity for 20 min over the pain site; Hot pack: for 20 minutes on the neck; exercise therapy: - the patient place both hands on the forehead and press the forehead into the palms while not moving. - The patient press the back of the head into both hands. - the patient press one hand against the side of the head and attempt to side-bend, as if trying to bring the ear toward the shoulder but not allowing motion, this exercise done for both left and right side. Each patient does exercises 20 times in a day and holds contraction to 6 seconds. The intensity of the contraction must be maximum. Control group receive 5 treatment sessions in a week.
Category
Rehabilitation
Recruitment centers
1
Recruitment center
Name of recruitment center
School of Rehabilitation Sciences
Full name of responsible person
Dr. Zahra Rojhani Shirazi
Street address
Abiverdi 1 Avenue, Chamran Blvd, Shiraz, Fars
City
Shiraz
Sponsors / Funding sources
1
Sponsor
Name of organization / entity
Shiraz University of Medical Sciences
Full name of responsible person
Dr. Seyed Basir Hashemi
Street address
Central building of Shiraz University of Medical Sciences, Zand avenue, Shiraz
City
Shiraz
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Shiraz University of Medical Sciences
Proportion provided by this source
100
Public or private sector
empty
Domestic or foreign origin
empty
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
empty
Person responsible for general inquiries
Contact
Name of organization / entity
Shiraz University of Medical Sciences
Full name of responsible person
Zeinab Shirzadi
Position
Student
Other areas of specialty/work
Street address
School of Rehabilitation Sciences, Abiverdi 1 Avenue, Chamran Blvd, Shiraz
City
Shiraz
Postal code
Phone
+98 71 3627 1552
Fax
Email
shirzadi.zeinab@gmail.com
Web page address
Person responsible for scientific inquiries
Contact
Name of organization / entity
Shiraz University of Medical Sciences
Full name of responsible person
Dr. Zahra Rojhani Shirazi
Position
Ph.D
Other areas of specialty/work
Street address
School of Rehabilitation Sciences, Abiverdi 1 Avenue, Chamran Blvd, Shiraz
City
Shiraz
Postal code
Phone
+98 71 3627 1552
Fax
Email
rojhaniz@sums.ac.ir
Web page address
Person responsible for updating data
Contact
Name of organization / entity
Shiraz University of Medical Sciences
Full name of responsible person
Zeinab Shirzadi
Position
Student
Other areas of specialty/work
Street address
School of Rehabilitation Sciences, Abiverdi 1 Avenue, Chamran Blvd, Shiraz
City
Shiraz
Postal code
Phone
+98 71 3627 1552
Fax
Email
shirzadi.zeinab@gmail.com
Web page address
Sharing plan
Deidentified Individual Participant Data Set (IPD)