Effects of Cailliet and Kendall Exercises in Nonspecific Neck Pain

Official title

Comparative Effects of Cailliet and Kendall Exercises on Pain, Functional Movement and Disability in Nonspecific Neck Pain: Randomized Control Trial

Overview

Objective of study will be to compare effects of Cailliet and Kendall exercises on pain, functional movement and disability in non-specific neck pain.This randomized clinical trial will be conducted at Good Hands Physiotherapy Clinic, Shahdara Lahore. Sample size of study will be 36. Participants will be randomly divided into two groups Group A and Group B. We will include patients with age group between 25 to 40 years, both genders having localized pain or stiffness in cervical spine for more than 3 months after exclusion of upper limb radiculopathy. Group A will receive Kendall exercises regime and Group B will receive Cailliet exercises regime. Both groups will receive baseline treatment including hot pack and Transcutaneous Electric Nerve Stimulation (TENS). Short term effects would be assessed after treatment for 3 sessions per week on alternate days for 4 weeks. Patients will be assessed by Numeric pain rating scale (NPRS) for pain, Selective Functional Movement Assessment (SFMA) for functional movement and Neck Disability Index (NDI) Urdu version for Disability. Analysis will be done by statistical package for social sciences SPSS 25.

Detailed description

Pain felt in an area circumscribed superiorly by the superior nuchal line, laterally by the neck's lateral borders, and inferiorly by an imagined transverse line passing through the T1 spinous process is defined as neck pain. An acute or chronic cervical and shoulder girdle issue originating from the occiput of the head to the spine of the scapula, with or without limiting cervical range of motion, and unrelated to any past history of infection or fracture can be characterized as non-specific neck pain. One of the most common musculoskeletal issues that impairs general population function and results in disability is neck pain. The cervical spine is a complicated biomechanical system made up of at least 20 pairs of muscles, many of which have similar roles, and countless degrees of flexibility for each joint. However, the etiology and basic pathology of neck pain are still unknown. Around the world, 330 million people experience some form of neck pain with mean estimates of 7.6% prevalence (range, 5.9-38.7%), 37% annual prevalence (range, 16.7-75%), and 48.5% lifetime prevalence (range, 14.2-71%).

There have been contradictory findings from earlier studies about the optimal management of neck pain. While some contend that exercise leads to greater results, others support the efficacy of conventional therapy. Comparing the short-term benefits of the exercise programs designed by Cailliet and Kendall, in order to ascertain which method produces better results in terms of symptom relief and pain reduction. By getting empirical data on the short-term impacts of exercise treatments, the study will advance evidence-based practice. Healthcare practitioners can rely on this information to make well-informed decisions and recommendations because it will provide scientific proof on their safety and efficacy. This will support the use of a more standardized and empirically supported approach in the treatment of generalized neck pain symptoms associated with the neck musculature.

Interventions

• Other Kendall exercises
  1. Positioning supine with the chin tucked in and lifting the head for 2 to 8 sec to strengthen deep cervical flexors. 2. Maintaining a sitting posture, with hands on the occipital region, and flexed spine while moving head downwards to stretch cervical extensors, maintaining an upright posture. 3. Keep the resistance band circling with strong support and stretching it with the upper limbs of both sides so that there is full retraction of the scapula to strengthen retractors of the shoulder. 4.
• Other Cailliet exercises
  The intervention of group B will include baseline treatment, followed by maneuvers, including: Neck Cailliet exercise using isometric contractions against the prisoner to the maximum that ends with relaxation and continued with stretching. Each posture was maintained for 30 s and 3 sets of 10 repetitions were performed with 3 sessions per week on alternate days for 4 weeks.

Primary outcome measures

• Numeric Pain Rating Scale [Time frame: 4 weeks]
• Selective Functional Movement Assessment (SFMA) [Time frame: 4 weeks]
• Neck Disability Index (NDI) for disability [Time frame: 4 weeks]

Eligibility criteria

Inclusion criteria

• Age group between 18 to 40 years
• Both gender male and female
• Individuals having localized pain or stiffness in spine or both combined between C3 and C7 without upper limb radiculopathy
• Negative Spurling's test, traction test, upper limb tension test, and shoulder abduction test.
• Pain reported on NPRS Moderate score in neck region for more than 3 months
• Neck Disability Index (NDI) score of 0-10 points out of 50 score

Exclusion criteria

• Tuberculosis, carcinoma, heart disease, and osteoporosis
• Neural disorders due to prolapsed intervertebral disc
• Any trauma, localized infection or history of surgery in cervical spine region in last 6 months
• Upper motor neuron disease, cervical stenosis, and metabolic diseases in bone and joint
• Hyper flexibility, Open sores
• Ongoing radiotherapy, chemotherapy, steroid therapy, or anticoagulants
• Psychiatric diseases such as phobia/obsession and depression
• Allergy to hot pack

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Pakistan · 1 center

• Good hands physiotherapy clinic — Lahore

Publications

• Bogduk N. The anatomy and pathophysiology of neck pain. Phys Med Rehabil Clin N Am. 2003 Aug;14(3):455-72, v. doi: 10.1016/s1047-9651(03)00041-x. PMID 12948338

Identifiers

NCT: NCT06875856 · REC/RCR & AHS/24/0151

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗