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Recruiting NCT07725861

Strain Counter Strain With and Without Sustained Natural Aphophyseal Glide in Non Specific Neck Pain

No phase Interventional Cervical Pain

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: Strain Counterstrain + SNAG with Common Treatment, Strain Counterstain (SCS) only.
Who it may be relevant to
Registry conditions: Cervical Pain. Basic parameters: 18 years — 60 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
Pakistan
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →

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Official title

Effects of Strain Counter Strain With and Without Sustained Natural Aphophyseal Glide on Pain Range Of Motion ,Craniovertebral Angle and Disability in Patients With Non Specific Neck Pain

Overview

Non-specific neck pain is a common problem that doesn't have a specific cause like an injury or disease. It usually includes neck pain, reduced movement, poor posture like forward head position, and some level of disability that can make daily activities difficult. Physiotherapists often use hands-on techniques like Strain Counterstrain (SCS) and SNAGs (Sustained Natural Apophyseal Glides) to help reduce pain, improve movement, and correct posture. This study aims to find out if adding SNAGs (Sustained Natural Apophyseal Glides) to the usual Strain Counterstrain (SCS) treatment helps more than SCS alone in patients with neck pain. We will measure changes in pain levels, neck movement, posture (craniovertebral angle), and daily life impact (NDI) over a four-week treatment program.

Detailed description

This study will be a randomized clinical trial and will take place at Ibne Sina Hospital in Multan. Patients will be chosen using convenience sampling. Those who meet the required conditions will be randomly divided into two groups using a computer program. Group A will receive the SCS and SNAG technique , while Group B will receive SCS alone . Treatment will be given three times a week for four weeks The outcomes will be measured before and after the treatment. These include: Pain (measured using the NPRS Scale ,Neck movement (measured with a goniometer), Craniovertebral angle (checked using digital photos) ,Disability level (measured using the Neck Disability Index - NDI) . The collected data will be analyzed using SPSS version 21. First, the normality of the data will be checked using the Shapiro-Wilk test. Based on the results, suitable statistical tests will be used to compare the results within and between the groups.

Interventions

  • Other Strain Counterstrain + SNAG with Common Treatment
    Group A (Experimental Group) will receive both Strain Counterstrain (SCS) and SNAGs (30). They will attend 12 sessions in total, three times per week for four weeks. First, the SCS technique will be applied to the upper trapezius, levator scapulae, and scalene muscles. The patient will lie on their back or side while the therapist finds tender points and positions the neck to reduce tension, holding that position for 90 seconds before gently returning it to neutral and checking for pain. After t
  • Other Strain Counterstain (SCS) only
    Group B (Control Group) will receive only the Strain Counterstrain (SCS) technique without SNAGs (31). The same neck muscles will be targeted, and the patient will lie in a similar position while the therapist identifies tender points and performs the SCS technique. No joint glides or mobilization will be applied in this group. Both groups will receive a total of 12 sessions over four weeks, with each session lasting about 40 minutes. Pre- and post-treatment assessments will be carried out to me

Primary outcome measures

  • Numeric pain rate scale (NPRS) [Time frame: upto 4 weeks]
  • Neck Disability index (NDI) [Time frame: Upto 4 weeks]
  • Universal Goniometer (UG) [Time frame: Upto 4 weeks]
  • Craniovertebral Angle (CVA) [Time frame: Upto 4 weeks]

Eligibility criteria

Inclusion criteria

  • •Both Males and Females (20)
  • Age 18 and 60 years
  • pain intensity 3-6 rating on NPRS
  • Pain localized to cervical or upper trapezius

Exclusion criteria

  • • Cervical radiculopathy(20)
  • History of whiplash injury
  • History of cervical and thoracic spine surgery
  • Neck pain associated with vertigo(20)
  • History of spinal osteoporosis
  • Vertebral Fractures
  • Tumours
  • Diagnosed psychological disorders

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
  • Ibne sina hospital and research institute. — Multan

Publications

  • Barbosa-Silva J, Luc A, Sobral de Oliveira-Souza AI, Martins de Abreu R, Cipriano J, de Schaetzen M, Pitance L, Armijo-Olivo S. The Effectiveness of Mulligan's Techniques in Non-Specific Neck Pain: A Systematic Review and Meta-Analysis. Physiother Res Int. 2025 Jul;30(3):e70045. doi: 10.1002/pri.70045. PMID 40439260
  • Blanpied PR, Gross AR, Elliott JM, Devaney LL, Clewley D, Walton DM, Sparks C, Robertson EK. Neck Pain: Revision 2017. J Orthop Sports Phys Ther. 2017 Jul;47(7):A1-A83. doi: 10.2519/jospt.2017.0302. PMID 28666405
  • de Koning CH, van den Heuvel SP, Staal JB, Smits-Engelsman BC, Hendriks EJ. Clinimetric evaluation of active range of motion measures in patients with non-specific neck pain: a systematic review. Eur Spine J. 2008 Jul;17(7):905-21. doi: 10.1007/s00586-008-0656-3. Epub 2008 Apr 22. PMID 18427843
  • Shukla Yu, Shah D. Effect of Craniocervical Flexion Training in Mechanical Neck Pain on Proprioception, Endurance and Pain -An Interventional Study. International Journal of Health Research. 2020;Vol.5:565.
  • Raja G P, Bhat N S, Fernandez-de-Las-Penas C, Gangavelli R, Davis F, Shankar R, Prabhu A. Effectiveness of deep cervical fascial manipulation and yoga postures on pain, function, and oculomotor control in patients with mechanical neck pain: study protocol of a pragmatic, parallel-group, randomized, controlled trial. Trials. 2021 Aug 28;22(1):574. doi: 10.1186/s13063-021-05533-w. PMID 34454582
  • Bernal-Utrera C, Gonzalez-Gerez JJ, Anarte-Lazo E, Rodriguez-Blanco C. Manual therapy versus therapeutic exercise in non-specific chronic neck pain: a randomized controlled trial. Trials. 2020 Jul 28;21(1):682. doi: 10.1186/s13063-020-04610-w. PMID 32723399
  • Cerezo-Tellez E, Torres-Lacomba M, Mayoral-Del-Moral O, Pacheco-da-Costa S, Prieto-Merino D, Sanchez-Sanchez B. Health related quality of life improvement in chronic non-specific neck pain: secondary analysis from a single blinded, randomized clinical trial. Health Qual Life Outcomes. 2018 Nov 6;16(1):207. doi: 10.1186/s12955-018-1032-6. PMID 30400984
  • Shamsi S, Alyazedi FM, Abdelkader SM, Khan S, Akhtar A. Efficacy of Sustained Natural Apophyseal Glides in the Management of Mechanical Neck Pain: A Randomized Clinical Trial. Indian Journal of Medical Specialities. 2021;12(4):199-206.

Identifiers

NCT: NCT07725861 · REC/RCR&AHS/25/0133 Hadeel

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗