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里法国际大学Effect of INIT on Cervical Proprioception in Patients With Forward Head Posture
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临床试验NCT06732700是一项针对前倾头姿的干预性研究试验，目前试验状态为招募中。试验始于2024年4月18日，计划招募42名患者。该研究由里法国际大学主导，预计于2024年12月22日完成。试验数据来源于ClinicalTrials.gov，最后更新时间为2024年12月13日。
简要概括
The purpose of the study is to determine the effects of Integrated Neuromuscular Inhibition Technique on Cervical Proprioception in Patients with Forward Head Posture. A randomized control trial was conducted at Riphah International University, Gulberg Green Campus, Islamabad. The sample size was 42 calculated through G-Power. The participants were divided into two interventional groups each having 21 participants. The study duration was six months. Sampling technique applied was Non-probability Purposive sampling for recruitment. Only 18 to 40 years participants with CVA angle less than 50 degree were included in the study. Tools used in this study are Inclinometer, Mobile phone, Labtop, Kinovea Software, NPRS Scale, Laser Beam. Data was collected at Baseline, after 1st session at the end of 2nd week and 4th week. Data analyzed through SPSS version 23.
详细描述
Forward Head Posture is defined as ≥5 cm in horizontal distance between the tragus of the ear and the posterior angle of acromion in a standing position. The forward head position is characterized by extension of the upper cervical spine (Cl-C3), and flexion of the lower cervical spine (C4-C7), while the cervical curvature is increased. According to study conducted in 2019, Craniovertebral angle is Formed between C7 spinous process and tragus of ear. Forward head posture is present in all age groups, 22-24 years is the mean age group in males with normal CVA about 48.8 degrees, while in females the CVA angle is 47.6 and their mean age is 23-66 years. Normal craniovertebral angle is 49.9 degrees.
Joint position sense is a part of proprioception, which affects body posture and stability. It is influenced by muscle spindles, which respond to changes in muscle length and speed. Forward Head Posture (FHP) causes changes in the lengths of neck muscles, leading to poor joint position sense.
The integrated neuromuscular inhibition technique is one of the manual therapies that are directed to trigger point treatment; this technique consists of ischemic compression, Strain Counter-Strain, and Muscle Energy Technique. Intermittent ischemic pressure increases blood flow, Strain Counter-Strain decreases muscle tone, and Muscle Energy Technique encourages muscle easing, this leads to improvements in pain, function, and range of motion.
A Study in 2019 reported the shortness of Levator scapulae associated with Forward Head Posture leads.
In 2020 Khan et al. carried out research which showed tightness of Sternocleidomastoid muscle in patients with Forward Head Posture.
A study conducted in 2023 evaluated the effect of dry needling of Upper trapezius muscle in Forward Head Posture and results showed one session of dry needle therapy with stretching exercises could improve Pain and Pressure Threshold, Range of Motion, craniovertebral angle, which improved Forward Head Posture.
According to a study conducted in 2020 The craniovertebral angle had a negative correlation with position sensing and individuals with Forward Head Posture had a higher error value when observing cervical position sensing than individual with normal head posture.
According to a study of 2018, integrated neuromuscular inhibition technique is effective in improving cervical function by reducing the trigger points on upper trapezius muscle in mechanical neck pain.
Mustafa et al. in 2023 found that integrated neuromuscular inhibition technique to a multimodal treatment program (Mulligan (SNAG, NAGS) with isometric exercises) improve neck function.
官方标题
The Effect of Integrated Neuromuscular Inhibition Technique on Cervical Proprioception in Patients With Forward Head Posture
疾病
前倾头姿出版物
关于此临床试验发表的科学文章和研究论文：- Dehqan B, Delkhoush CT, Mirmohammadkhani M, Ehsani F. Does forward head posture change subacromial space in active or passive arm elevation? J Man Manip Ther. 2021 Aug;29(4):227-234. doi: 10.1080/10669817.2020.1854010. Epub 2020 Nov 30.
- Gonzalez HE, Manns A. Forward head posture: its structural and functional influence on the stomatognathic system, a conceptual study. Cranio. 1996 Jan;14(1):71-80. doi: 10.1080/08869634.1996.11745952.
- Kim DH, Kim CJ, Son SM. Neck Pain in Adults with Forward Head Posture: Effects of Craniovertebral Angle and Cervical Range of Motion. Osong Public Health Res Perspect. 2018 Dec;9(6):309-313. doi: 10.24171/j.phrp.2018.9.6.04.
- Deshpande V, Bathia K, Kanase S, Pawar A, Jain P, Patel G. Effect of mckenzie approach and neck exercises on forward head posture in young adults. SCOPUS IJPHRD CITATION SCORE. 2019 Jul;10(7):123.
- Lee MY, Lee HY, Yong MS. Characteristics of cervical position sense in subjects with forward head posture. J Phys Ther Sci. 2014 Nov;26(11):1741-3. doi: 10.1589/jpts.26.1741. Epub 2014 Nov 13.
- Ali Ismail AM, Abd El-Azeim AS, El-Sayed Felaya EE. Integrated neuromuscular inhibition technique versus spray and stretch technique in neck pain patients with upper trapezius trigger points: a randomized clinical trial. J Man Manip Ther. 2024 Apr;32(2):141-149. doi: 10.1080/10669817.2023.2192899. Epub 2023 Mar 23.
- Khosravi F, Peolsson A, Karimi N, Rahnama L. Scapular Upward Rotator Morphologic Characteristics in Individuals With and Without Forward Head Posture: A Case-Control Study. J Ultrasound Med. 2019 Feb;38(2):337-345. doi: 10.1002/jum.14693. Epub 2018 May 15.
- Khan A, Khan Z, Bhati P, Hussain ME. Influence of Forward Head Posture on Cervicocephalic Kinesthesia and Electromyographic Activity of Neck Musculature in Asymptomatic Individuals. J Chiropr Med. 2020 Dec;19(4):230-240. doi: 10.1016/j.jcm.2020.07.002. Epub 2020 Nov 24.
- Golzareh S, Shadmehr A, Otadi K, Fereydounnia S. Dry Needling Effects of the Upper Trapezius Muscle on the Angles and Range of Motion of the Neck in Individuals with Forward Head Posture. Journal of Modern Rehabilitation. 2023.
- Ha SY, Sung YH. A temporary forward head posture decreases function of cervical proprioception. J Exerc Rehabil. 2020 Apr 28;16(2):168-174. doi: 10.12965/jer.2040106.053. eCollection 2020 Apr.
- Aggarwal S, Bansal G. Efficacy of integrated neuromuscular inhibition technique in improving cervical function by reducing the trigger points on upper trapezius muscle: A randomized controlled trial. Muller Journal of Medical Sciences and Research. 2018;9(1):1-6.
- Zalabia M, Abutaleb EE, Diab R, editors. Addition of integrated neuromuscular inhibition technique to amultimodal treatment program for chronic non specific neck pain. International Scientific Conference Faculty of Physical Therapy; 2018.
其他研究标识符
- REC/01940 Iqra Rashid
NCT编号
实际开始日期
2024-04-18
最近更新发布
2024-12-13
预计完成日期
2024-12-22
计划入组人数
42
研究类型
干预性研究
试验分期 (阶段)
不适用
试验状态
招募中
关键词
INIT, Forward Head Posture, Joint Position Error Test
主要目的
治疗方法
分配方式
随机
干预模型
平行
盲法
无（开放性试验）
试验组/干预措施
| 参与者组/试验组 | 干预措施/治疗方法 |
|---|---|
实验性Experimental Group: 1 INIT+ Posture Corrective Exercises INIT consists of Ischemic Compression, Strain-Counter Strain and Muscle Energy Technique. INIT will be performed on Upper Trapezius, Levator Scapulae and Sternocleidomastoid. The patient will be lying supine; First We will identify the TrPs in the muscle. After that the patient will be placed in comfortable position, first technique applied will be Ischemic Compression. The technique will be applied for 90 secs. After this SCS will be applied, moderate digital pressure will maintained over the active TrP as the position of ease will be identified, it will be held for 20-30 s and repeated for three to five repetitions. Lastly, the subjects will receive MET directed towards the involved muscle. Each isometric contraction will be held for 7-10 sec and stretch will be held for 30 seconds and will be repeated three to five times per treatment session.
Posture corrective exercises given to control group will also be performed | Integrated Neuromuscular Inhibition Technique and Posture Corrective Exercises. INIT will be performed for experimental group and then posture corrective exercises will be performed and for control group only posture corrective exercises will be performed |
阳性对照Control Group: 2 Posture corrective exercise Strengthening exercises: a) chin tuck in supine lying with the head in contact with the floor, (1 sets, 10 reps) b) Y-to-I exercise in a prone position (1 sets, 10 reps) c) Prone horizontal abduction with external rotation (1 sets, 10 reps).
Stretching Exercises:
d) one-sided unilateral self-stretch of pectoralis minor in standing position (stretch 30 sec, 5 reps) e) static sternocleidomastoid stretch (stretch 30 sec, 5 reps) f) static levator scapulae stretch (stretch 30 sec, 5 reps). | Integrated Neuromuscular Inhibition Technique and Posture Corrective Exercises. INIT will be performed for experimental group and then posture corrective exercises will be performed and for control group only posture corrective exercises will be performed |
主要终点
| 结果指标 | 度量标准描述 | 时间框架 |
|---|---|---|
Numeric Pain Rating Scale | The NPRS is a segmented numeric version of the visual analog scale (VAS) in which a respondent selects a whole number (0-10 integers) that best reflects the intensity of his/her pain. Where 0 means no pain and 10 means worst imaginable pain. NPRS was measured at Baseline, 1st Session, 2nd Week and 4th Week | 40 minutes session, thrice a week for 4 weeks. |
Cranio-vertebral Angle | For measuring the angle, the reflective markers will be placed on the tragus of the ear and spinous process of the C7. The camera will be positioned on a tripod 50 cm away from the participant. The axis of the lens of the camera was placed at the level of the shoulder. The photos will be taken and the CVA angle will be calculated by Software Kinovea. CVA was measured at Baseline, 1st Session, 2nd Week and 4th Week | 40 minutes session, thrice a week for 4 weeks. |
Cervical Joint Position Error Test | For measurement of proprioception, Joint Position Error Test is used. The distance/deviation will represent the proprioception deficit (JPE) of each participant. Angle is then calculated by taking arc tan of error distance divided by 90. A meaningful distance of 7.1cm or angle greater than 4.5 degree represents proprioception deficit. JPE Test was measured at Baseline, 1st Session, 2nd Week and 4th Week | 40 minutes session, thrice a week for 4 weeks. |
Cervical Range of Motion | Cervical ROM will be measured by using an inclinometer for Flexion, Extension, Lateral Flexion and Rotation. The normal Range for Flexion is usually approximately 80º. Normal cervical extension is usually 50°, Value for Lateral Flexion is 45° and for rotation its approximately 80°. Cervical ROM were measured at Baseline, 1st Session, 2nd Week and 4th Week | 40 minutes session, thrice a week for 4 weeks. |
资格标准
适龄参与研究
成人
最低年龄要求
18 Years
适龄性别
全部
接受健康志愿者
是
- Both Male and Female patients
- CVA less than 50 degree
- Age 18-40 years
- Neck pain for more than 3 months
- NPRS > 3
- Decreased Cervical ROMs
- Active trigger points in following muscles (Upper Trapezius, Sternocleidomastoid, Levator Scapulae)
- History of cervical or facial trauma or surgery.
- Congenital anomalies of spine such as scoliosis.
- Systemic arthritis.
- Any disorder of Central Nervous System.
- Patients with cognitive deficit
里法国际大学425 个活跃的临床试验可供探索研究中心联系人
联系人: Imran Amjad, PhD, 03324390125, [email protected]
1 位于 1 个国家/地区的研究中心
Federal
Riphah International University, Islamabad, Federal, 44000, Pakistan
Lal Gul Khan, MScPT, 联系人, 03002146287, [email protected]
Iqra Rashid, MSPT(OMPT), 主要研究者
招募中