Comparison of Manipulation, Mobilization, and Exercise for Nonspecific Neck Tension

This study is designed to investigate the clinical, physical, psychological, and myofascial outcomes of manual therapy techniques (manipulation and mobilization) and neck exercises in individuals experiencing non-specific neck tension using a rigorous and multifaceted methodology.

According to the study protocol, participants receive a standardized intervention program consisting of 2 sessions per week for a period of 4 weeks, totaling 8 sessions. During the data collection process of the study, the clinical and functional status of the patients are evaluated using comprehensive scales and standard measurement tools. In this context, pain severity is assessed using the Visual Analog Scale (VAS), range of motion with a goniometer, neck functionality with the Copenhagen Neck Disability Index, quality of life with the SF-36 scale, and anxiety-depression statuses using the Hospital Anxiety and Depression Scale.

Furthermore, during the physical and myofascial examination phase, muscle tightness, palpation findings, and muscle restriction conditions are evaluated and recorded with precision. All of these clinical parameters, myofascial findings, and measurements are repeated before and after the treatment and subjected to comparative statistical analyses to objectively and scientifically demonstrate the effectiveness of the applied physiotherapy approaches.

• Manipulation and Exercise (Other): Participants undergo cervical (general, C1) and thoracic manipulation, followed by a standardized exercise program including neck range of motion exercises (flexion, extension, lateral flexion, rotation), pectoral and trapezius stretching, and chin tucks.
• Mobilization and Exercise (Other): Participants undergo cervical (C2-C4) and thoracic mobilization, traction with rotation, and gliding techniques (anterior-posterior/lateral), followed by the same standardized exercise program as mentioned above (neck ROM, stretching, chin tucks).
• Standardized Exercise Program (Behavioral): Participants perform only the standardized exercise program consisting of neck range of motion exercises (flexion, extension, lateral flexion, rotation), pectoral and trapezius stretching, and chin tuck exercises.

Primary outcomes

• Visual Analog Scale [At baseline and the 4-week treatment period.]: Measurement of pain intensity.

Secondary outcomes

• Goniometric Measurement (ROM) [At baseline and the 4-week treatment period.]: Measurement of cervical range of motion (flexion, extension, lateral flexion, rotation) using a goniometer.

Other outcomes

• Copenhagen Neck Functional Disability Scale [At baseline and the 4-week treatment period.]: Assessment of neck functional disability.
• Short Form-36 (SF-36) [At baseline and the 4-week treatment period.]: Assessment of health-related quality of life.
• Hospital Anxiety and Depression Scale - Anxiety Subscale [At baseline and the 4-week treatment period.]: Assessment of anxiety levels using the first 7 items of the HADS questionnaire.
• Palpation and Restriction Assessment [At baseline and after the 4-week treatment period.]: Assessment of tenderness and limitation during palpation, graded by intensity (mild, moderate, severe) and recorded as a numerical value.

Sex: All, ages: 18 Years to 30 Years

Inclusion Criteria:

* \- Non-specific neck muscle tension
* Being between 18-30 years of age
* Not having a chronic disease
* Not having undergone any surgery,
* Having limited mobility in the cervical region
* Having at least 2 pains according to the Visual Analog Scale at rest
* Individuals with subacute and chronic non-specific neck pain were included in this study
* Having a negative vertebrobasilar artery test

Exclusion Criteria:

* -Having a chronic systemic disease
* Having cervical straightening and cervical herniation (with a diagnosis and report)
* Having undergone surgery
* Having instability in the cervical joints and trauma within the last year
* Having severe osteoporosis
* Having neurological findings
* Having received physical therapy within the last 6 months
* Having vertigo

• Gamze BAŞKENT, Dr, Study director, Istanbul Rumeli University