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Brain ConcussionConCervNCT06616272

Cervical Spine Focused Treatment for Patients With Persistent Concussion Symptoms and Neck Pain

A study testing Cervical rehabilitation and Standard Concussion Care in people with Brain Concussion and Neck Pain, run by University of Pittsburgh at 4 sites in 3 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Assess the feasibility of recruiting, enrolling and randomizing patients with concussion symptoms and neck pain to receive manual therapy and cervical rehabilitative exercises in addition to standard concussion treatment. Read more about this study

Who is it for?
Ages 12 to 50 years
Conditions the study is for
Brain Concussion, Neck Pain
What is being tested?
Cervical rehabilitation and Standard Concussion Care
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2 participants
Where
4 sitesin 3 countries
Study dates
28 Aug 2025to 15 Apr 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 12 to 50 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Diagnosed concussion
  • Patient endorses neck pain OR difficulty moving their neck (moderate or severe; score of 2 or 3 for items 16 and 25 from concussion CP screen)
  • Willingness to be randomized
  • 8-90 days post injury
  • English Speaking

Who cannot join

  • Previous concussion within the past 6 months
  • Prior history of ischemic/vascular events
  • Previous treatment for current symptoms
  • Prior treatment for neck pain/headaches in the past year
  • Workers' compensation claim and/or litigation associated with injury
  • Diagnosed substance use disorder
Show all 9Show fewer
  • Prior cervical spine surgery
  • Prior fracture and or dislocation/subluxation of the cervical spine
  • Diagnosed inflammatory arthritis

Trial locations and contacts

4 sites in 3 countries.

4 sites in 3 countries

United States2 sites
  • Greenfield Clinic-Children's Wisconsin

    Milwaukee, Wisconsin, 53227

  • UPMC sports medicine

    Pittsburgh, Pennsylvania, 15203

Other trials in United States

Ireland1 site
  • UPMC Sports Surgery Clinic

    Dublin

Other trials in Ireland

United Kingdom1 site
  • Sports Medicine Northern Ireland

    Belfast

Other trials in United Kingdom

About this study

Official title: Cervical Spine Focused Treatment for Patients With Persistent Concussion Symptoms and Neck Pain: Pilot Study

Assess the feasibility of recruiting, enrolling and randomizing patients with concussion symptoms and neck pain to receive manual therapy and cervical rehabilitative exercises in addition to standard concussion treatment.

In the usual care workflow provided at the participating concussion clinic, cervical spine rehab is not typically introduced until after week 4. The rationale is that neck pain is often a self-limiting condition that may resolve spontaneously, without the need for specific cervical spine rehab.

This study is chiefly focused on feasibility aims that revolve around developing changes to barriers in workflow issues at the participating concussion clinic, that would allow for earlier introduction of cervical spine rehab.

Read the detailed description

This is a a single site pilot randomized controlled trial consisting of a total of 40 participants with concussion and neck pain, randomized to one of two groups (n=20 per group):

  1. early cervical spine focused treatment combined with standard concussion care.
  2. standard concussion care alone for 4 weeks, followed by delayed introduction (after 4 weeks) of cervical spine focused treatment (which is the usual care workflow at our clinical partner site.)

Both groups will receive the combination of cervical spine focused treatment and standard concussion care; the only variation being the timing of the introduction of the cervical spine care.

The primary endpoint will be 4 weeks from start of cervical rehabilitation intervention. The secondary would be the point of discharge. The duration of active participation in the study will be 8 weeks for the participants.

Being tested
Cervical rehabilitation, Standard Concussion Care
Keywords
concussion care, cervical rehabilitation, neck pain
Medical subject headings
Brain Concussion, Neck Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cervical rehabilitationOther

    • Manual joint mobilization (Grades I-V) of painful and restricted cervical spine segments.
    • Supine manual cervical traction to stretch and mobilize the cervical spinal tissues.
    • Manual soft tissue mobilization of the cervical, upper thoracic and/or shoulder muscles.
    • Passive stretching of hypertonic muscles and active strengthening of hypotonic muscles.
    • Motor-control and isometric exercises to activate the deep neck flexors.
  • Standard Concussion CareOther

    Standard Concussion Care interventions are individualized to each patient and their adjudicated profile(s)/moderating factor(s) and may include any/all of the following:

    • Behavioral regulation
    • Vestibular rehabilitation
    • Oculomotor rehabilitation
    • Exertion rehabilitation
    • Pharmacological management
    • Behavioral sleep intervention
    • *Cervical spine rehabilitation (the variable of interest in this study)
    • Psychotherapy
Study groups in NCT06616272
Study groupRoleWhat they receive
Early cervical spine focused treatment and standard concussion careActive comparatorThe cervical spine focused treatment will start concurrently with the standard care once the participant is randomized to this group. The participants will receive early cervical spine focused treatment 2x/week for 4 weeks. In addition to the cervical spine focused treatment, this group will also receive standard concussion care interventions individualized to the participant's needs 1x/week concurrently during the same 4-week period of time. After 4 weeks, the participant will discontinue the cervical spine focused treatment but may continue with standard concussion care for an additional 4 weeks (maximum total treatment duration is 8 weeks).
Receives: Other: Cervical rehabilitation; Other: Standard Concussion Care
Standard concussion care alone followed by delayed cervical spine focused treatmentActive comparatorParticipants randomized to the delayed cervical spine focused treatment group will only receive the standard concussion care (individualized to their needs) 1x/week for the initial 4 weeks. At the 4-week timepoint, the cervical spine focused treatment will be added to the standard concussion care at a frequency of twice a week for 4 weeks. Should a participant be cleared for return to activity prior to the end of the 4-week period, cervical spine focused treatment will be suspended. The maximum total treatment duration is 8 weeks; 1x/week for weeks 1-8 for the standard concussion care and 2x/week for weeks 4-8 for the cervical spine focused treatment.
Receives: Other: Cervical rehabilitation; Other: Standard Concussion Care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Recruitment rate

    Enrolling 6 new participants per month

    Measured: 6 months

  2. Treatment Adherence

    Assess the rate of adherence to treatment with a goal of participant attending ≥ 75% (6 of 8) of scheduled visits.

    Measured: 2 months

  3. Conversion Rate

    Ratio of concussion patients with neck pain approached about participation or referred for screening to those actually screened. As well as conversion rate of concussion patients screened for participation to those enrolled and randomized.

    Measured: 6 months

  4. Adverse Event Rate

    Rates of expected side effects and adverse events

    Measured: 2 months

Secondary outcomes (4)
  1. Concussion Clinical Profile screen (CP screen)

    Patient reported outcome regarding their concussion symptoms. The raw score ranges from 0 to 87. The scale helps identify specific clinical profiles and associated modifiers in concussion patients.

    Measured: Baseline, 4 week, 8 week

  2. Numeric pain rating scale (NPRS)

    Patient reported measure regarding average neck pain over past week. The score range from 0 to 10 where 0 is no pain and 10 is considered the worst pain imaginable.

    Measured: Baseline, 4 week, 8 week

  3. Neck Disability index (NDI)

    Patient reported outcome regarding their neck pain related disability. The scale ranges from 0-50 that are then converted to percentages. The scores are interpreted as: 0-20%: minimal disability; 21-40%: moderate disability; 41-60%: severe disability; and >60%: complete disability.

    Measured: Baseline, 4 week, 8 week

  4. Pain, Enjoyment and General Activity Score (PEG)

    Patient reported outcome regarding their pain and its interference to enjoyment in life and general activity in the past week. The scale has three individual items that are scored from 0 to 10. The overall score is the average of the three individual item scores rounded to the nearest whole number for clinical use.

    Measured: Baseline, 4 week, 8 week

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Sep 2024
  2. Study start28 Aug 2025
  3. Primary completion15 Apr 2026
  4. Study completion15 Apr 2026

Why it stopped: We ran into structural and workflow barriers in the concussion center, hence decided to stop enrollment

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Crossover
Masking
Single blind
Who is masked
Investigator
Enrolment
2 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06616272
Sponsor's protocol ID
STUDY24040157
Acronym
ConCerv
Status last verified
Mar 2026
First submitted
16 Sep 2024
Last updated
19 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Kontos AP, Elbin RJ, Trbovich A, Womble M, Said A, Sumrok VF, French J, Kegel N, Puskar A, Sherry N, Holland C, Collins M. Concussion Clinical Profiles Screening (CP Screen) Tool: Preliminary Evidence to Inform a Multidisciplinary Approach. Neurosurgery. 2020 Aug 1;87(2):348-356. doi: 10.1093/neuros/nyz545.

    PubMed 31950187
  • Quatman-Yates CC, Hunter-Giordano A, Shimamura KK, Landel R, Alsalaheen BA, Hanke TA, McCulloch KL. Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury. J Orthop Sports Phys Ther. 2020 Apr;50(4):CPG1-CPG73. doi: 10.2519/jospt.2020.0301.

    PubMed 32241234
  • McCrory P, Meeuwisse WH, Aubry M, Cantu B, Dvorak J, Echemendia RJ, Engebretsen L, Johnston K, Kutcher JS, Raftery M, Sills A, Benson BW, Davis GA, Ellenbogen RG, Guskiewicz K, Herring SA, Iverson GL, Jordan BD, Kissick J, McCrea M, McIntosh AS, Maddocks D, Makdissi M, Purcell L, Putukian M, Schneider K, Tator CH, Turner M. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. Br J Sports Med. 2013 Apr;47(5):250-8. doi: 10.1136/bjsports-2013-092313. No abstract available.

    PubMed 23479479
  • McCrory PR, Ariens T, Berkovic SF. The nature and duration of acute concussive symptoms in Australian football. Clin J Sport Med. 2000 Oct;10(4):235-8. doi: 10.1097/00042752-200010000-00002.

    PubMed 11086747
  • 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.

    PubMed 28666405
  • Hurwitz EL, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Cote P, Hogg-Johnson S, Cassidy JD, Haldeman S; Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Treatment of neck pain: noninvasive interventions: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976). 2008 Feb 15;33(4 Suppl):S123-52. doi: 10.1097/BRS.0b013e3181644b1d.

    PubMed 18204386
  • Reid SA, Rivett DA, Katekar MG, Callister R. Sustained natural apophyseal glides (SNAGs) are an effective treatment for cervicogenic dizziness. Man Ther. 2008 Aug;13(4):357-66. doi: 10.1016/j.math.2007.03.006. Epub 2007 Oct 22.

    PubMed 17951095
  • van der Walt K, Tyson A, Kennedy E. How often is neck and vestibulo-ocular physiotherapy treatment recommended in people with persistent post-concussion symptoms? A retrospective analysis. Musculoskelet Sci Pract. 2019 Feb;39:130-135. doi: 10.1016/j.msksp.2018.12.004. Epub 2018 Dec 11.

    PubMed 30583251
  • Jones C, Sterling M. Clinimetrics: Neck Disability Index. J Physiother. 2021 Apr;67(2):144. doi: 10.1016/j.jphys.2020.09.001. Epub 2021 Mar 19. No abstract available.

    PubMed 33753016
  • Cleland JA, Childs JD, Whitman JM. Psychometric properties of the Neck Disability Index and Numeric Pain Rating Scale in patients with mechanical neck pain. Arch Phys Med Rehabil. 2008 Jan;89(1):69-74. doi: 10.1016/j.apmr.2007.08.126.

    PubMed 18164333

Questions about this trial

What is this clinical trial studying?

A study testing Cervical rehabilitation and Standard Concussion Care in people with Brain Concussion and Neck Pain, run by University of Pittsburgh at 4 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 19 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United States, Ireland, United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: We ran into structural and workflow barriers in the concussion center, hence decided to stop enrollment). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Recruitment rate (time frame: 6 months). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06616272, which also lists 10 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 May 2026; AzTrials last refreshed its copy on 6 Nov 2026.

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