Manual TherapiesNCT06959160
Comparison of the Immediate Effects of Manual Therapy Techniques in Non-Specific Neck Pain
A study testing Atlanto-occipital manipulation, Cervical mobilization and Trigger point therapy in people with Manual Therapies and Neck Pain, run by Halic University at 1 site in Turkey (Türkiye).
Trial summary
The aim of this study is to investigate the effects of manual therapy techniques on joint range of motion, pain tolerance, grip strength, and functionality in individuals with non-specific neck pain. The study is experimental in design. Read more about this study
- Who is it for?
- Ages 18 to 55 yearsHealthy volunteers can take part
- Conditions the study is for
- Manual Therapies, Neck Pain
- What is being tested?
- Atlanto-occipital manipulation, Cervical mobilization and Trigger point therapy
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 39 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 15 Sep 2023to 10 Jan 2025
- 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 18 to 55 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Be between the ages of 18 and 55
- Have been diagnosed with non-specific neck pain by a specialized physician
- Have been experiencing neck pain for less than 3 months
- Have a neck pain level of at least 3 on the Visual Analog Scale
- Have bilateral active trigger points in the upper trapezius muscle
- Have restricted active cervical range of motion
Who cannot join
- Presence of neurological deficit or radicular pain
- History of pathology or surgery in the cranio-cervical region
- Positive response in the extension-rotation test
- Use of anticoagulants or corticosteroids
- Presence of one or more red flags defined for non-specific neck pain
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Comparison of the Immediate Effects of Manual Therapy Techniques on Joint Range of Motion, Grip Strength, Pressure Pain Threshold, and Functionality in Non-Specific Neck Pain
The aim of this study is to investigate the effects of manual therapy techniques on joint range of motion, pain tolerance, grip strength, and functionality in individuals with non-specific neck pain. The study is experimental in design. Individuals aged between 18 and 55 who were diagnosed with non-specific neck pain and met the inclusion criteria participated in the study.
Read the detailed description
Participants who agreed to take part and signed the informed consent form were asked to complete the "Patient Assessment Form" during the initial interview.
In addition, the following assessment tools were used: the Cervical Range of Motion (CROM) device to evaluate joint range of motion, a hand dynamometer to assess grip strength, an algometer to measure pain tolerance, and the "Neck Disability Index" to evaluate functionality.
Participants were then randomly assigned to one of three groups:
Group 1: Atlanto-occipital manipulation
Group 2: Cervical mobilization
Group 3: Trigger point therapy
Participants in the first group received atlanto-occipital manipulation, those in the second group underwent Grade II-III mobilization techniques, and those in the third group received trigger point therapy, which consisted of ischemic compression followed by myofascial stretching on the upper trapezius muscle.
Immediately after the treatments, joint range of motion, pain tolerance, and functionality were reassessed. The manual therapy interventions for all three groups were performed by different specialized physiotherapists trained in these techniques. The evaluations, however, were conducted by another physiotherapist who was blinded to the treatments (double-blind study).
The data were statistically analyzed using the Statistical Package for the Social Sciences program, and a p-value of less than 0.05 was considered statistically significant.
- Conditions
- Manual Therapies, Neck Pain
- Being tested
- Atlanto-occipital manipulation, Cervical mobilization, Trigger point therapy
- Keywords
- Manual Therapy Techniques, Non-Specific Neck Pain, Immediate Effects
- Medical subject headings
- Neck Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Atlanto-occipital manipulationOther
Participants in the first group received atlanto-occipital manipulation. The patient was positioned in a supine position, with the head rotated to one side. The therapist placed the middle and ring fingers of one hand on the patient's mastoid process, while the palm of the other hand made contact with the patient's jawline and cheek. A gentle traction force was applied to the cranial region using both hands. When the therapist sensed joint tension, a high-velocity, low-amplitude thrust was delivered in the direction of the traction with a slight rotational force. The procedure was performed bilaterally and lasted approximately 5 minutes.
Cervical mobilizationOther
Participants in the second group underwent Grade II-III cervical mobilization techniques, administered over a period of 10 minutes. The patient was positioned in a supine position, and the physiotherapist performed 10 minutes of Grade II-III mobilizations with an upward and downward incline (postero-anterior and antero-posterior mobilizations following the movement plane of the cervical zygapophyseal joints).
Trigger point therapyOther
Participants in the third group received trigger point therapy, which included ischemic compression followed by myofascial stretching on the upper trapezius muscle. The patient was positioned in a supine position, and the physiotherapist performed 10 minutes of Grade II-III mobilizations with an upward and downward incline (postero-anterior and antero-posterior mobilizations following the movement plane of the cervical zygapophyseal joints).
| Study group | Role | What they receive |
|---|---|---|
| Atlanto-occipital Manipulation Group | Experimental | Participants in the first group received atlanto-occipital manipulation. Receives: Other: Atlanto-occipital manipulation |
| Cervical Mobilization Group | Experimental | Participants in the second group underwent Grade II-III cervical mobilization techniques. Receives: Other: Cervical mobilization |
| Trigger Point Therapy Group | Experimental | Participants in the third group received trigger point therapy, which included ischemic compression followed by myofascial stretching on the upper trapezius muscle. Receives: Other: Trigger point therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Assessment of Cervical Joint Range of Motion
The evaluation of cervical flexion, extension, right-left lateral flexion, and right-left rotation range of motion conducted using the CROM device. The CROM device is an inclinometer system affected by magnetic forces and gravity. Validity and reliability studies have been carried out to assess the movements of the cervical region using this device. There are no risks or side effects associated with this assessment method.
Measured: Immediately before and after interventions, assessed within a single session
Assessment of Grip Strength
Grip strength of the individuals was measured using the "Jamar Hand Dynamometer" (Takei Scientific Instruments Co., Ltd. - Japan). Measurements were conducted as recommended in the literature, with the patient comfortably seated, shoulder abducted, elbow in 90 degrees of flexion, forearm in a neutral position, and wrist in 0-30 degrees of extension. Measurements were repeated three times with five-second intervals between each trial for both the dominant and non-dominant hands, and the average value was recorded as the result. There are no risks or side effects associated with this assessment method.
Measured: Immediately before and after interventions, assessed within a single session
Measurement of Pain Tolerance Threshold
Pain tolerance was measured using the J-tech algometer device. Measurements were taken bilaterally, both on the right and left sides, at the C5 level and at the midpoint of the upper trapezius muscle. The measurements were repeated three times, and the average value was recorded as the result. There are no risks or side effects associated with this assessment method.
Measured: Immediately before and after interventions, assessed within a single session
Neck Disability Index
This questionnaire is used for the evaluation of cervical function and has undergone validity and reliability studies. The questionnaire consists of 10 sections, with 6 multiple-choice options for each section. Scoring ranges from 0 to 5 for each section based on the selected response. The total score determines the overall result of the test. There are no risks or side effects associated with this assessment method.
Measured: Immediately before and after interventions, assessed within a single session
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 May 2025
- Study start15 Sep 2023
- Primary completion30 Dec 2024
- Study completion10 Jan 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Manual TherapiesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 39 participants (actual)
Sponsor and investigators
- Lead sponsor
- Halic University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Seda Saka, assoc. prof., Principal investigator, Halic University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06959160
- Sponsor's protocol ID
- Acetinkaya006
- Status last verified
- Jul 2025
- First submitted
- 28 Apr 2025
- Last updated
- 3 Aug 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 3 Aug 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of the Immediate Effects of Manual Therapy Techniques on Joint Range of Motion, Grip Strength, Pressure Pain Threshold, and Functionality in Non-Specific Neck Pain
- ClinicalTrials.gov ID
- NCT06959160
- Acronym / sponsor ID
- Acetinkaya006
- Conditions
- Manual Therapies, Neck Pain
- Keywords
- Manual Therapy Techniques, Non-Specific Neck Pain, Immediate Effects
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 39 participants (actual)
- Lead sponsor
- Halic UniversityUniversity, hospital or other
- Study start
- 15 Sep 2023 (actual)
- Primary completion
- 30 Dec 2024 (actual)
- Study completion
- 10 Jan 2025 (actual)
- First posted
- 6 May 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this study is to investigate the effects of manual therapy techniques on joint range of motion, pain tolerance, grip strength, and functionality in individuals with non-specific neck pain. The study is experimental in design. Individuals aged between 18 and 55 who were diagnosed with non-specific neck pain and met the inclusion criteria participated in the study.
Detailed description
Participants who agreed to take part and signed the informed consent form were asked to complete the "Patient Assessment Form" during the initial interview.
In addition, the following assessment tools were used: the Cervical Range of Motion (CROM) device to evaluate joint range of motion, a hand dynamometer to assess grip strength, an algometer to measure pain tolerance, and the "Neck Disability Index" to evaluate functionality.
Participants were then randomly assigned to one of three groups:
Group 1: Atlanto-occipital manipulation
Group 2: Cervical mobilization
Group 3: Trigger point therapy
Participants in the first group received atlanto-occipital manipulation, those in the second group underwent Grade II-III mobilization techniques, and those in the third group received trigger point therapy, which consisted of ischemic compression followed by myofascial stretching on the upper trapezius muscle.
Immediately after the treatments, joint range of motion, pain tolerance, and functionality were reassessed. The manual therapy interventions for all three groups were performed by different specialized physiotherapists trained in these techniques. The evaluations, however, were conducted by another physiotherapist who was blinded to the treatments (double-blind study).
The data were statistically analyzed using the Statistical Package for the Social Sciences program, and a p-value of less than 0.05 was considered statistically significant.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Atlanto-occipital Manipulation Group | Experimental | Other: Atlanto-occipital manipulationParticipants in the first group received atlanto-occipital manipulation. |
| Cervical Mobilization Group | Experimental | Other: Cervical mobilizationParticipants in the second group underwent Grade II-III cervical mobilization techniques. |
| Trigger Point Therapy Group | Experimental | Other: Trigger point therapyParticipants in the third group received trigger point therapy, which included ischemic compression followed by myofascial stretching on the upper trapezius muscle. |
Who may qualify
- Ages
- 18 to 55 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (6 listed)
- Be between the ages of 18 and 55
- Have been diagnosed with non-specific neck pain by a specialized physician
- Have been experiencing neck pain for less than 3 months
- Have a neck pain level of at least 3 on the Visual Analog Scale
- Have bilateral active trigger points in the upper trapezius muscle
Key exclusion criteria (5 listed)
- Presence of neurological deficit or radicular pain
- History of pathology or surgery in the cranio-cervical region
- Positive response in the extension-rotation test
- Use of anticoagulants or corticosteroids
- Presence of one or more red flags defined for non-specific neck pain
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Atlanto-occipital manipulationParticipants in the first group received atlanto-occipital manipulation. The patient was positioned in a supine position, with the head rotated to one side. The therapist placed the middle and ring fingers of one hand on the patient's mastoid process, while the palm of the other hand made contact with the patient's jawline and cheek. A gentle traction force was applied to the cranial region using both hands. When the therapist sensed joint tension, a high-velocity, low-amplitude thrust was delivered in the direction of the traction with a slight rotational force. The procedure was performed bilaterally and lasted approximately 5 minutes. | Other | Atlanto-occipital Manipulation Group |
| Cervical mobilizationParticipants in the second group underwent Grade II-III cervical mobilization techniques, administered over a period of 10 minutes. The patient was positioned in a supine position, and the physiotherapist performed 10 minutes of Grade II-III mobilizations with an upward and downward incline (postero-anterior and antero-posterior mobilizations following the movement plane of the cervical zygapophyseal joints). | Other | Cervical Mobilization Group |
| Trigger point therapyParticipants in the third group received trigger point therapy, which included ischemic compression followed by myofascial stretching on the upper trapezius muscle. The patient was positioned in a supine position, and the physiotherapist performed 10 minutes of Grade II-III mobilizations with an upward and downward incline (postero-anterior and antero-posterior mobilizations following the movement plane of the cervical zygapophyseal joints). | Other | Trigger Point Therapy Group |
Primary outcome
Assessment of Cervical Joint Range of Motion
Time frame: Immediately before and after interventions, assessed within a single session
The evaluation of cervical flexion, extension, right-left lateral flexion, and right-left rotation range of motion conducted using the CROM device. The CROM device is an inclinometer system affected by magnetic forces and gravity. Validity and reliability studies have been carried out to assess the movements of the cervical region using this device. There are no risks or side effects associated with this assessment method.
Assessment of Grip Strength
Time frame: Immediately before and after interventions, assessed within a single session
Grip strength of the individuals was measured using the "Jamar Hand Dynamometer" (Takei Scientific Instruments Co., Ltd. - Japan). Measurements were conducted as recommended in the literature, with the patient comfortably seated, shoulder abducted, elbow in 90 degrees of flexion, forearm in a neutral position, and wrist in 0-30 degrees of extension. Measurements were repeated three times with five-second intervals between each trial for both the dominant and non-dominant hands, and the average value was recorded as the result. There are no risks or side effects associated with this assessment method.
Measurement of Pain Tolerance Threshold
Time frame: Immediately before and after interventions, assessed within a single session
Pain tolerance was measured using the J-tech algometer device. Measurements were taken bilaterally, both on the right and left sides, at the C5 level and at the midpoint of the upper trapezius muscle. The measurements were repeated three times, and the average value was recorded as the result. There are no risks or side effects associated with this assessment method.
Neck Disability Index
Time frame: Immediately before and after interventions, assessed within a single session
This questionnaire is used for the evaluation of cervical function and has undergone validity and reliability studies. The questionnaire consists of 10 sections, with 6 multiple-choice options for each section. Scoring ranges from 0 to 5 for each section based on the selected response. The total score determines the overall result of the test. There are no risks or side effects associated with this assessment method.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Aug 2025.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Seda Saka, assoc. prof. principal investigator
Halic University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Atlanto-occipital manipulation, Cervical mobilization and Trigger point therapy in people with Manual Therapies and Neck Pain, run by Halic University at 1 site in Turkey (Türkiye).
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 6 inclusion and 5 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: finished, as of the sponsor's last update on 3 Aug 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). 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 is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Assessment of Cervical Joint Range of Motion (time frame: Immediately before and after interventions, assessed within a single session). 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?
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 3 Aug 2025.