Chronic Neck PainCervPro-RCTNCT06960525
Joint Mobilization vs. Strengthening Exercises on Cervical Proprioception for Nonspecific Neck Pain
A study testing Cervical joint mobilization and cervical strengthening exercises in people with Chronic Neck Pain and Nonspecific Neck Pain, run by Imam Abdulrahman Bin Faisal University at 1 site in Saudi Arabia.
Trial summary
This clinical trial aims to compare the effects of cervical joint mobilization versus cervical strengthening exercises in patients with chronic neck pain. The study will assess neck proprioception, pain intensity, cervical muscle strength, range of motion, and neck disability. Read more about this study
- Who is it for?
- Ages 18 to 50 years
- Conditions the study is for
- Chronic Neck Pain, Nonspecific Neck Pain
- What is being tested?
- Cervical joint mobilization and cervical strengthening exercises
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 26 participants
- Where
- 1 siteSaudi Arabia
- Study dates
- 20 Oct 2024to 20 Feb 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 50 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- 18 to 50 years
- Pain ≥ 3 months
- Neck pain on VAS ≥ 3/10
- NDI ≥ 5/50 points
- ZZ Errors ≥ 9 or the time to complete the task ≥ 28s
Who cannot join
- Unilateral headache aggravated by neck movement.
- Upper extremity symptoms beyond the elbow.
- Any history of neck trauma including whiplash
- Recent fractures (last 8 weeks)
- Cervical surgery (last 3 months)
- Current neck-related dizziness
Show all 9Show fewer
- Known or suspected ves3bular pathology
- Internal fixation of the cervical spine
- Physical therapy for the neck (last 3 months)
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Comparison of Joint Mobilization vs. Strengthening Exercises for Improving Cervical Proprioception in Individuals With Nonspecific Neck Pain: A Randomized Clinical Trial
This clinical trial aims to compare the effects of cervical joint mobilization versus cervical strengthening exercises in patients with chronic neck pain. The study will assess neck proprioception, pain intensity, cervical muscle strength, range of motion, and neck disability.
The main question it aims to answer is:
Which treatment is superior, or do they have equal effects after the first session and after the 12th session?
Participants will:
Receive either cervical joint mobilization or cervical strengthening exercises for 12 sessions.
Do not perform any physical therapy treatment outside the trial. Visit the clinic three times per week for treatment.
Read the detailed description
Neck pain refers to a type of generalized neck discomfort characterized by mechanical features. This condition is a widespread issue, causing significant levels of pain, disability, and can lead to economical strain. Patients suffering from neck pain often experience functional impairments, including weak neck muscles and impaired proprioception. Strengthening exercises and cervical joint mobilization offer effective relief of pain and improve disability. Exploring the superiority of these techniques in improving cervical proprioception to prevent recurrence is still a vague topic. Therefore, this study will investigate the effect of Maitland joint mobilization versus cervical strengthening exercises in patients with nonspecific chronic neck pain on neck proprioception, pain intensity, cervical muscles strength, range of motion and neck disability. This is a double-blinded randomized clinical trial with a parallel-group design. Twenty-six participants will be allocated randomly to one of two groups. Group one (Mobilization) will have cervical joint mobilization according to Maitland approach. Group two (Exercises) will perform craniocervical, cervical and axioscapular muscles strengthening exercises. Treatment will be provided for 12 sessions. Both groups will receive standardized care, including patient education and transcutaneous electrical nerve stimulation.
- Conditions
- Chronic Neck Pain, Nonspecific Neck Pain
- Being tested
- Cervical joint mobilization, cervical strengthening exercises
- Keywords
- chronic neck pain, Nonspecific neck pain, cervical proprioception, cervical mobilization, cervical strengthening exercises, neck, cervical, proprioception, mobilization, manual, strengthening, pain
- Medical subject headings
- Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Cervical joint mobilizationOther
Passive cervical joint mobilization following Maitland's approach for 3 sets of 1 minute on the most painful segment with one minute rest between sets.
cervical strengthening exercisesOther
concentric and eccentric training of the craniocervical, cervical flexors, extensors, muscles involved in cervical spine rotation and axioscapular muscles.
| Study group | Role | What they receive |
|---|---|---|
| Joint mobilization group | Experimental | This group will receive passive cervical joint mobilization following Maitland's approach for 3 sets of 1 minute on the most painful segment with one minute rest between sets. The specific technique and most painful level will be determined during the clinical examination. The participant lies prone on a treatment bed, then the therapist uses both thumbs to apply grade III or IV based on the patient's irritability using posteroanterior pressure to the cervical spinous process or articular pillar, with a rhythm of 2 to 3 Hz per second. This intervention could be applied in different positions of the cervical spine, depending on the patient's response, in a pain-free manner. Receives: Other: Cervical joint mobilization |
| Strengthening exercises group | Experimental | The exercise program will include concentric and eccentric training of the craniocervical, cervical flexors, extensors, muscles involved in cervical spine rotation and axioscapular muscles. The strengthening exercises with high frequency - low intensity will be performed. Low frequency - high intensity will be implemented when the patient's irritability is low. Receives: Other: cervical strengthening exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
Active cervical movement sense
Participants will be comfortably seated upright on a chair with a backrest, positioned 1 meter away from a board displaying a zigzag pattern (ZZ). They will wear a headband with a laser pointer attached. The pattern is affixed to the board in a manner that directs the laser beam to the pattern's centre.
Measured: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4
Cervical joint position error
Participants were comfortably seated upright on a chair with a backrest, positioned 0.9 meters away from a wall. Using a distance laser meter, for accurate measurement, the distance between the forehead of the participant and the wall was measured after the participant wore a headband with a laser pointer attached. A point on the wall was located as the patient was in a self-neutral position. A warm-up session was given as the patient with open eyes was instructed to perform flexion, extension, and rotation on both sides and return to the selected point after each movement. After that, the patient was asked to perform the movement for three trials in each movement direction with their eyes closed.
Measured: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4
Secondary outcomes (4)
Visual Analogue Scale
Pain intensity was assessed using the Visual Analogue Scale (VAS) which a ruler with 100 mm measured. The 0 mm indicates 'No pain" and 100 mm indicates " worse pain". Patient were asked to mark their level of pain.
Measured: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4
Cervical muscles strength
Measure the cervical muscles using a hand-held dynamometer. The patient was asked to perform flexion, extension, lateral flexion and rotation to both sides.
Measured: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4
Cervical range of motion
The range of motion was measured three times in flexion, extension, left-right lateral flexion and rotation using a therapeutic range of motion inclinometer.
Measured: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4
Neck Disability Index
Neck Disability Index (NDI) was used to evaluate the score of self-rated disability linked to neck pain experienced during the preceding week. This assessment consists of 10 questions, each question rated from 0 (indicating no disability) to 5 (representing total disability), with a maximum score of 50 points (see Appendix D.). Disability can be categorized as no disability (0-4 points), mild disability (5-14 points), moderate disability (15-24 points), severe disability (25-34 points), and (35-50 points) present complete disability.
Measured: Three points: 1) baseline, 2) week 4
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 May 2025
- Study start20 Oct 2024
- Primary completion18 Feb 2025
- Study completion20 Feb 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Chronic Neck PainStudies 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
- Model description
- This is a double-blinded randomized clinical trial with a parallel-group design.
- Masking
- Double blind
- Who is masked
- Care provider, Outcomes assessor
- Enrolment
- 26 participants (actual)
Sponsor and investigators
- Lead sponsor
- Imam Abdulrahman Bin Faisal University
- Sponsor type
- University, hospital or other
- Collaborators
- Al Hada Military Hospital
- Responsible party
- Principal investigator, Faisal Fahad Alharthi, Imam Abdulrahman Bin Faisal University
- Investigators
- Ali M Alshami, Phd, Study director, Imam Abdulrahman Bin Faisal University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06960525
- Sponsor's protocol ID
- IRB-PGS-2024-03-574
- Other IDs
- 14-2024-06-07-95
- Acronym
- CervPro-RCT
- Status last verified
- May 2025
- First submitted
- 6 Apr 2025
- Last updated
- 30 Dec 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
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 28666405de Zoete RMJ. Exercise Therapy for Chronic Neck Pain: Tailoring Person-Centred Approaches within Contemporary Management. J Clin Med. 2023 Nov 15;12(22):7108. doi: 10.3390/jcm12227108.
PubMed 38002720de Zoete RM, Armfield NR, McAuley JH, Chen K, Sterling M. Comparative effectiveness of physical exercise interventions for chronic non-specific neck pain: a systematic review with network meta-analysis of 40 randomised controlled trials. Br J Sports Med. 2020 Nov 2:bjsports-2020-102664. doi: 10.1136/bjsports-2020-102664. Online ahead of print.
PubMed 33139256Ernst MJ, Williams L, Werner IM, Crawford RJ, Treleaven J. Clinical assessment of cervical movement sense in those with neck pain compared to asymptomatic individuals. Musculoskelet Sci Pract. 2019 Oct;43:64-69. doi: 10.1016/j.msksp.2019.06.006. Epub 2019 Jul 2.
PubMed 31277033
Study at a glance
From the registry record, last updated by the sponsor on 30 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of Joint Mobilization vs. Strengthening Exercises for Improving Cervical Proprioception in Individuals With Nonspecific Neck Pain: A Randomized Clinical Trial
- ClinicalTrials.gov ID
- NCT06960525
- Acronym / sponsor ID
- CervPro-RCT / IRB-PGS-2024-03-574
- Conditions
- Chronic Neck Pain, Nonspecific Neck Pain
- Keywords
- chronic neck pain, Nonspecific neck pain, cervical proprioception, cervical mobilization, cervical strengthening exercises, neck, cervical, proprioception
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 26 participants (actual)
- Lead sponsor
- Imam Abdulrahman Bin Faisal UniversityUniversity, hospital or other
- Collaborators
- Al Hada Military Hospital
- Study start
- 20 Oct 2024 (actual)
- Primary completion
- 18 Feb 2025 (actual)
- Study completion
- 20 Feb 2025 (actual)
- First posted
- 7 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.
This clinical trial aims to compare the effects of cervical joint mobilization versus cervical strengthening exercises in patients with chronic neck pain. The study will assess neck proprioception, pain intensity, cervical muscle strength, range of motion, and neck disability.
The main question it aims to answer is:
Which treatment is superior, or do they have equal effects after the first session and after the 12th session?
Participants will:
Receive either cervical joint mobilization or cervical strengthening exercises for 12 sessions.
Do not perform any physical therapy treatment outside the trial. Visit the clinic three times per week for treatment.
Detailed description
Neck pain refers to a type of generalized neck discomfort characterized by mechanical features. This condition is a widespread issue, causing significant levels of pain, disability, and can lead to economical strain. Patients suffering from neck pain often experience functional impairments, including weak neck muscles and impaired proprioception. Strengthening exercises and cervical joint mobilization offer effective relief of pain and improve disability. Exploring the superiority of these techniques in improving cervical proprioception to prevent recurrence is still a vague topic. Therefore, this study will investigate the effect of Maitland joint mobilization versus cervical strengthening exercises in patients with nonspecific chronic neck pain on neck proprioception, pain intensity, cervical muscles strength, range of motion and neck disability. This is a double-blinded randomized clinical trial with a parallel-group design. Twenty-six participants will be allocated randomly to one of two groups. Group one (Mobilization) will have cervical joint mobilization according to Maitland approach. Group two (Exercises) will perform craniocervical, cervical and axioscapular muscles strengthening exercises. Treatment will be provided for 12 sessions. Both groups will receive standardized care, including patient education and transcutaneous electrical nerve stimulation.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (care provider, outcomes assessor)
- Number of arms
- 2
- Model description
- This is a double-blinded randomized clinical trial with a parallel-group design.
| Arm | Type | Receives |
|---|---|---|
| Joint mobilization group | Experimental | Other: Cervical joint mobilizationThis group will receive passive cervical joint mobilization following Maitland's approach for 3 sets of 1 minute on the most painful segment with one minute rest between sets. The specific technique and most painful level will be determined during the clinical examination. The participant lies prone on a treatment bed, then the therapist uses both thumbs to apply grade III or IV based on the patient's irritability using posteroanterior pressure to the cervical spinous process or articular pillar, with a rhythm of 2 to 3 Hz per second. This intervention could be applied in different positions of the cervical spine, depending on the patient's response, in a pain-free manner. |
| Strengthening exercises group | Experimental | Other: cervical strengthening exercisesThe exercise program will include concentric and eccentric training of the craniocervical, cervical flexors, extensors, muscles involved in cervical spine rotation and axioscapular muscles. The strengthening exercises with high frequency - low intensity will be performed. Low frequency - high intensity will be implemented when the patient's irritability is low. |
Who may qualify
- Ages
- 18 to 50 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- 18 to 50 years
- Pain ≥ 3 months
- Neck pain on VAS ≥ 3/10
- NDI ≥ 5/50 points
- ZZ Errors ≥ 9 or the time to complete the task ≥ 28s
Key exclusion criteria (9 listed)
- Unilateral headache aggravated by neck movement.
- Upper extremity symptoms beyond the elbow.
- Any history of neck trauma including whiplash
- Recent fractures (last 8 weeks)
- Cervical surgery (last 3 months)
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 |
|---|---|---|
| Cervical joint mobilizationPassive cervical joint mobilization following Maitland's approach for 3 sets of 1 minute on the most painful segment with one minute rest between sets. | Other | Joint mobilization group |
| cervical strengthening exercisesconcentric and eccentric training of the craniocervical, cervical flexors, extensors, muscles involved in cervical spine rotation and axioscapular muscles. | Other | Strengthening exercises group |
Primary outcome
Active cervical movement sense
Time frame: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4
Participants will be comfortably seated upright on a chair with a backrest, positioned 1 meter away from a board displaying a zigzag pattern (ZZ). They will wear a headband with a laser pointer attached. The pattern is affixed to the board in a manner that directs the laser beam to the pattern's centre.
Cervical joint position error
Time frame: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4
Participants were comfortably seated upright on a chair with a backrest, positioned 0.9 meters away from a wall. Using a distance laser meter, for accurate measurement, the distance between the forehead of the participant and the wall was measured after the participant wore a headband with a laser pointer attached. A point on the wall was located as the patient was in a self-neutral position. A warm-up session was given as the patient with open eyes was instructed to perform flexion, extension, and rotation on both sides and return to the selected point after each movement. After that, the patient was asked to perform the movement for three trials in each movement direction with their eyes closed.
4 secondary outcomes
Visual Analogue Scale
Time frame: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4
Cervical muscles strength
Time frame: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4
Cervical range of motion
Time frame: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4
Neck Disability Index
Time frame: Three points: 1) baseline, 2) week 4
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 30 Dec 2025.
- Background: PubMed 28666405Blanpied 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.
- Background: PubMed 38002720de Zoete RMJ. Exercise Therapy for Chronic Neck Pain: Tailoring Person-Centred Approaches within Contemporary Management. J Clin Med. 2023 Nov 15;12(22):7108. doi: 10.3390/jcm12227108.
- Background: PubMed 33139256de Zoete RM, Armfield NR, McAuley JH, Chen K, Sterling M. Comparative effectiveness of physical exercise interventions for chronic non-specific neck pain: a systematic review with network meta-analysis of 40 randomised controlled trials. Br J Sports Med. 2020 Nov 2:bjsports-2020-102664. doi: 10.1136/bjsports-2020-102664. Online ahead of print.
- Background: PubMed 31277033Ernst MJ, Williams L, Werner IM, Crawford RJ, Treleaven J. Clinical assessment of cervical movement sense in those with neck pain compared to asymptomatic individuals. Musculoskelet Sci Pract. 2019 Oct;43:64-69. doi: 10.1016/j.msksp.2019.06.006. Epub 2019 Jul 2.
- 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.
Ali M Alshami, Phd study director
Imam Abdulrahman Bin Faisal 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 Cervical joint mobilization and cervical strengthening exercises in people with Chronic Neck Pain and Nonspecific Neck Pain, run by Imam Abdulrahman Bin Faisal University at 1 site in Saudi Arabia.
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: finished, as of the sponsor's last update on 30 Dec 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 Saudi Arabia. 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?
Active cervical movement sense (time frame: Three points: 1) baseline, 2) immediately after intervention, and 3) week 4). The study lists 2 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 NCT06960525, which also lists 4 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 30 Dec 2025.