Neck Pain ChronicNCT07026019
Exercise and Chronic Mechanical Neck Pain
A study testing Bruegger's relief exercise and Multimodal exercise program in people with Neck Pain Chronic, run by Riphah International University at 1 site in Pakistan.
Trial summary
This Randomized Clinical Trial will be conducted at Riphah Rehabilitation and Research Center and spans 4 weeks. Non-probability Convenient sampling will be used to collect the data. A sample size of 40 subjects with age group between 18-45 years will be taken. Read more about this study
- Who is it for?
- Ages 18 to 45 years
- Conditions the study is for
- Neck Pain Chronic
- What is being tested?
- Bruegger's relief exercise and Multimodal exercise program
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 sitePakistan
- Study dates
- 1 May 2025to 30 Sep 2025
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age group between 18-45 years (10).
- Both gender
- Neck pain associated with degenerative changes and myofascial pain syndromes
- Individuals having localized pain or stiffness in the cervical spine (C3-C7) without upper limb radiculopathy
- People with a disability and therefore cannot come to the clinic
- People living in highly populated cities where the healthcare system is overcrowded
- People who use electronic gadgets i.e. computers, and smartphones for more than 4 hours
Who cannot join
- Tuberculosis, carcinoma, heart disease, and osteoporosis
- Previous surgery related to the cervical spine
- Having radical symptoms such as paresis, tingling, or numbness
- Any trauma or localized infection in the neck region
- Having inflammatory rheumatologic diseases, or structural deformity
- Ongoing radiotherapy, chemotherapy, steroid therapy, or anticoagulants
- Positive Spurling's test, traction test, upper limb tension test, and shoulder abduction test
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site, 1 recruiting
- Recruiting
Riphah Rehabilitation Clinic
Lahore, Punjab Province, 54000
Syed Shakil ur Rehman, PhD, +92 320 7866611, shakil.urrehman@riphah.edu.pk
Kiran Fatima, MS*
About this study
Official title: Effects Of Tele-Based Multimodal Versus Bruegger's Relief Exercise Program In Electronic Gadget Users With Chronic Mechanical Neck Pain
This Randomized Clinical Trial will be conducted at Riphah Rehabilitation and Research Center and spans 4 weeks. Non-probability Convenient sampling will be used to collect the data. A sample size of 40 subjects with age group between 18-45 years will be taken. Data will be collected from patients who use electronic gadgets and have present complaints of mechanical neck pain. Outcome measures will be taken using the Numeric pain rating scale (NPRS) for pain, Neck Disability Index (NDI) for disability, Goniometer for Range of motion, and Kinovea software for shoulder, eye, and craniovertebral angle measurement. Subjects will be selected based on inclusion and exclusion criteria and will be equally divided into two groups by random number generator table. The first assessment will be conducted physically and after that, both groups will receive treatment via MS teams under the supervision of a physiotherapist. Both the Groups will receive Hot Pack, and baseline treatment (neck isometrics, upper trapezius and scalene stretches), while Group A will receive multimodal exercises (chin tucks, bilateral pectoral stretching, scapular region strengthening exercises, and Wand exercises) and Group B will receive Bruegger's relief exercise. Outcome measures will be measured at baseline and after 4 weeks. Data analysis will be done by SPSS version 25.
Read the detailed description
Neck pain is defined as "activity-limiting neck pain with or without radiation to the upper limbs lasting for at least 24 hours" is a major public health concern globally due to significant direct and indirect individual and societal costs, and the negative impact on overall health, function, well-being and quality of life. Mechanical neck pain (MNP), also known as chronic non-specific neck pain, is a common musculoskeletal chronic disease . When the duration of symptoms is greater than 12 weeks of evolution, it acquires the value of chronicity, being denominated non-specific chronic neck pain . Neck pain is a prevalent medical condition affecting a vast number of individuals worldwide. Neck pain can significantly impede daily activities and even progress into a debilitating physical disability . The annual prevalence of musculoskeletal disorders in office workers is 63% and the most common sites for musculoskeletal disorders are neck (42%) and low back (34%). Between 20% and 70% of people will experience neck pain in their lifetime .
Several epidemiological studies have reported a high prevalence of neck and shoulder pain among worldwide users of handheld devices. For example, a study of 140 handheld device users at a Canadian university showed that 68% of users had neck pain, while 46% and 52% had pain in their left and right shoulders, respectively. Also, a study of 774 smartphone users at Khon Kaen University reported that 48.4% of users had shoulder pain, and 43.1% of users had neck pain. Interestingly, regarding posture when using a smartphone, it was found that 91% of 859 subjects had a flexed neck position, in which the head is bent down to look at the smartphone screen, and the head is tilted in a forward position for a long time, which causes fatigue and contributes to the development of pain in the neck. The duration of smartphone use in a poor posture for 20 minutes can induce muscle fatigue in the cervical muscles, such as the upper trapezius and cervical erector spinae muscles.
International guidelines recommend that in the absence of sinister 'red flag' pathology (e.g. fracture, neoplasm), first-line interventions for the majority of musculoskeletal conditions should involve simple non-surgical management, where interventions are tailored to the individual's needs and clinical presentation. Despite these recommendations, the timely, affordable and equitable access to such healthcare services can be severely limited for some. This has demanded organizations to rethink how traditional healthcare services can be delivered with many services rapidly adopting telehealth service delivery methods. Telerehabilitation interventions can include any type of treatment - such as treatment based on education, exercise prescription, and self-management - that can be offered at a distance. The most common ways to deliver telerehabilitation interventions are through websites, smartphone apps, videoconferences, over the telephone, and text messages.
With the growing reliance on electronic devices in daily life, understanding the most effective exercise program for managing neck pain in gadget users is essential for healthcare practitioners and individuals seeking relief. This study aims to fill a gap in current knowledge by evaluating the comparative effectiveness of tele based multimodal and Bruegger's relief exercise program, ultimately guiding healthcare professionals in recommending the most suitable exercise regimen for electronic gadget users with chronic neck pain.
- Conditions
- Neck Pain Chronic
- Being tested
- Bruegger's relief exercise, Multimodal exercise program
- Keywords
- Neck pain, Telehealth, Range of motion, Photogrammetry
- Medical subject headings
- Neck Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Bruegger's relief exerciseOther
Participant will be in a high sitting position. An elastic resistance band will be wrapped on each hand of the participant leaving the palm open and will be told to abduct and extend of thumb along with fingers, followed by wrist extension and forearm supination, the participant will be instructed to perform scapular retraction with shoulder external rotation, elbow extension, shoulder abduction, and extension and chin tuck. The treatment protocol will be for 4 weeks, having 3 sessions in a week and 4 sets of 12 repetitions in each session. Intervention was started from 10 seconds hold to 30 seconds with 2 seconds increment in every session. Rest time was 30 seconds.
Multimodal exercise programOther
Multimodal exercise program including chin tucks, bilateral pectoral stretching, scapular region strengthening exercises and Wand exercises. The training program applied 3 times a week, 50 minutes each time, for 4 weeks
| Study group | Role | What they receive |
|---|---|---|
| Multimodal exercise program | Active comparator | Not described Receives: Other: Multimodal exercise program |
| Bruegger's Relief Exercise | Experimental | Not described Receives: Other: Bruegger's relief exercise |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numerical Pain Rating Scale
The NPRS is an 11-point numeric scale in which 0 represents "NO PAIN" and 10 represents "EXTREME PAIN" (e.g., "pain as bad as you can imagine" and "worst pain imaginable").
Measured: Baseline, 4th Week
Neck Disability Index
The NDI is a self-reported instrument for measuring perceived neck disability that consists of 10 'themes': pain intensity, personal care, weight lifting, reading, headache, concentration, work (or domestic activities), driving, sleep and recreational activities. Each question is scored from 0 to 5. The final score is expressed as a percentage
Measured: Baseline, 4th Week
Cervical Range of Motion
Universal Goniometer, a tool used most commonly for evaluating joint ROM in the clinical settings, comes out as a simple alternative for global use at low price. Notably, the reliability and validity of cervical goniometric measurements are considered excellent, ensuring accurate measurement of cervical range of motion
Measured: Baseline, 4th Week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Jun 2025
- Study start1 May 2025
- Primary completion30 Aug 2025 (estimated)
- Study completion30 Sep 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Neck Pain ChronicStudies 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
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Syed Shakil ur Rehman, PhD, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07026019
- Sponsor's protocol ID
- Kiran- REC/RCR&AHS 24/0139
- Status last verified
- Jun 2025
- First submitted
- 11 Jun 2025
- Last updated
- 18 Jun 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Waongenngarm P, van der Beek AJ, Akkarakittichoke N, Janwantanakul P. Perceived musculoskeletal discomfort and its association with postural shifts during 4-h prolonged sitting in office workers. Appl Ergon. 2020 Nov;89:103225. doi: 10.1016/j.apergo.2020.103225. Epub 2020 Aug 2.
PubMed 32755740Bernal-Utrera C, Gonzalez-Gerez JJ, Anarte-Lazo E, Rodriguez-Blanco C. Manual therapy versus therapeutic exercise in non-specific chronic neck pain: a randomized controlled trial. Trials. 2020 Jul 28;21(1):682. doi: 10.1186/s13063-020-04610-w.
PubMed 32723399
Study at a glance
From the registry record, last updated by the sponsor on 18 Jun 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects Of Tele-Based Multimodal Versus Bruegger's Relief Exercise Program In Electronic Gadget Users With Chronic Mechanical Neck Pain
- ClinicalTrials.gov ID
- NCT07026019
- Acronym / sponsor ID
- Kiran- REC/RCR&AHS 24/0139
- Conditions
- Neck Pain Chronic
- Keywords
- Neck pain, Telehealth, Range of motion, Photogrammetry
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 1 May 2025 (actual)
- Primary completion
- 30 Aug 2025 (estimated)
- Study completion
- 30 Sep 2025 (estimated)
- First posted
- 18 Jun 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 Randomized Clinical Trial will be conducted at Riphah Rehabilitation and Research Center and spans 4 weeks. Non-probability Convenient sampling will be used to collect the data. A sample size of 40 subjects with age group between 18-45 years will be taken. Data will be collected from patients who use electronic gadgets and have present complaints of mechanical neck pain. Outcome measures will be taken using the Numeric pain rating scale (NPRS) for pain, Neck Disability Index (NDI) for disability, Goniometer for Range of motion, and Kinovea software for shoulder, eye, and craniovertebral angle measurement. Subjects will be selected based on inclusion and exclusion criteria and will be equally divided into two groups by random number generator table. The first assessment will be conducted physically and after that, both groups will receive treatment via MS teams under the supervision of a physiotherapist. Both the Groups will receive Hot Pack, and baseline treatment (neck isometrics, upper trapezius and scalene stretches), while Group A will receive multimodal exercises (chin tucks, bilateral pectoral stretching, scapular region strengthening exercises, and Wand exercises) and Group B will receive Bruegger's relief exercise. Outcome measures will be measured at baseline and after 4 weeks. Data analysis will be done by SPSS version 25.
Detailed description
Neck pain is defined as "activity-limiting neck pain with or without radiation to the upper limbs lasting for at least 24 hours" is a major public health concern globally due to significant direct and indirect individual and societal costs, and the negative impact on overall health, function, well-being and quality of life. Mechanical neck pain (MNP), also known as chronic non-specific neck pain, is a common musculoskeletal chronic disease . When the duration of symptoms is greater than 12 weeks of evolution, it acquires the value of chronicity, being denominated non-specific chronic neck pain . Neck pain is a prevalent medical condition affecting a vast number of individuals worldwide. Neck pain can significantly impede daily activities and even progress into a debilitating physical disability . The annual prevalence of musculoskeletal disorders in office workers is 63% and the most common sites for musculoskeletal disorders are neck (42%) and low back (34%). Between 20% and 70% of people will experience neck pain in their lifetime .
Several epidemiological studies have reported a high prevalence of neck and shoulder pain among worldwide users of handheld devices. For example, a study of 140 handheld device users at a Canadian university showed that 68% of users had neck pain, while 46% and 52% had pain in their left and right shoulders, respectively. Also, a study of 774 smartphone users at Khon Kaen University reported that 48.4% of users had shoulder pain, and 43.1% of users had neck pain. Interestingly, regarding posture when using a smartphone, it was found that 91% of 859 subjects had a flexed neck position, in which the head is bent down to look at the smartphone screen, and the head is tilted in a forward position for a long time, which causes fatigue and contributes to the development of pain in the neck. The duration of smartphone use in a poor posture for 20 minutes can induce muscle fatigue in the cervical muscles, such as the upper trapezius and cervical erector spinae muscles.
International guidelines recommend that in the absence of sinister 'red flag' pathology (e.g. fracture, neoplasm), first-line interventions for the majority of musculoskeletal conditions should involve simple non-surgical management, where interventions are tailored to the individual's needs and clinical presentation. Despite these recommendations, the timely, affordable and equitable access to such healthcare services can be severely limited for some. This has demanded organizations to rethink how traditional healthcare services can be delivered with many services rapidly adopting telehealth service delivery methods. Telerehabilitation interventions can include any type of treatment - such as treatment based on education, exercise prescription, and self-management - that can be offered at a distance. The most common ways to deliver telerehabilitation interventions are through websites, smartphone apps, videoconferences, over the telephone, and text messages.
With the growing reliance on electronic devices in daily life, understanding the most effective exercise program for managing neck pain in gadget users is essential for healthcare practitioners and individuals seeking relief. This study aims to fill a gap in current knowledge by evaluating the comparative effectiveness of tele based multimodal and Bruegger's relief exercise program, ultimately guiding healthcare professionals in recommending the most suitable exercise regimen for electronic gadget users with chronic neck pain.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Multimodal exercise program | Active comparator | Other: Multimodal exercise program |
| Bruegger's Relief Exercise | Experimental | Other: Bruegger's relief exercise |
Who may qualify
- Ages
- 18 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (7 listed)
- Age group between 18-45 years (10).
- Both gender
- Neck pain associated with degenerative changes and myofascial pain syndromes
- Individuals having localized pain or stiffness in the cervical spine (C3-C7) without upper limb radiculopathy
- People with a disability and therefore cannot come to the clinic
Key exclusion criteria (7 listed)
- Tuberculosis, carcinoma, heart disease, and osteoporosis
- Previous surgery related to the cervical spine
- Having radical symptoms such as paresis, tingling, or numbness
- Any trauma or localized infection in the neck region
- Having inflammatory rheumatologic diseases, or structural deformity
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 |
|---|---|---|
| Bruegger's relief exerciseParticipant will be in a high sitting position. An elastic resistance band will be wrapped on each hand of the participant leaving the palm open and will be told to abduct and extend of thumb along with fingers, followed by wrist extension and forearm supination, the participant will be instructed to perform scapular retraction with shoulder external rotation, elbow extension, shoulder abduction, and extension and chin tuck. The treatment protocol will be for 4 weeks, having 3 sessions in a week and 4 sets of 12 repetitions in each session. Intervention was started from 10 seconds hold to 30 seconds with 2 seconds increment in every session. Rest time was 30 seconds. | Other | Bruegger's Relief Exercise |
| Multimodal exercise programMultimodal exercise program including chin tucks, bilateral pectoral stretching, scapular region strengthening exercises and Wand exercises. The training program applied 3 times a week, 50 minutes each time, for 4 weeks | Other | Multimodal exercise program |
Primary outcome
Numerical Pain Rating Scale
Time frame: Baseline, 4th Week
The NPRS is an 11-point numeric scale in which 0 represents "NO PAIN" and 10 represents "EXTREME PAIN" (e.g., "pain as bad as you can imagine" and "worst pain imaginable").
Neck Disability Index
Time frame: Baseline, 4th Week
The NDI is a self-reported instrument for measuring perceived neck disability that consists of 10 'themes': pain intensity, personal care, weight lifting, reading, headache, concentration, work (or domestic activities), driving, sleep and recreational activities. Each question is scored from 0 to 5. The final score is expressed as a percentage
Cervical Range of Motion
Time frame: Baseline, 4th Week
Universal Goniometer, a tool used most commonly for evaluating joint ROM in the clinical settings, comes out as a simple alternative for global use at low price. Notably, the reliability and validity of cervical goniometric measurements are considered excellent, ensuring accurate measurement of cervical range of motion
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Jun 2025.
- Background: PubMed 32755740Waongenngarm P, van der Beek AJ, Akkarakittichoke N, Janwantanakul P. Perceived musculoskeletal discomfort and its association with postural shifts during 4-h prolonged sitting in office workers. Appl Ergon. 2020 Nov;89:103225. doi: 10.1016/j.apergo.2020.103225. Epub 2020 Aug 2.
- Background: PubMed 32723399Bernal-Utrera C, Gonzalez-Gerez JJ, Anarte-Lazo E, Rodriguez-Blanco C. Manual therapy versus therapeutic exercise in non-specific chronic neck pain: a randomized controlled trial. Trials. 2020 Jul 28;21(1):682. doi: 10.1186/s13063-020-04610-w.
- Individual participant dataSharing planned: No
Related trials for Neck Pain Chronic
Active, not recruiting
Cervical Stabilization vs Scapular Clock Exercises for Chronic Non-Specific Neck Pain
Chronic Non-Specific Neck Pain
Not yet recruiting
Effects of the Timing of Vagus Nerve Stimulation Combined With Exercise in Chronic Neck Pain
Chronic Neck Pain
Not yet recruiting
The Clinical Efficacy and Multimodal Imaging Mechanism of the Knot-tying Technique in the Treatment of Chronic Neck Pain
Chronic Neck Pain
Recruiting
EFFECT OF MULLIGAN CERVICAL SUSTAINED NATURAL APOPHYSEAL GLIDE ON POSTURAL STABILITY IN PATIENTS WITH CHRONIC NECK PAIN
Chronic Neck Pain With Mobility Deficits, Chronic Neck Pain With Mobility Deficits (> 3 Months)
Recruiting
Effects of Instrument-Assisted Soft Tissue Mobilization Versus Post Facilitation Stretch Technique in Chronic Neck Pain
Cerival Pain, Chronic Neck Pain
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.
Syed Shakil ur Rehman, PhD principal investigator
Riphah International 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 Bruegger's relief exercise and Multimodal exercise program in people with Neck Pain Chronic, run by Riphah International University at 1 site in Pakistan.
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 7 inclusion and 7 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: looking for participants now, as of the sponsor's last update on 18 Jun 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 Pakistan. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Syed Shakil ur Rehman, PhD (+92 320 786661, shakil.urrehman@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numerical Pain Rating Scale (time frame: Baseline, 4th Week). The study lists 3 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 NCT07026019, which also lists 2 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 18 Jun 2025; AzTrials last refreshed its copy on 30 Oct 2026.