Mechanical Neck PainNCT07040605
Deep Cervical Flexor and Sensorimotor Training for Chronic Neck Pain
A study testing Deep cervical flexors muscle training and sensorimotor training and conventional physical therapy exercise in people with Mechanical Neck Pain, run by Al-Neelain University at 1 site in Egypt.
Trial summary
This randomized controlled trial aims to investigate the effectiveness of deep cervical flexor muscle training combined with sensorimotor (proprioception) training in patients with chronic mechanical neck pain. Read more about this study
- Who is it for?
- Ages 20 to 40 years
- Conditions the study is for
- Mechanical Neck Pain
- What is being tested?
- Deep cervical flexors muscle training and sensorimotor training and conventional physical therapy exercise
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteEgypt
- Study dates
- 19 Jun 2025to Dec 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 20 to 40 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Participants aged between 20-40 years.
- participant having neck pain report more than 4 in NPRS, and at least within the last three months known as chronic pain.
- participant with CVA more than 45 degrees and less than 50.
- Participant with poor cervical muscle endurance.
Who cannot join
- Participant with acute neck pain (less than three month).
- Participant with radiated neck pain.
- Participant who undergone recent surgeries within the thoracic, shoulder girdle, and cervical spine regions.
- Participants who were already undergoing treatment for neck pain.
- Participant with fixed spinal deformity.
- Pregnant women.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt1 site, 1 recruiting
- Recruiting
Out-patient clinic- Faculty of physical therapy
Cairo, Giza Governorate, 12111
Karima A Mohamed, PhD, +201114032967, karima_hassan2008@yahoo.com
About this study
Official title: Effect of Deep Cervical Flexor Muscle Training and Sensorimotor Training in Patient With Chronic Mechanical Neck Pain
This randomized controlled trial aims to investigate the effectiveness of deep cervical flexor muscle training combined with sensorimotor (proprioception) training in patients with chronic mechanical neck pain. The study will be conducted in outpatient clinic of the faculty of physical therapy- Cairo University, involving 60 participants aged 20-40 years with neck pain persisting for more than three months. Participants will be randomly allocated into an experimental group receiving conventional physical therapy plus deep flexor and sensorimotor training, and a control group receiving conventional treatment alone. Outcome measures will include pain intensity, craniovertebral angle (CVA), cervical range of motion (ROM), segmental mobility, neuromotor control, proprioception (head repositioning accuracy), and respiratory function (FEV1 and PEF). Assessments will be performed at baseline and after four weeks of intervention. The study seeks to provide evidence-based recommendations for physiotherapy management of mechanical neck pain, particularly addressing the gaps in literature within the regional context.
Read the detailed description
Participants in the experimental group will receive a structured four-week physiotherapy intervention consisting of conventional physical therapy treatment combined with deep cervical flexor muscle training and proprioception (sensorimotor) training. All participants will attend three supervised sessions per week, with each session lasting approximately 45-60 minutes. Conventional physiotherapy will include stretching exercises targeting the sternocleidomastoid, upper trapezius, levator scapulae, scalene, Rhomboids and pectoralis muscles, performed in three repetitions, holding each stretch for thirty seconds, strengthening exercises will be provided Isometrically for the cervical flexors, extensors and at sides using a prescription of three sets of ten repetitions with a ten-second hold and two minutes of rest between sets.
In addition, deep cervical flexor muscle training will be performed according to the protocol of Jull and Falla using a pressure biofeedback unit. Participants will be positioned in a supine crook-lying posture with the neck in a neutral position, and the air bag of the pressure biofeedback unit will be placed beneath the cervical lordosis and inflated to a baseline of 20 mmHg. Patients will be instructed to perform a gentle nodding action, increasing the pressure by 2 mmHg increments up to 30 mmHg. Each increment will be held for ten seconds, repeated in three sets of ten repetitions, with a two-minute rest between sets. To enhance activation of the deep flexors, patients will be instructed to keep their mouth open during the exercise.
Proprioception training will include head relocation practice, oculomotor exercises, and eye-head coordination exercises. Head relocation exercises will be conducted using a laser pointer attached to a helmet, with participants practicing relocating their head to a neutral position or predetermined positions, initially with eyes open using visual feedback and later progressing to eyes closed. Oculomotor exercises will begin with eye movements while keeping the head stationary, progressing to combined head and eye movements following visual targets. Eye-head coordination exercises will involve moving the eyes and head to the same side, followed by movements where the eyes lead and the head follows, and eventually progressing to eyes and head moving in opposite directions. Exercises will be progressed by increasing speed, range, and target difficulty. This proprioceptive training will also be performed three times per week for four weeks.
The control group will receive the conventional physical therapy program alone, without the additional deep cervical flexor or proprioception training components. Outcome measures for both groups will be assessed at baseline and after four weeks, including pain intensity using the Numeric Pain Rating Scale (NPRS), craniovertebral angle measured by the APECS mobile application, cervical range of motion via Digital Inclinometer, Segmental mobility using spinal mouse, neuromotor control using the Craniocervical Flexion Test with a pressure biofeedback unit, proprioception assessed through head repositioning accuracy tests, and respiratory function parameters (FEV1 and peak expiratory flow) measured with the spirometer.
- Conditions
- Mechanical Neck Pain
- Being tested
- Deep cervical flexors muscle training and sensorimotor training, conventional physical therapy exercise
- Keywords
- mechanical neck pain, sensorimotor training, Deep cervical flexors muscles
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Deep cervical flexors muscle training and sensorimotor trainingOther
deep cervical flexor muscle training will be performed according to the protocol of Jull and Falla using a pressure biofeedback unit. Participants will be positioned in a supine crook-lying posture with the neck in a neutral position, and the air bag of the pressure biofeedback unit will be placed beneath the cervical lordosis and inflated to a baseline of 20 mmHg. Patients will be instructed to perform a gentle nodding action, increasing the pressure by 2 mmHg increments up to 30 mmHg. Each increment will be held for ten seconds, repeated in three sets of ten repetitions, with a two-minute rest between sets. To enhance activation of the deep flexors, patients will be instructed to keep their mouth open during the exercise.
Proprioception training will include head relocation practice, oculomotor exercises, and eye-head coordination exercises.
conventional physical therapy exerciseOther
will include stretching exercises targeting the sternocleidomastoid, upper trapezius, levator scapulae, scalene, Rhomboids and pectoralis muscles, performed in three repetitions, holding each stretch for thirty seconds, strengthening exercises will be provided Isometrically for the cervical flexors, extensors and at sides using a prescription of three sets of ten repetitions with a ten-second hold and two minutes of rest between sets.
TENS and Hot back.
| Study group | Role | What they receive |
|---|---|---|
| core stability exercise and proprioception training | Experimental | Participants in the experimental group will receive a structured four-week physiotherapy intervention consisting of conventional physical therapy treatment combined with deep cervical flexor muscle training and proprioception (sensorimotor) training. Receives: Other: Deep cervical flexors muscle training and sensorimotor training |
| conventional physical therapy exercise | Active comparator | . Conventional physiotherapy will include stretching exercises targeting the sternocleidomastoid, upper trapezius, levator scapulae, scalene, Rhomboids and pectoralis muscles, performed in three repetitions, holding each stretch for thirty seconds, strengthening exercises will be provided Isometrically for the cervical flexors, extensors and at sides using a prescription of three sets of ten repetitions with a ten-second hold and two minutes of rest between sets.
TENS for 15 min. hot back for 15 min. Receives: Other: conventional physical therapy exercise |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Pain Intensity Score on the Numeric Pain Rating Scale (NPRS) from Baseline to 4 Weeks
which will be measured using the Numeric Pain Rating Scale (NPRS), a validated 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain).
Measured: 4 weeks
Secondary outcomes (5)
Change in Cervical Range of Motion (ROM) in Degrees Measured by Digital Inclinometer from Baseline to 4 Weeks
Flexion, Extension and Rotation range will be assessed using the Digital Inclinometer,
Measured: 4 weeks
Change in Neuromotor Control of the Deep Cervical Flexor Muscles Assessed by Craniocervical Flexion Test (CCFT) from Baseline to 4 Weeks
will be evaluated using the Craniocervical Flexion Test (CCFT) with a pressure biofeedback unit (PBU),
Measured: 4 weeks
Change in Craniovertebral Angle (CVA) Measured by AI Posture Evaluation and Correction System (APECS) from Baseline to 4 Weeks
will be used as a key postural assessment parameter, measured via the AI Posture Evaluation and Correction System (APECS) mobile application, which provides reliable digital posture analysis using lateral photographic images to quantify forward head posture.
Measured: 4 weeks
Change in Cervical Proprioceptive Function Assessed by Head Repositioning Accuracy (HRA) Test in centimetre from Baseline to 4 Weeks
will be evaluated through the Head Repositioning Accuracy (HRA) Test,
Measured: 4 weeks
Change in Respiratory Function Parameters (FEV1 and PEF) Measured by Spirometer from Baseline to 4 Weeks
will be assessed by measuring forced expiratory volume in the first second (FEV1) and peak expiratory flow (PEF) using the spirometer
Measured: 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Jun 2025
- Study start19 Jun 2025
- Primary completionNov 2025 (estimated)
- Study completionDec 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Mechanical 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
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Al-Neelain University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Halla Taj Elsir Ahmed, Al-Neelain University
- Investigators
- Khaled A Ayad, Professor, Study chair, Cairo UniversityKarima A Mohamed, PhD, Study director, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07040605
- Sponsor's protocol ID
- P.T.REC/012/005888
- Status last verified
- Jun 2025
- First submitted
- 19 Jun 2025
- Last updated
- 29 Jun 2025
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: study result
Study at a glance
From the registry record, last updated by the sponsor on 29 Jun 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Deep Cervical Flexor Muscle Training and Sensorimotor Training in Patient With Chronic Mechanical Neck Pain
- ClinicalTrials.gov ID
- NCT07040605
- Acronym / sponsor ID
- P.T.REC/012/005888
- Conditions
- Mechanical Neck Pain
- Keywords
- mechanical neck pain, sensorimotor training, Deep cervical flexors muscles
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Al-Neelain UniversityUniversity, hospital or other
- Study start
- 19 Jun 2025 (actual)
- Primary completion
- Nov 2025 (estimated)
- Study completion
- Dec 2025 (estimated)
- First posted
- 27 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 controlled trial aims to investigate the effectiveness of deep cervical flexor muscle training combined with sensorimotor (proprioception) training in patients with chronic mechanical neck pain. The study will be conducted in outpatient clinic of the faculty of physical therapy- Cairo University, involving 60 participants aged 20-40 years with neck pain persisting for more than three months. Participants will be randomly allocated into an experimental group receiving conventional physical therapy plus deep flexor and sensorimotor training, and a control group receiving conventional treatment alone. Outcome measures will include pain intensity, craniovertebral angle (CVA), cervical range of motion (ROM), segmental mobility, neuromotor control, proprioception (head repositioning accuracy), and respiratory function (FEV1 and PEF). Assessments will be performed at baseline and after four weeks of intervention. The study seeks to provide evidence-based recommendations for physiotherapy management of mechanical neck pain, particularly addressing the gaps in literature within the regional context.
Detailed description
Participants in the experimental group will receive a structured four-week physiotherapy intervention consisting of conventional physical therapy treatment combined with deep cervical flexor muscle training and proprioception (sensorimotor) training. All participants will attend three supervised sessions per week, with each session lasting approximately 45-60 minutes. Conventional physiotherapy will include stretching exercises targeting the sternocleidomastoid, upper trapezius, levator scapulae, scalene, Rhomboids and pectoralis muscles, performed in three repetitions, holding each stretch for thirty seconds, strengthening exercises will be provided Isometrically for the cervical flexors, extensors and at sides using a prescription of three sets of ten repetitions with a ten-second hold and two minutes of rest between sets.
In addition, deep cervical flexor muscle training will be performed according to the protocol of Jull and Falla using a pressure biofeedback unit. Participants will be positioned in a supine crook-lying posture with the neck in a neutral position, and the air bag of the pressure biofeedback unit will be placed beneath the cervical lordosis and inflated to a baseline of 20 mmHg. Patients will be instructed to perform a gentle nodding action, increasing the pressure by 2 mmHg increments up to 30 mmHg. Each increment will be held for ten seconds, repeated in three sets of ten repetitions, with a two-minute rest between sets. To enhance activation of the deep flexors, patients will be instructed to keep their mouth open during the exercise.
Proprioception training will include head relocation practice, oculomotor exercises, and eye-head coordination exercises. Head relocation exercises will be conducted using a laser pointer attached to a helmet, with participants practicing relocating their head to a neutral position or predetermined positions, initially with eyes open using visual feedback and later progressing to eyes closed. Oculomotor exercises will begin with eye movements while keeping the head stationary, progressing to combined head and eye movements following visual targets. Eye-head coordination exercises will involve moving the eyes and head to the same side, followed by movements where the eyes lead and the head follows, and eventually progressing to eyes and head moving in opposite directions. Exercises will be progressed by increasing speed, range, and target difficulty. This proprioceptive training will also be performed three times per week for four weeks.
The control group will receive the conventional physical therapy program alone, without the additional deep cervical flexor or proprioception training components. Outcome measures for both groups will be assessed at baseline and after four weeks, including pain intensity using the Numeric Pain Rating Scale (NPRS), craniovertebral angle measured by the APECS mobile application, cervical range of motion via Digital Inclinometer, Segmental mobility using spinal mouse, neuromotor control using the Craniocervical Flexion Test with a pressure biofeedback unit, proprioception assessed through head repositioning accuracy tests, and respiratory function parameters (FEV1 and peak expiratory flow) measured with the spirometer.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| core stability exercise and proprioception training | Experimental | Other: Deep cervical flexors muscle training and sensorimotor trainingParticipants in the experimental group will receive a structured four-week physiotherapy intervention consisting of conventional physical therapy treatment combined with deep cervical flexor muscle training and proprioception (sensorimotor) training. |
| conventional physical therapy exercise | Active comparator | Other: conventional physical therapy exercise. Conventional physiotherapy will include stretching exercises targeting the sternocleidomastoid, upper trapezius, levator scapulae, scalene, Rhomboids and pectoralis muscles, performed in three repetitions, holding each stretch for thirty seconds, strengthening exercises will be provided Isometrically for the cervical flexors, extensors and at sides using a prescription of three sets of ten repetitions with a ten-second hold and two minutes of rest between sets. TENS for 15 min. hot back for 15 min. |
Who may qualify
- Ages
- 20 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Participants aged between 20-40 years.
- participant having neck pain report more than 4 in NPRS, and at least within the last three months known as chronic pain.
- participant with CVA more than 45 degrees and less than 50.
- Participant with poor cervical muscle endurance.
Key exclusion criteria (6 listed)
- Participant with acute neck pain (less than three month).
- Participant with radiated neck pain.
- Participant who undergone recent surgeries within the thoracic, shoulder girdle, and cervical spine regions.
- Participants who were already undergoing treatment for neck pain.
- Participant with fixed spinal 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 |
|---|---|---|
| Deep cervical flexors muscle training and sensorimotor trainingdeep cervical flexor muscle training will be performed according to the protocol of Jull and Falla using a pressure biofeedback unit. Participants will be positioned in a supine crook-lying posture with the neck in a neutral position, and the air bag of the pressure biofeedback unit will be placed beneath the cervical lordosis and inflated to a baseline of 20 mmHg. Patients will be instructed to perform a gentle nodding action, increasing the pressure by 2 mmHg increments up to 30 mmHg. Each increment will be held for ten seconds, repeated in three sets of ten repetitions, with a two-minute rest between sets. To enhance activation of the deep flexors, patients will be instructed to keep their mouth open during the exercise. Proprioception training will include head relocation practice, oculomotor exercises, and eye-head coordination exercises. | Other | core stability exercise and proprioception training |
| conventional physical therapy exercisewill include stretching exercises targeting the sternocleidomastoid, upper trapezius, levator scapulae, scalene, Rhomboids and pectoralis muscles, performed in three repetitions, holding each stretch for thirty seconds, strengthening exercises will be provided Isometrically for the cervical flexors, extensors and at sides using a prescription of three sets of ten repetitions with a ten-second hold and two minutes of rest between sets. TENS and Hot back. | Other | conventional physical therapy exercise |
Primary outcome
Change in Pain Intensity Score on the Numeric Pain Rating Scale (NPRS) from Baseline to 4 Weeks
Time frame: 4 weeks
which will be measured using the Numeric Pain Rating Scale (NPRS), a validated 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain).
5 secondary outcomes
Change in Cervical Range of Motion (ROM) in Degrees Measured by Digital Inclinometer from Baseline to 4 Weeks
Time frame: 4 weeks
Change in Neuromotor Control of the Deep Cervical Flexor Muscles Assessed by Craniocervical Flexion Test (CCFT) from Baseline to 4 Weeks
Time frame: 4 weeks
Change in Craniovertebral Angle (CVA) Measured by AI Posture Evaluation and Correction System (APECS) from Baseline to 4 Weeks
Time frame: 4 weeks
Change in Cervical Proprioceptive Function Assessed by Head Repositioning Accuracy (HRA) Test in centimetre from Baseline to 4 Weeks
Time frame: 4 weeks
Change in Respiratory Function Parameters (FEV1 and PEF) Measured by Spirometer from Baseline to 4 Weeks
Time frame: 4 weeks
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 29 Jun 2025.
- Individual participant dataSharing planned: Yes. study result
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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.
Khaled A Ayad, Professor study chair
Cairo University
Karima A Mohamed, PhD study director
Cairo 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 Deep cervical flexors muscle training and sensorimotor training and conventional physical therapy exercise in people with Mechanical Neck Pain, run by Al-Neelain University at 1 site in Egypt.
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 4 inclusion and 6 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 29 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 Egypt. 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 Halla T Ahmed, MSc (+966545277073, htajelsir@ju.edu.sa), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Pain Intensity Score on the Numeric Pain Rating Scale (NPRS) from Baseline to 4 Weeks (time frame: 4 weeks). 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 29 Jun 2025; AzTrials last refreshed its copy on 1 Nov 2026.