Neck PainNCT07063004
Combined Effects of Bruegger's Exercises and Upper Thoracic Mobilizations in Patients With Non-specific Neck Pain
A study testing Bruegger's Exercise and Upper Thoracic Mobilization and Standard Physical Therapy in people with Neck Pain, run by Riphah International University at 1 site in Pakistan.
Trial summary
Neck pain is a multifactorial disease, and is a major problem in modern society. Patients with NCNP usually have alterations in cervical proprioception and PS. They may also develop symptoms such as dizziness or vertigo. Read more about this study
- Who is it for?
- Ages 25 to 45 years
- Conditions the study is for
- Neck Pain
- What is being tested?
- Bruegger's Exercise and Upper Thoracic Mobilization and Standard Physical Therapy
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 48 participants
- Where
- 1 sitePakistan
- Study dates
- Jul 2025to Oct 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 25 to 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Males and Females between 25 and 45 years of age with nonspecific neck pain, and Current neck pain of at least 3 months duration.
Who cannot join
- Cervical radiculopathy, History of whiplash injury and surgery
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
Medical and Rehabilitation Center, Gujrat
Gujrat, Punjab Province, 50700
Ramsha, MSPT, 923310044345, rimshamubashar3@gmail.com
About this study
Official title: Combined Effects of Bruegger's Exercises and Upper Thoracic Mobilizations Along With Standard Physical Therapy in Patients With Non-specific Neck Pain
Neck pain is a multifactorial disease, and is a major problem in modern society. Patients with NCNP usually have alterations in cervical proprioception and PS. They may also develop symptoms such as dizziness or vertigo. A recently published study shows that patients with NCNP suffer greater sensations of stunning and lack of proprioception than patients with benign paroxysmal vertigo.
Read the detailed description
This study will be a randomized controlled trial and will be conducted on general population in Gujrat. Non-probability convenient sampling will be used to collect the data. Sample size of 48 subjects with age group between 25-45 years will be taken. Data will be collected from the patients having present complaint of Nonspecific Neck pain. Outcome measures will be taken using Numeric pain rating scale (NPRS) for pain, Neck disability index (NDI) for measuring disability and goniometer for range of motion (ROM). An informed consent will be taken. Subjects will be selected based on inclusion and exclusion criteria and will be equally divided into two groups by random number generator table. Both the Groups will receive standard physical therapy, while Group A will receive bruegger's exercises and Group B will receive Upper thoracic mobilization. Outcome measures will be measured at baseline then after 4 weeks(post). Data analysis will be done by SPSS version 21.
- Conditions
- Neck Pain
- Being tested
- Bruegger's Exercise and Upper Thoracic Mobilization, Standard Physical Therapy
- Keywords
- Pain, Disability, Manual therapy
- Medical subject headings
- Neck Pain, Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Bruegger's Exercise and Upper Thoracic MobilizationOther
Bruegger's Exercise: The position will be held for 10 second at first session and then there will be an increment of 2 seconds during each session.
Upper Thoracic Mobilization: Upper thoracic (T1-T6) mobilization (Maitland mobilization (Grade I, II and III; PA glide) applied in prone lying position from via spinous process. Amount of treatment will be 3-4 mobilizations for a vertebra for 30 seconds approximately.
Standard Physical TherapyOther
Isometric exercises will be done for flexors, extensors, rotators, and lateral flexors of the neck. Isometrically contracting working muscle for 5 seconds against patients own hand, which was placed in compliance with the working muscles, with a total of 10 repetitions.
Passive stretching will apply to Upper trapezius, Levator scapulae, Sternocleidomastoid, Scalene, Pectoralis major and minor muscle for 3-5 repetition 10 with 20-30 second hold. Intensity of exercise will be prescribed according to patient's tolerance level. Duration of stretch will 15 to 30 seconds, 3-5repetition and for 10 minutes.
Postero-anterior Maitland mobilization (Grade I \& II) for C1-C2, Maitland lateral PA glide (Grade-III \& IV) for C3-C6. Time of oscillations will be two or three oscillations in a second for one to two minutes.
| Study group | Role | What they receive |
|---|---|---|
| Bruegger's Exercise and Upper Thoracic Mobilization | Experimental | Bruegger's Exercise: The position will be held for 10 second at first session and then there will be an increment of 2 seconds during each session.
Upper Thoracic Mobilization: Upper thoracic (T1-T6) mobilization (Maitland mobilization (Grade I, II and III; PA glide) applied in prone lying position from via spinous process. Amount of treatment will be 3-4 mobilizations for a vertebra for 30 seconds approximately. Receives: Other: Bruegger's Exercise and Upper Thoracic Mobilization |
| Standard Physical Therapy | Active comparator | * Isometric exercises will be done for flexors, extensors, rotators, and lateral flexors of the neck. Isometrically contracting working muscle for 5 seconds against patients own hand, which was placed in compliance with the working muscles, with a total of 10 repetitions.
* Passive stretching will apply to Upper trapezius, Levator scapulae, Sternocleidomastoid, Scalene, Pectoralis major and minor muscle for 3-5 repetition 10 with 20-30 second hold. Intensity of exercise will be prescribed according to patient's tolerance level. Duration of stretch will 15 to 30 seconds, 3-5repetition and for 10 minutes.
* Postero-anterior Maitland mobilization (Grade I \& II) for C1-C2, Maitland lateral PA glide (Grade-III \& IV) for C3-C6. Time of oscillations will be two or three oscillations in a second for one to two minutes. Receives: Other: Standard Physical Therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numerical Pain Rating Scale (NPRS)
Patient level of pain will be assessed using the NPRS scale. The NPRS was used to capture the patient's level of pain. Patients were asked to indicate the intensity of their current pain level using an 11-point scale, ranging from 0 (no pain) to 10 (worst pain imaginable).
Measured: upto 4 weeks
Neck Disability Index (NDI)
Patient level of Disability will be assessed using NDI. The NDI is a self-report questionnaire with 10-items: pain intensity, personal care, lifting work, headaches, concentration, sleeping, driving, reading, and recreation. The response to each item is rated on a 6-point scale from 0 (no disability) to 5 (complete disability). The numeric responses for each item are summed for a total score ranging between 0 and 50; however, some evaluators have chosen to multiply the raw score by 2 and then report the NDI on a 0-100% Higher scores represent increased levels of disability.
Measured: upto 4 weeks
Universal Goniometer (UG)
A large UG having 12-inch arms and full-circle plastic body will be used for measuring ACROM..It will be used to measure cervical AROM: flexion, extension, lateral flexion, and rotation.
Measured: upto 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Jul 2025
- Study startJul 2025 (estimated)
- Primary completionSep 2025 (estimated)
- Study completionOct 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for Neck PainStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- 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
- Outcomes assessor
- Enrolment
- 48 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07063004
- Sponsor's protocol ID
- REC/RCR &AHS/24/0159 Maryam
- Status last verified
- Jul 2025
- First submitted
- 3 Jul 2025
- Last updated
- 14 Jul 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, Kolahi AA, Safiri S. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord. 2022 Jan 3;23(1):26. doi: 10.1186/s12891-021-04957-4.
PubMed 34980079Bernal-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 32723399Fandim JV, Nitzsche R, Michaleff ZA, Pena Costa LO, Saragiotto B. The contemporary management of neck pain in adults. Pain Manag. 2021 Jan;11(1):75-87. doi: 10.2217/pmt-2020-0046. Epub 2020 Nov 25.
PubMed 33234017Joshi S, Balthillaya G, Neelapala YVR. Thoracic Posture and Mobility in Mechanical Neck Pain Population: A Review of the Literature. Asian Spine J. 2019 Jun 3;13(5):849-860. doi: 10.31616/asj.2018.0302. Print 2019 Oct.
PubMed 31154701Arsh A, Darain H, Iqbal M, Rahman MU, Ullah I, Khalid S. Effectiveness of manual therapy to the cervical spine with and without manual therapy to the upper thoracic spine in the management of non-specific neck pain; a randomized controlled trial. J Pak Med Assoc. 2020 Mar;70(3):399-403. doi: 10.5455/JPMA.300523.
PubMed 32207414SALWA SHENDY PD, EL-KHOZAMY PD. Effect of Upper Thoracic Mobilization on Chronic Mechanical Neck Pain. The Medical Journal of Cairo University. 2019;87(June):1449-57.
Hidalgo B, Hall T, Bossert J, Dugeny A, Cagnie B, Pitance L. The efficacy of manual therapy and exercise for treating non-specific neck pain: A systematic review. J Back Musculoskelet Rehabil. 2017 Nov 6;30(6):1149-1169. doi: 10.3233/BMR-169615.
PubMed 28826164
Study at a glance
From the registry record, last updated by the sponsor on 14 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Combined Effects of Bruegger's Exercises and Upper Thoracic Mobilizations Along With Standard Physical Therapy in Patients With Non-specific Neck Pain
- ClinicalTrials.gov ID
- NCT07063004
- Acronym / sponsor ID
- REC/RCR &AHS/24/0159 Maryam
- Conditions
- Neck Pain
- Keywords
- Pain, Disability, Manual therapy
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 48 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- Jul 2025 (estimated)
- Primary completion
- Sep 2025 (estimated)
- Study completion
- Oct 2025 (estimated)
- First posted
- 14 Jul 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.
Neck pain is a multifactorial disease, and is a major problem in modern society. Patients with NCNP usually have alterations in cervical proprioception and PS. They may also develop symptoms such as dizziness or vertigo. A recently published study shows that patients with NCNP suffer greater sensations of stunning and lack of proprioception than patients with benign paroxysmal vertigo.
Detailed description
This study will be a randomized controlled trial and will be conducted on general population in Gujrat. Non-probability convenient sampling will be used to collect the data. Sample size of 48 subjects with age group between 25-45 years will be taken. Data will be collected from the patients having present complaint of Nonspecific Neck pain. Outcome measures will be taken using Numeric pain rating scale (NPRS) for pain, Neck disability index (NDI) for measuring disability and goniometer for range of motion (ROM). An informed consent will be taken. Subjects will be selected based on inclusion and exclusion criteria and will be equally divided into two groups by random number generator table. Both the Groups will receive standard physical therapy, while Group A will receive bruegger's exercises and Group B will receive Upper thoracic mobilization. Outcome measures will be measured at baseline then after 4 weeks(post). Data analysis will be done by SPSS version 21.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Bruegger's Exercise and Upper Thoracic Mobilization | Experimental | Other: Bruegger's Exercise and Upper Thoracic MobilizationBruegger's Exercise: The position will be held for 10 second at first session and then there will be an increment of 2 seconds during each session. Upper Thoracic Mobilization: Upper thoracic (T1-T6) mobilization (Maitland mobilization (Grade I, II and III; PA glide) applied in prone lying position from via spinous process. Amount of treatment will be 3-4 mobilizations for a vertebra for 30 seconds approximately. |
| Standard Physical Therapy | Active comparator | Other: Standard Physical Therapy* Isometric exercises will be done for flexors, extensors, rotators, and lateral flexors of the neck. Isometrically contracting working muscle for 5 seconds against patients own hand, which was placed in compliance with the working muscles, with a total of 10 repetitions. * Passive stretching will apply to Upper trapezius, Levator scapulae, Sternocleidomastoid, Scalene, Pectoralis major and minor muscle for 3-5 repetition 10 with 20-30 second hold. Intensity of exercise will be prescribed according to patient's tolerance level. Duration of stretch will 15 to 30 seconds, 3-5repetition and for 10 minutes. * Postero-anterior Maitland mobilization (Grade I \& II) for C1-C2, Maitland lateral PA glide (Grade-III \& IV) for C3-C6. Time of oscillations will be two or three oscillations in a second for one to two minutes. |
Who may qualify
- Ages
- 25 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (1 listed)
- Males and Females between 25 and 45 years of age with nonspecific neck pain, and Current neck pain of at least 3 months duration.
Key exclusion criteria (1 listed)
- Cervical radiculopathy, History of whiplash injury and surgery
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 Exercise and Upper Thoracic MobilizationBruegger's Exercise: The position will be held for 10 second at first session and then there will be an increment of 2 seconds during each session. Upper Thoracic Mobilization: Upper thoracic (T1-T6) mobilization (Maitland mobilization (Grade I, II and III; PA glide) applied in prone lying position from via spinous process. Amount of treatment will be 3-4 mobilizations for a vertebra for 30 seconds approximately. | Other | Bruegger's Exercise and Upper Thoracic Mobilization |
| Standard Physical TherapyIsometric exercises will be done for flexors, extensors, rotators, and lateral flexors of the neck. Isometrically contracting working muscle for 5 seconds against patients own hand, which was placed in compliance with the working muscles, with a total of 10 repetitions. Passive stretching will apply to Upper trapezius, Levator scapulae, Sternocleidomastoid, Scalene, Pectoralis major and minor muscle for 3-5 repetition 10 with 20-30 second hold. Intensity of exercise will be prescribed according to patient's tolerance level. Duration of stretch will 15 to 30 seconds, 3-5repetition and for 10 minutes. Postero-anterior Maitland mobilization (Grade I \& II) for C1-C2, Maitland lateral PA glide (Grade-III \& IV) for C3-C6. Time of oscillations will be two or three oscillations in a second for one to two minutes. | Other | Standard Physical Therapy |
Primary outcome
Numerical Pain Rating Scale (NPRS)
Time frame: upto 4 weeks
Patient level of pain will be assessed using the NPRS scale. The NPRS was used to capture the patient's level of pain. Patients were asked to indicate the intensity of their current pain level using an 11-point scale, ranging from 0 (no pain) to 10 (worst pain imaginable).
Neck Disability Index (NDI)
Time frame: upto 4 weeks
Patient level of Disability will be assessed using NDI. The NDI is a self-report questionnaire with 10-items: pain intensity, personal care, lifting work, headaches, concentration, sleeping, driving, reading, and recreation. The response to each item is rated on a 6-point scale from 0 (no disability) to 5 (complete disability). The numeric responses for each item are summed for a total score ranging between 0 and 50; however, some evaluators have chosen to multiply the raw score by 2 and then report the NDI on a 0-100% Higher scores represent increased levels of disability.
Universal Goniometer (UG)
Time frame: upto 4 weeks
A large UG having 12-inch arms and full-circle plastic body will be used for measuring ACROM..It will be used to measure cervical AROM: flexion, extension, lateral flexion, and rotation.
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 14 Jul 2025.
- Background: PubMed 34980079Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, Kolahi AA, Safiri S. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord. 2022 Jan 3;23(1):26. doi: 10.1186/s12891-021-04957-4.
- 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.
- Background: PubMed 33234017Fandim JV, Nitzsche R, Michaleff ZA, Pena Costa LO, Saragiotto B. The contemporary management of neck pain in adults. Pain Manag. 2021 Jan;11(1):75-87. doi: 10.2217/pmt-2020-0046. Epub 2020 Nov 25.
- Background: PubMed 31154701Joshi S, Balthillaya G, Neelapala YVR. Thoracic Posture and Mobility in Mechanical Neck Pain Population: A Review of the Literature. Asian Spine J. 2019 Jun 3;13(5):849-860. doi: 10.31616/asj.2018.0302. Print 2019 Oct.
- Background: PubMed 32207414Arsh A, Darain H, Iqbal M, Rahman MU, Ullah I, Khalid S. Effectiveness of manual therapy to the cervical spine with and without manual therapy to the upper thoracic spine in the management of non-specific neck pain; a randomized controlled trial. J Pak Med Assoc. 2020 Mar;70(3):399-403. doi: 10.5455/JPMA.300523.
- BackgroundSALWA SHENDY PD, EL-KHOZAMY PD. Effect of Upper Thoracic Mobilization on Chronic Mechanical Neck Pain. The Medical Journal of Cairo University. 2019;87(June):1449-57.
- Background: PubMed 28826164Hidalgo B, Hall T, Bossert J, Dugeny A, Cagnie B, Pitance L. The efficacy of manual therapy and exercise for treating non-specific neck pain: A systematic review. J Back Musculoskelet Rehabil. 2017 Nov 6;30(6):1149-1169. doi: 10.3233/BMR-169615.
- 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.
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 Exercise and Upper Thoracic Mobilization and Standard Physical Therapy in people with Neck Pain, 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 1 inclusion and 1 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: opening soon, as of the sponsor's last update on 14 Jul 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 Samrood Akram, PhD Scholar (03324806143, samrood.akram@riphah.edu.pk.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numerical Pain Rating Scale (NPRS) (time frame: upto 4 weeks). 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 NCT07063004, which also lists 7 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 14 Jul 2025.