Chronic Neck PainNCT07328256
Effects of Post Isometric Relaxation as Compared to Post Isometric Stretching Muscle Energy Technique in the Management of Neck Pain: a Randomized Controlled Trial
A study testing Post Isometric Relaxation and Post Isometric Stretching in people with Chronic Neck Pain, run by Foundation University Islamabad at 1 site in Pakistan.
Trial summary
This study aims to compare the effects of post-isometric relaxation (PIR) and post isometric stretching (PIS) techniques on reducing neck pain, improving range of motion, and decreasing neck disability in individuals with neck pain. Read more about this study
- Who is it for?
- Ages 19 to 44 years
- Conditions the study is for
- Chronic Neck Pain
- What is being tested?
- Post Isometric Relaxation and Post Isometric Stretching
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 sitePakistan
- Study dates
- 15 Jan 2025to 15 Dec 2026
- 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 19 to 44 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Both gender
- With sub-acute or chronic neck pain for at least 4 to 12 weeks
- Pain intensity on NPRS ranging 4-8
- Limitation on neck movement
Who cannot join
- • Positive history of fracture
- Surgery in the cervical region
- Any sort of physical trauma in the cervical region in the last 12 months
- Thoracic Outlet syndrome
- Cervical radiculopathy
- Cervical myelopathy
Show all 11Show fewer
- Cervical spondylosis
- Cervical syringomyelia
- Any systemic disorder including malignancy or inflammatory and rheumatic disorders
- Infection
- Vascular syndromes such as vertebrobasilar insufficiency (VBI).
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
Foundation University College of Physical Therapy
Islamabad, Punjab Province, 46000
Areeka Riasat, DPT, 03219390688, arikariasat4830@gmail.com
About this study
Official title: Effects of Post Isometric Relaxation as Compared to Post Isometric Stretching Muscle Energy Technique in the Management of Neck Pain
This study aims to compare the effects of post-isometric relaxation (PIR) and post isometric stretching (PIS) techniques on reducing neck pain, improving range of motion, and decreasing neck disability in individuals with neck pain. A randomized controlled trial will be conducted with 50 participants, who will be randomly assigned to one of two groups: one receiving PIR and the other receiving PIS. A single-blind method will be used, meaning the participants will not know which group they belong to. Participants will be selected based on specific criteria related to neck pain and will then be randomly allocated to the PIR or PIS group. Initially, all participants will receive two standard treatments: Transcutaneous Electrical Nerve Stimulation (TENS) and hot pack application. After these treatments, one group will undergo post-isometric relaxation (PIR), which involves 3-5 repetitions of muscle contraction and relaxation, conducted over five consecutive sessions. The other group will receive post-isometric stretching (PIS), which involves stretching after muscle contraction and relaxation, also administered over five consecutive sessions. At the end of the intervention, pain, range of motion, and neck disability will be measured. Pain will be assessed using a standardised pain scale, range of motion will be measured with a goniometer or other appropriate tools, and neck disability will be evaluated using the Neck Disability Index (NDI). Statistical analysis will be performed to compare the effectiveness of PIR and PIS in terms of pain reduction, range of motion improvement, and decreased neck disability.
Read the detailed description
Neck pain is one of the most prevalent musculoskeletal complaints among young adults, with studies reporting a prevalence of up to 75.7%, making it the fourth leading cause of disability worldwide. Research suggests that weak cervical musculature, reduced muscle-to-bodyweight ratios, and imbalances in muscle strength are key contributors to neck pain and associated disability. Muscle Energy Techniques (METs), particularly Post-Isometric Relaxation (PIR) and Post-Isometric Stretching (PIS), have been widely used to address these issues. PIR involves gentle isometric contractions followed by muscle relaxation and is effective for managing active muscle tone, making it suitable for acute conditions. However, it lacks a stretching component to target passive tone. PIS adds a post-contraction stretch, potentially addressing both active and passive tone, but may cause discomfort in sensitive individuals. While both techniques have shown positive outcomes in reducing pain and improving function, limited research directly compares their effectiveness. Therefore, this study aims to compare PIR and PIS in terms of pain relief, cervical range of motion, and functional improvement in individuals with mechanical neck pain.
According to M.Osama et al in 2020 a study was conducted to compared autogenic inhibition (AI) and reciprocal inhibition (RI) muscle energy techniques (MET) to static stretching (SS) for managing mechanical neck pain. Both AI-MET and RI-MET outperformed SS in enhancing isometric strength, with no adverse effects observed. The findings highlight AI-MET's superiority and support its use in neck pain rehabilitation.
Another study was conducted by Osama M 2024, 78 participants a randomized trial concluded that Muscle and Movement specific PIR is effective in improving neck pain, disability and ROM. Dudonienė V et al preformed a study in 2024 that aimed to investigate the 3 effectiveness of post-isometric relaxation (PIR) compared to self-stretching (SS) in working-age individuals with chronic non-specific neck pain. Result showed PIR group achieved lower pain intensity, greater neck extension ROM and lower neck disability index compared to the SS group.
A study conducted in 2022 investigates the effects of post-isometric relaxation (PIR) versus myofascial release therapy on non-specific neck pain management. Results showed that the PIR group had significant improvements in pain (measured by VAS), disability (NDI), cervical extension, and social QoL compared to the MFR group.
Another study investigated the effectiveness of post isometric relaxation (PIR) combined with traditional physical therapy for treating chronic mechanical neck pain compared to traditional therapy alone. Results showed significant reductions in pain and increases in cervical range of motion (ROM) for group adding PIR to conventional therapy.
The study compares the effectiveness of post-isometric relaxation (PIR) and passive neck retraction mobilization (PNRM) in treating nonspecific neck pain. This study suggests that PIR to be a more effective treatment option for nonspecific neck discomfort.
- Conditions
- Chronic Neck Pain
- Being tested
- Post Isometric Relaxation, Post Isometric Stretching
- Keywords
- Subacute neck pain, Neck Muscles, Chronic Neck Pain, Pain Management, Muscle Relaxation, Isometric Contraction
- Medical subject headings
- Agnosia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Post Isometric RelaxationProcedure or surgery
All patients were given Trans-Cutaneous Electrical Nerve Stimulation (TENS) in combination with superficial heat for 10 minutes. with a session of 5 days/ week.
Group A (PIR) : In this group, participants performed 3-5 rounds of post-isometric relaxation (PIR). Each round involved contracting the target muscle at 30-50% strength for 7-10 seconds, resting for 5 seconds .
Post Isometric StretchingProcedure or surgery
All patients were given Trans-Cutaneous Electrical Nerve Stimulation (TENS) in combination with superficial heat for 10 minutes. with a session of 5 days/ week.Group B (PIS) : In this group participants performed 3-5 rounds of post-isometric relaxation (PIR), which is then followed by a stretch of the same muscle to its new range of motion. Followed by rest of 5 seconds, and then stretching the muscle and holding the stretch for 10-60 seconds
| Study group | Role | What they receive |
|---|---|---|
| Post Isometric Relaxation | Active comparator | Post-Isometric Relaxation (PIR) is used for treating muscle tightness or spasms. It involves a sequence of steps that aim to improve flexibility and reduce muscle tension. Receives: Procedure: Post Isometric Relaxation |
| Post Isometric Stretching | Experimental | Post-Isometric Stretching (PIS) is a technique used improve flexibility while working on passive tone of the muscle Receives: Procedure: Post Isometric Relaxation; Procedure: Post Isometric Stretching |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain Intensity
The Visual Analog Scale (VAS) will be used to measure the intensity of neck pain before and after the intervention. Participants will mark their level of pain on a 100 mm horizontal line, where:
0 mm indicates "no pain", and 100 mm indicates "the worst imaginable pain".
Measured: 1 week
Cervical range of motion
A universal goniometer will be used to assess cervical spine mobility in the following directions:
Flexion Extension Lateral Flexion (Right and Left) Rotation (Right and Left) ROM will be recorded in degrees.
Measured: 1 week
Functional Disability
The Neck Disability Index (NDI) will be used to assess functional impairment related to neck pain. It is a self-administered questionnaire consisting of 10 sections, including pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, and recreation.
Each section is scored from 0 to 5, with higher total scores indicating greater disability. The NDI is a validated, open-access tool commonly used in research to measure changes in disability levels pre- and post-intervention.
Measured: 1 week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Jan 2026
- Study start15 Jan 2025
- Primary completion30 Dec 2025 (estimated)
- Study completion15 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- 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
- Masking
- None (open label)
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Foundation University Islamabad
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- FUI, Principal investigator, Foundation University Islamabad
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07328256
- Sponsor's protocol ID
- FUI/CTR/2025/08
- Status last verified
- Oct 2025
- First submitted
- 26 Dec 2025
- Last updated
- 9 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 9 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Post Isometric Relaxation as Compared to Post Isometric Stretching Muscle Energy Technique in the Management of Neck Pain
- ClinicalTrials.gov ID
- NCT07328256
- Acronym / sponsor ID
- FUI/CTR/2025/08
- Conditions
- Chronic Neck Pain
- Keywords
- Subacute neck pain, Neck Muscles, Chronic Neck Pain, Pain Management, Muscle Relaxation, Isometric Contraction
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- Foundation University IslamabadUniversity, hospital or other
- Study start
- 15 Jan 2025 (actual)
- Primary completion
- 30 Dec 2025 (estimated)
- Study completion
- 15 Dec 2026 (estimated)
- First posted
- 9 Jan 2026 (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 study aims to compare the effects of post-isometric relaxation (PIR) and post isometric stretching (PIS) techniques on reducing neck pain, improving range of motion, and decreasing neck disability in individuals with neck pain. A randomized controlled trial will be conducted with 50 participants, who will be randomly assigned to one of two groups: one receiving PIR and the other receiving PIS. A single-blind method will be used, meaning the participants will not know which group they belong to. Participants will be selected based on specific criteria related to neck pain and will then be randomly allocated to the PIR or PIS group. Initially, all participants will receive two standard treatments: Transcutaneous Electrical Nerve Stimulation (TENS) and hot pack application. After these treatments, one group will undergo post-isometric relaxation (PIR), which involves 3-5 repetitions of muscle contraction and relaxation, conducted over five consecutive sessions. The other group will receive post-isometric stretching (PIS), which involves stretching after muscle contraction and relaxation, also administered over five consecutive sessions. At the end of the intervention, pain, range of motion, and neck disability will be measured. Pain will be assessed using a standardised pain scale, range of motion will be measured with a goniometer or other appropriate tools, and neck disability will be evaluated using the Neck Disability Index (NDI). Statistical analysis will be performed to compare the effectiveness of PIR and PIS in terms of pain reduction, range of motion improvement, and decreased neck disability.
Detailed description
Neck pain is one of the most prevalent musculoskeletal complaints among young adults, with studies reporting a prevalence of up to 75.7%, making it the fourth leading cause of disability worldwide. Research suggests that weak cervical musculature, reduced muscle-to-bodyweight ratios, and imbalances in muscle strength are key contributors to neck pain and associated disability. Muscle Energy Techniques (METs), particularly Post-Isometric Relaxation (PIR) and Post-Isometric Stretching (PIS), have been widely used to address these issues. PIR involves gentle isometric contractions followed by muscle relaxation and is effective for managing active muscle tone, making it suitable for acute conditions. However, it lacks a stretching component to target passive tone. PIS adds a post-contraction stretch, potentially addressing both active and passive tone, but may cause discomfort in sensitive individuals. While both techniques have shown positive outcomes in reducing pain and improving function, limited research directly compares their effectiveness. Therefore, this study aims to compare PIR and PIS in terms of pain relief, cervical range of motion, and functional improvement in individuals with mechanical neck pain.
According to M.Osama et al in 2020 a study was conducted to compared autogenic inhibition (AI) and reciprocal inhibition (RI) muscle energy techniques (MET) to static stretching (SS) for managing mechanical neck pain. Both AI-MET and RI-MET outperformed SS in enhancing isometric strength, with no adverse effects observed. The findings highlight AI-MET's superiority and support its use in neck pain rehabilitation.
Another study was conducted by Osama M 2024, 78 participants a randomized trial concluded that Muscle and Movement specific PIR is effective in improving neck pain, disability and ROM. Dudonienė V et al preformed a study in 2024 that aimed to investigate the 3 effectiveness of post-isometric relaxation (PIR) compared to self-stretching (SS) in working-age individuals with chronic non-specific neck pain. Result showed PIR group achieved lower pain intensity, greater neck extension ROM and lower neck disability index compared to the SS group.
A study conducted in 2022 investigates the effects of post-isometric relaxation (PIR) versus myofascial release therapy on non-specific neck pain management. Results showed that the PIR group had significant improvements in pain (measured by VAS), disability (NDI), cervical extension, and social QoL compared to the MFR group.
Another study investigated the effectiveness of post isometric relaxation (PIR) combined with traditional physical therapy for treating chronic mechanical neck pain compared to traditional therapy alone. Results showed significant reductions in pain and increases in cervical range of motion (ROM) for group adding PIR to conventional therapy.
The study compares the effectiveness of post-isometric relaxation (PIR) and passive neck retraction mobilization (PNRM) in treating nonspecific neck pain. This study suggests that PIR to be a more effective treatment option for nonspecific neck discomfort.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Post Isometric Relaxation | Active comparator | Procedure: Post Isometric RelaxationPost-Isometric Relaxation (PIR) is used for treating muscle tightness or spasms. It involves a sequence of steps that aim to improve flexibility and reduce muscle tension. |
| Post Isometric Stretching | Experimental | Procedure: Post Isometric Relaxation, Procedure: Post Isometric StretchingPost-Isometric Stretching (PIS) is a technique used improve flexibility while working on passive tone of the muscle |
Who may qualify
- Ages
- 19 to 44 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Both gender
- With sub-acute or chronic neck pain for at least 4 to 12 weeks
- Pain intensity on NPRS ranging 4-8
- Limitation on neck movement
Key exclusion criteria (11 listed)
- • Positive history of fracture
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 |
|---|---|---|
| Post Isometric RelaxationAll patients were given Trans-Cutaneous Electrical Nerve Stimulation (TENS) in combination with superficial heat for 10 minutes. with a session of 5 days/ week. Group A (PIR) : In this group, participants performed 3-5 rounds of post-isometric relaxation (PIR). Each round involved contracting the target muscle at 30-50% strength for 7-10 seconds, resting for 5 seconds . | Procedure or surgery | Post Isometric Relaxation, Post Isometric Stretching |
| Post Isometric StretchingAll patients were given Trans-Cutaneous Electrical Nerve Stimulation (TENS) in combination with superficial heat for 10 minutes. with a session of 5 days/ week.Group B (PIS) : In this group participants performed 3-5 rounds of post-isometric relaxation (PIR), which is then followed by a stretch of the same muscle to its new range of motion. Followed by rest of 5 seconds, and then stretching the muscle and holding the stretch for 10-60 seconds | Procedure or surgery | Post Isometric Stretching |
Primary outcome
Pain Intensity
Time frame: 1 week
The Visual Analog Scale (VAS) will be used to measure the intensity of neck pain before and after the intervention. Participants will mark their level of pain on a 100 mm horizontal line, where: 0 mm indicates "no pain", and 100 mm indicates "the worst imaginable pain".
Cervical range of motion
Time frame: 1 week
A universal goniometer will be used to assess cervical spine mobility in the following directions: Flexion Extension Lateral Flexion (Right and Left) Rotation (Right and Left) ROM will be recorded in degrees.
Functional Disability
Time frame: 1 week
The Neck Disability Index (NDI) will be used to assess functional impairment related to neck pain. It is a self-administered questionnaire consisting of 10 sections, including pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, and recreation. Each section is scored from 0 to 5, with higher total scores indicating greater disability. The NDI is a validated, open-access tool commonly used in research to measure changes in disability levels pre- and post-intervention.
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 9 Jan 2026.
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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.
FUI principal investigator
Foundation University Islamabad
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Post Isometric Relaxation and Post Isometric Stretching in people with Chronic Neck Pain, run by Foundation University Islamabad 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 4 inclusion and 11 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 9 Jan 2026. 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 Areeka Riasat, DPT (03219390688, arikariasat4830@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain Intensity (time frame: 1 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?
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 9 Jan 2026.