Cervical Spinal StenosisNF-DNFNCT07604935
Comparative Effects of Nerve Flossing and Deep Neck Flexor Muscle Strengthening on Pain, Range of Motion and Functional Disability on Cervical Spinal Stenosis
A study testing Nerve Flossing and Deep Neck Flexor Strengthening in people with Cervical Spinal Stenosis, run by Green International University at 1 site in Pakistan.
Trial summary
The goal of this randomized clinical trial is to compare the effectiveness of Nerve Flossing and Deep Neck Flexor strengthening exercises in individuals with cervical spinal stenosis. Read more about this study
- Who is it for?
- Ages 20 to 50 years
- Conditions the study is for
- Cervical Spinal Stenosis
- What is being tested?
- Nerve Flossing and Deep Neck Flexor Strengthening
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 62 participants
- Where
- 1 sitePakistan
- Study dates
- 6 Apr 2026to 6 May 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 to 50 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Adults aged 20-50 years, both male and female.
- Clinical and radiological (MRI) diagnosis of cervical spinal stenosis.
- Cervical pain with or without radiating to the upper limb.
- At least one neurological sign, such as sensory disturbance, muscle weakness or diminished reflexes.
- Symptoms present for more than 4 weeks but less than 6 months.
- Ability to understand and follow exercise instructions.
- VAS pain score ≥ 3/10 at baseline.
Who cannot join
- History of cervical spine surgery
- Recent trauma, fracture, or cervical instability.
- History of disc herniation involving surgery.
- Other neurological or musculoskeletal conditions, including peripheral neuropathy, thoracic outlet syndrome, and rheumatoid arthritis.
- Pregnancy.
- Recent medication use that may impact nerve function (e.g., systemic steroids).
Trial locations and contacts
1 site in 1 country.
About this study
The goal of this randomized clinical trial is to compare the effectiveness of Nerve Flossing and Deep Neck Flexor strengthening exercises in individuals with cervical spinal stenosis. The study aims to determine which treatment is more effective in reducing neck pain, improving cervical range of motion, and enhancing the ability to perform daily activities. Participants will be randomly assigned to receive either Nerve Flossing or Deep Neck Flexor exercises for specified duration. Both groups will attend physiotherapy sessions 3 times per week as assigned. Outcomes such as pain intensity, neck disability, and range of motion will be measured before and after the intervention using standard assessment tools. This study will help identify a more effective physiotherapy approach for managing symptoms of cervical spinal stenosis.
Read the detailed description
Cervical spinal stenosis is a condition characterized by narrowing of the spinal canal in the cervical region, leading to compression of neural structures. This often results in neck pain, reduced cervical range of motion, and functional disability that affects daily activities and quality of life. Conservative management through physiotherapy is the preferred initial approach before considering surgical intervention. Among conservative techniques, Nerve Flossing and Deep Neck Flexor strengthening are commonly used but their comparative effectiveness remains unclear. Nerve Flossing involves controlled, low-amplitude movements of the neck and upper limb to mobilize neural tissues and reduce nerve-related pain and sensitivity. Deep Neck Flexor strengthening uses specific low-load exercises to improve the activation and endurance of the deep cervical flexors that support head and neck posture. This study is conducted to address the gap in evidence by directly comparing these two interventions in patients with cervical spinal stenosis. The findings will help physiotherapists and clinicians select the most effective treatment approach for reducing pain and improving function in this population.
- Conditions
- Cervical Spinal Stenosis
- Being tested
- Nerve Flossing, Deep Neck Flexor Strengthening
- Keywords
- Cervical Spinal Stenosis, Nerve Flossing, Neural Mobilization, Deep Neck Flexor, Neck Pain, Cervical Spine, Physiotherapy, Physical Therapy, Neck Disability, Range of Motion
- Medical subject headings
- Neck Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Nerve FlossingBehavioural
Also called Group A
This intervention involves controlled, low-amplitude movements of the neck and upper limb to mobilize the cervical and upper limb neural tissues. The technique aims to reduce mechanical sensitivity of the nerves, improve neural mobility, and alleviate nerve-related pain in patients with cervical spinal stenosis. The specific dosage, frequency, and duration will be applied as per the study protocol.
Deep Neck Flexor StrengtheningBehavioural
Also called Group B
Low-load, targeted exercises to improve activation and endurance of the deep cervical flexor muscles. Focuses on enhancing cervical stability and posture. Frequency, duration, and repetitions will follow the study protocol.
| Study group | Role | What they receive |
|---|---|---|
| Nerve Flossing Group | Experimental | Participants in this arm will receive Nerve Flossing techniques targeting the cervical and upper limb neural tissues. The intervention involves controlled, low-amplitude movements of the neck and upper limb to improve neural mobility. Sessions will be conducted as per the study protocol. Receives: Behavioral: Nerve Flossing |
| Deep Neck Flexor Strengthening Group | Experimental | Participants in this arm will receive Deep Neck Flexor strengthening exercises using low-load, targeted movements to improve activation and strength of the deep cervical flexor muscles. The exercises focus on enhancing cervical stability and posture. Sessions will be conducted as per the study protocol. Receives: Behavioral: Deep Neck Flexor Strengthening |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain Intensity
Pain intensity will be measured using the Visual Analogue Scale (VAS), where participants mark their pain level on 100mm line ranging from "no pain" (0) to "worst imaginable pain (100). Higher scores indicate greater pain intensity.
Measured: Baseline and 12 weeks post-intervention
Secondary outcomes (2)
Change in Neck Disability Index Score
Change in neck-related disability from baseline to 6 weeks and post-intervention, measured using the Neck Disability Index (NDI) on a scale of 0-50. Higher scores indicate greater disability.
Measured: Baseline and 12 weeks post-intervention
Change in Cervical Range of Motion
Change in cervical flexion, extension, and rotation range of motion from baseline to 6 weeks and 12 weeks, measured by using inclinometer.
Measured: Baseline and 12 weeks post-intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 May 2026
- Study start6 Apr 2026
- Primary completion29 Apr 2026
- Study completion6 May 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Cervical Spinal StenosisStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- This is a randomized, parallel-group interventional study with two arms. Participants diagnosed with cervical spinal stenosis will be randomly assigned to either Arm 1, receiving Nerve Flossing techniques, or Arm 2, receiving Deep Neck Flexor strengthening exercises. Each group will follow their assigned intervention for the specified duration. Outcomes will be assessed at baseline and post-intervention to compare the effectiveness between the two treatment arms.
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Outcomes assessor
- Enrolment
- 62 participants (actual)
Sponsor and investigators
- Lead sponsor
- Green International University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Akasha Khan, Green International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07604935
- Sponsor's protocol ID
- GIU/REC/26-34
- Acronym
- NF-DNF
- Status last verified
- May 2026
- First submitted
- 17 May 2026
- Last updated
- 22 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Only IPD used in the results publication will be shared
Study at a glance
From the registry record, last updated by the sponsor on 22 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effects of Nerve Flossing and Deep Neck Flexor Muscle Strengthening on Pain, Range of Motion and Functional Disability on Cervical Spinal Stenosis
- ClinicalTrials.gov ID
- NCT07604935
- Acronym / sponsor ID
- NF-DNF / GIU/REC/26-34
- Conditions
- Cervical Spinal Stenosis
- Keywords
- Cervical Spinal Stenosis, Nerve Flossing, Neural Mobilization, Deep Neck Flexor, Neck Pain, Cervical Spine, Physiotherapy, Physical Therapy
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 62 participants (actual)
- Lead sponsor
- Green International UniversityUniversity, hospital or other
- Study start
- 6 Apr 2026 (actual)
- Primary completion
- 29 Apr 2026 (actual)
- Study completion
- 6 May 2026 (actual)
- First posted
- 22 May 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.
The goal of this randomized clinical trial is to compare the effectiveness of Nerve Flossing and Deep Neck Flexor strengthening exercises in individuals with cervical spinal stenosis. The study aims to determine which treatment is more effective in reducing neck pain, improving cervical range of motion, and enhancing the ability to perform daily activities. Participants will be randomly assigned to receive either Nerve Flossing or Deep Neck Flexor exercises for specified duration. Both groups will attend physiotherapy sessions 3 times per week as assigned. Outcomes such as pain intensity, neck disability, and range of motion will be measured before and after the intervention using standard assessment tools. This study will help identify a more effective physiotherapy approach for managing symptoms of cervical spinal stenosis.
Detailed description
Cervical spinal stenosis is a condition characterized by narrowing of the spinal canal in the cervical region, leading to compression of neural structures. This often results in neck pain, reduced cervical range of motion, and functional disability that affects daily activities and quality of life. Conservative management through physiotherapy is the preferred initial approach before considering surgical intervention. Among conservative techniques, Nerve Flossing and Deep Neck Flexor strengthening are commonly used but their comparative effectiveness remains unclear. Nerve Flossing involves controlled, low-amplitude movements of the neck and upper limb to mobilize neural tissues and reduce nerve-related pain and sensitivity. Deep Neck Flexor strengthening uses specific low-load exercises to improve the activation and endurance of the deep cervical flexors that support head and neck posture. This study is conducted to address the gap in evidence by directly comparing these two interventions in patients with cervical spinal stenosis. The findings will help physiotherapists and clinicians select the most effective treatment approach for reducing pain and improving function in this population.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, outcomes assessor)
- Number of arms
- 2
- Model description
- This is a randomized, parallel-group interventional study with two arms. Participants diagnosed with cervical spinal stenosis will be randomly assigned to either Arm 1, receiving Nerve Flossing techniques, or Arm 2, receiving Deep Neck Flexor strengthening exercises. Each group will follow their assigned intervention for the specified duration. Outcomes will be assessed at baseline and post-intervention to compare the effectiveness between the two treatment arms.
| Arm | Type | Receives |
|---|---|---|
| Nerve Flossing Group | Experimental | Behavioral: Nerve FlossingParticipants in this arm will receive Nerve Flossing techniques targeting the cervical and upper limb neural tissues. The intervention involves controlled, low-amplitude movements of the neck and upper limb to improve neural mobility. Sessions will be conducted as per the study protocol. |
| Deep Neck Flexor Strengthening Group | Experimental | Behavioral: Deep Neck Flexor StrengtheningParticipants in this arm will receive Deep Neck Flexor strengthening exercises using low-load, targeted movements to improve activation and strength of the deep cervical flexor muscles. The exercises focus on enhancing cervical stability and posture. Sessions will be conducted as per the study protocol. |
Who may qualify
- Ages
- 20 to 50 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (7 listed)
- Adults aged 20-50 years, both male and female.
- Clinical and radiological (MRI) diagnosis of cervical spinal stenosis.
- Cervical pain with or without radiating to the upper limb.
- At least one neurological sign, such as sensory disturbance, muscle weakness or diminished reflexes.
- Symptoms present for more than 4 weeks but less than 6 months.
Key exclusion criteria (6 listed)
- History of cervical spine surgery
- Recent trauma, fracture, or cervical instability.
- History of disc herniation involving surgery.
- Other neurological or musculoskeletal conditions, including peripheral neuropathy, thoracic outlet syndrome, and rheumatoid arthritis.
- Pregnancy.
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 |
|---|---|---|
| Nerve FlossingAlso: Group AThis intervention involves controlled, low-amplitude movements of the neck and upper limb to mobilize the cervical and upper limb neural tissues. The technique aims to reduce mechanical sensitivity of the nerves, improve neural mobility, and alleviate nerve-related pain in patients with cervical spinal stenosis. The specific dosage, frequency, and duration will be applied as per the study protocol. | Behavioural | Nerve Flossing Group |
| Deep Neck Flexor StrengtheningAlso: Group BLow-load, targeted exercises to improve activation and endurance of the deep cervical flexor muscles. Focuses on enhancing cervical stability and posture. Frequency, duration, and repetitions will follow the study protocol. | Behavioural | Deep Neck Flexor Strengthening Group |
Primary outcome
Pain Intensity
Time frame: Baseline and 12 weeks post-intervention
Pain intensity will be measured using the Visual Analogue Scale (VAS), where participants mark their pain level on 100mm line ranging from "no pain" (0) to "worst imaginable pain (100). Higher scores indicate greater pain intensity.
2 secondary outcomes
Change in Neck Disability Index Score
Time frame: Baseline and 12 weeks post-intervention
Change in Cervical Range of Motion
Time frame: Baseline and 12 weeks post-intervention
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 May 2026.
- Individual participant dataSharing planned: Yes. Only IPD used in the results publication will be shared
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Nerve Flossing and Deep Neck Flexor Strengthening in people with Cervical Spinal Stenosis, run by Green 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 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: finished, as of the sponsor's last update on 22 May 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain Intensity (time frame: Baseline and 12 weeks post-intervention). 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 22 May 2026.