Non-specific Mechanical Neck PainINIT-NeckNCT07694102
Effect of Integrated Neuromuscular Inhibition Technique on Patients With Non-Specific Neck Pain
A study testing Integrated Neuromuscular Inhibition Technique (INIT), Conventional Physiotherapy and Cervical Mobilization in people with Non-specific Mechanical Neck Pain, run by Ibadat International University, Islamabad at 1 site in Pakistan.
Trial summary
Non-specific mechanical neck pain (NSNP) is a common musculoskeletal condition that causes neck pain, reduced movement, and difficulty performing daily activities. Manual therapy techniques are frequently used to manage this condition; however, evidence regarding the combined use of Integrated Neuromuscular Inhibition… Read more about this study
- Who is it for?
- Ages 30 to 60 years
- Conditions the study is for
- Non-specific Mechanical Neck Pain
- What is being tested?
- Integrated Neuromuscular Inhibition Technique (INIT), Conventional Physiotherapy and Cervical Mobilization
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 42 participants
- Where
- 1 sitePakistan
- Study dates
- 10 Jan 2026to 2 Jul 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 30 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Adults aged 30 to 60 years.
- Clinical diagnosis of non-specific mechanical neck pain.
- Neck pain duration of less than 6 months.
- Painful cervical extension and rotation.
- Negative Sharp-Purser test.
- Negative vertebral artery insufficiency test.
- No history of whiplash injury.
- Able and willing to provide written informed consent and comply with the study protocol
Who cannot join
- Specific causes of neck pain (e.g., fracture, infection, tumor, inflammatory disease, or cervical myelopathy).
- History of cervical spine surgery.
- Positive Sharp-Purser test or vertebral artery insufficiency test.
- History of whiplash injury.
- Neurological disorders affecting the cervical spine or upper extremities.
- Pregnancy.
- Receipt of physiotherapy or manual therapy for neck pain within the previous 4 weeks.
- Any medical condition that would prevent safe participation in the intervention or outcome assessment.
Trial locations and contacts
1 site in 1 country.
Pakistan1 site
Physical Medicine and Rehabilitation Department, Fauji Foundation Hospital
Islamabad, 44800
About this study
Non-specific mechanical neck pain (NSNP) is a common musculoskeletal condition that causes neck pain, reduced movement, and difficulty performing daily activities. Manual therapy techniques are frequently used to manage this condition; however, evidence regarding the combined use of Integrated Neuromuscular Inhibition Technique (INIT) and cervical mobilization remains limited.
This randomized controlled trial aims to compare the effectiveness of INIT combined with cervical mobilization versus cervical mobilization with conventional physiotherapy in adults with non-specific mechanical neck pain. Forty-two participants aged 30-60 years will be allocated to one of two treatment groups. The experimental group will receive INIT, consisting of muscle energy technique, strain-counterstrain, and ischemic compression, in addition to cervical mobilization. The control group will receive cervical mobilization with conventional physiotherapy modalities. Both groups will receive five treatment sessions.
The primary outcomes are pain intensity, neck-related disability, and cervical range of motion. Outcomes will be assessed before treatment and after completion of the intervention using the Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), and cervical range of motion measurements. The findings of this study are expected to determine whether adding INIT to cervical mobilization provides greater improvements in pain, cervical mobility, and functional ability than conventional physiotherapy alone, thereby supporting evidence-based management of non-specific mechanical neck pain.
Read the detailed description
Non-specific mechanical neck pain (NSNP) is one of the most prevalent musculoskeletal disorders worldwide and is associated with pain, reduced cervical mobility, functional limitations, decreased work productivity, and impaired quality of life. The condition is commonly related to myofascial trigger points, altered neuromuscular control, muscle imbalance, postural dysfunction, and restricted cervical joint mobility. Although conventional physiotherapy, including electrotherapy and cervical mobilization, has demonstrated beneficial effects, many patients continue to experience persistent symptoms and recurrent episodes.
Integrated Neuromuscular Inhibition Technique (INIT) is a multimodal manual therapy approach that combines muscle energy technique (MET), strain-counterstrain, and ischemic compression to address both myofascial and neuromuscular dysfunction. These techniques are intended to reduce pain, deactivate myofascial trigger points, improve muscle extensibility, restore neuromuscular control, and increase cervical range of motion. Previous studies have demonstrated promising results for INIT; however, evidence regarding its effectiveness when combined with cervical mobilization remains limited.
This study is a prospective, randomized, parallel-group controlled trial conducted at the Physiotherapy Outpatient Department of Fauji Foundation Hospital, Rawalpindi, Pakistan. Forty-two participants diagnosed with non-specific mechanical neck pain will be allocated equally to either an experimental group receiving INIT combined with cervical mobilization or a control group receiving cervical mobilization with conventional physiotherapy. Each participant will complete five treatment sessions.
The primary outcome measures include pain intensity assessed using the Numeric Pain Rating Scale (NPRS), neck-related disability assessed using the Neck Disability Index (NDI), and cervical range of motion measured with a universal goniometer. Assessments will be performed at baseline and immediately after completion of the treatment protocol.
The study aims to determine whether the addition of INIT to cervical mobilization results in superior improvements in pain, cervical mobility, and functional disability compared with conventional physiotherapy. The findings are expected to provide high-quality evidence regarding the clinical effectiveness of this multimodal manual therapy approach and may contribute to improving rehabilitation strategies and clinical practice guidelines for the management of non-specific mechanical neck pain.
- Conditions
- Non-specific Mechanical Neck Pain
- Being tested
- Integrated Neuromuscular Inhibition Technique (INIT), Conventional Physiotherapy, Cervical Mobilization
- Keywords
- Integrated Neuromuscular Inhibition Technique, Cervical Mobilization, Muscle Energy Technique, Strain Counterstrain, Ischemic Compression
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Integrated Neuromuscular Inhibition Technique (INIT)Procedure or surgery
Integrated Neuromuscular Inhibition Technique (INIT) is a multimodal manual therapy consisting of Muscle Energy Technique (MET), Strain-Counterstrain (SCS), and Ischemic Compression (IC). The intervention targets myofascial trigger points, muscle tightness, and neuromuscular dysfunction to reduce pain, improve cervical range of motion, and decrease functional disability. Participants received INIT in combination with cervical mobilization during five treatment sessions.
Conventional PhysiotherapyProcedure or surgery
Conventional physiotherapy consisted of transcutaneous electrical nerve stimulation (TENS) applied for 15 minutes and hot pack therapy applied to the cervical and upper back region for 10-15 minutes. These modalities were provided together with cervical mobilization during each of the five treatment sessions.
Cervical MobilizationProcedure or surgery
Cervical mobilization was performed using Maitland mobilization techniques applied to the cervical spine (C1-C7) to improve joint mobility, reduce pain, and restore cervical range of motion. Mobilization was administered in three sets of ten repetitions during each of the five treatment sessions. This intervention was provided to participants in both study groups.
| Study group | Role | What they receive |
|---|---|---|
| Integrated Neuromuscular Inhibition Technique + Cervical Mobilization | Experimental | Participants receive the Integrated Neuromuscular Inhibition Technique (muscle energy technique, strain-counterstrain, and ischemic compression) combined with cervical mobilization and conventional physiotherapy for five treatment sessions. Receives: Procedure: Integrated Neuromuscular Inhibition Technique (INIT); Procedure: Cervical Mobilization |
| Conventional Physiotherapy + Cervical Mobilization | Active comparator | Participants receive cervical mobilization together with conventional physiotherapy, including TENS and hot pack therapy, for five treatment sessions. Receives: Procedure: Conventional Physiotherapy; Procedure: Cervical Mobilization |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain Intensity
Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), an 11-point validated scale ranging from 0 (no pain) to 10 (worst imaginable pain). Lower scores indicate reduced pain intensity.
Measured: Baseline and immediately after completion of five treatment sessions (approximately 1 week).
Neck-Related Disability
Neck-related disability will be evaluated using the Neck Disability Index (NDI), a validated 10-item questionnaire with total scores ranging from 0 to 50. Higher scores indicate greater disability, while lower scores indicate improvement in functional status.
Measured: Baseline and immediately after completion of five treatment sessions (approximately 1 week).
Cervical Range of Motion
Active cervical extension and rotation will be measured using a universal goniometer. Changes in cervical range of motion will be compared between groups to evaluate improvements in cervical mobility following the intervention.
Measured: Baseline and immediately after completion of five treatment sessions (approximately 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 Jul 2026
- Study start10 Jan 2026
- Primary completion1 Jul 2026
- Study completion2 Jul 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Non-specific 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
- Model description
- Participants are assigned to one of two groups and remain in that group for the duration of the study. This is the standard definition of a parallel-group randomized controlled trial.
- Masking
- None (open label)
- Enrolment
- 42 participants (actual)
Sponsor and investigators
- Lead sponsor
- Ibadat International University, Islamabad
- Sponsor type
- University, hospital or other
- Collaborators
- Riphah International University
- Responsible party
- Sponsor
- Investigators
- Dr Hafiz Masood Ahmad Tahir, MSPT, Principal investigator, Fauji Foundation Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07694102
- Sponsor's protocol ID
- RIPHAH/RCRS/REC/Letter-00410
- Acronym
- INIT-Neck
- Status last verified
- Jul 2026
- First submitted
- 3 Jul 2026
- Last updated
- 1 Sep 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data (IPD) will not be shared because participant consent did not include permission for public data sharing, and the study institution does not have a policy supporting external sharing of de-identified participant-level data. Results will be reported in aggregate form to protect participant confidentiality.
Study at a glance
From the registry record, last updated by the sponsor on 1 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Integrated Neuromuscular Inhibition Technique on Patients With Non-Specific Neck Pain
- ClinicalTrials.gov ID
- NCT07694102
- Acronym / sponsor ID
- INIT-Neck / RIPHAH/RCRS/REC/Letter-00410
- Conditions
- Non-specific Mechanical Neck Pain
- Keywords
- Integrated Neuromuscular Inhibition Technique, Cervical Mobilization, Muscle Energy Technique, Strain Counterstrain, Ischemic Compression
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 42 participants (actual)
- Lead sponsor
- Ibadat International University, IslamabadUniversity, hospital or other
- Collaborators
- Riphah International University
- Study start
- 10 Jan 2026 (actual)
- Primary completion
- 1 Jul 2026 (actual)
- Study completion
- 2 Jul 2026 (actual)
- First posted
- 9 Jul 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.
Non-specific mechanical neck pain (NSNP) is a common musculoskeletal condition that causes neck pain, reduced movement, and difficulty performing daily activities. Manual therapy techniques are frequently used to manage this condition; however, evidence regarding the combined use of Integrated Neuromuscular Inhibition Technique (INIT) and cervical mobilization remains limited.
This randomized controlled trial aims to compare the effectiveness of INIT combined with cervical mobilization versus cervical mobilization with conventional physiotherapy in adults with non-specific mechanical neck pain. Forty-two participants aged 30-60 years will be allocated to one of two treatment groups. The experimental group will receive INIT, consisting of muscle energy technique, strain-counterstrain, and ischemic compression, in addition to cervical mobilization. The control group will receive cervical mobilization with conventional physiotherapy modalities. Both groups will receive five treatment sessions.
The primary outcomes are pain intensity, neck-related disability, and cervical range of motion. Outcomes will be assessed before treatment and after completion of the intervention using the Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), and cervical range of motion measurements. The findings of this study are expected to determine whether adding INIT to cervical mobilization provides greater improvements in pain, cervical mobility, and functional ability than conventional physiotherapy alone, thereby supporting evidence-based management of non-specific mechanical neck pain.
Detailed description
Non-specific mechanical neck pain (NSNP) is one of the most prevalent musculoskeletal disorders worldwide and is associated with pain, reduced cervical mobility, functional limitations, decreased work productivity, and impaired quality of life. The condition is commonly related to myofascial trigger points, altered neuromuscular control, muscle imbalance, postural dysfunction, and restricted cervical joint mobility. Although conventional physiotherapy, including electrotherapy and cervical mobilization, has demonstrated beneficial effects, many patients continue to experience persistent symptoms and recurrent episodes.
Integrated Neuromuscular Inhibition Technique (INIT) is a multimodal manual therapy approach that combines muscle energy technique (MET), strain-counterstrain, and ischemic compression to address both myofascial and neuromuscular dysfunction. These techniques are intended to reduce pain, deactivate myofascial trigger points, improve muscle extensibility, restore neuromuscular control, and increase cervical range of motion. Previous studies have demonstrated promising results for INIT; however, evidence regarding its effectiveness when combined with cervical mobilization remains limited.
This study is a prospective, randomized, parallel-group controlled trial conducted at the Physiotherapy Outpatient Department of Fauji Foundation Hospital, Rawalpindi, Pakistan. Forty-two participants diagnosed with non-specific mechanical neck pain will be allocated equally to either an experimental group receiving INIT combined with cervical mobilization or a control group receiving cervical mobilization with conventional physiotherapy. Each participant will complete five treatment sessions.
The primary outcome measures include pain intensity assessed using the Numeric Pain Rating Scale (NPRS), neck-related disability assessed using the Neck Disability Index (NDI), and cervical range of motion measured with a universal goniometer. Assessments will be performed at baseline and immediately after completion of the treatment protocol.
The study aims to determine whether the addition of INIT to cervical mobilization results in superior improvements in pain, cervical mobility, and functional disability compared with conventional physiotherapy. The findings are expected to provide high-quality evidence regarding the clinical effectiveness of this multimodal manual therapy approach and may contribute to improving rehabilitation strategies and clinical practice guidelines for the management of non-specific mechanical neck pain.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Participants are assigned to one of two groups and remain in that group for the duration of the study. This is the standard definition of a parallel-group randomized controlled trial.
| Arm | Type | Receives |
|---|---|---|
| Integrated Neuromuscular Inhibition Technique + Cervical Mobilization | Experimental | Procedure: Integrated Neuromuscular Inhibition Technique (INIT), Procedure: Cervical MobilizationParticipants receive the Integrated Neuromuscular Inhibition Technique (muscle energy technique, strain-counterstrain, and ischemic compression) combined with cervical mobilization and conventional physiotherapy for five treatment sessions. |
| Conventional Physiotherapy + Cervical Mobilization | Active comparator | Procedure: Conventional Physiotherapy, Procedure: Cervical MobilizationParticipants receive cervical mobilization together with conventional physiotherapy, including TENS and hot pack therapy, for five treatment sessions. |
Who may qualify
- Ages
- 30 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (8 listed)
- Adults aged 30 to 60 years.
- Clinical diagnosis of non-specific mechanical neck pain.
- Neck pain duration of less than 6 months.
- Painful cervical extension and rotation.
- Negative Sharp-Purser test.
Key exclusion criteria (8 listed)
- Specific causes of neck pain (e.g., fracture, infection, tumor, inflammatory disease, or cervical myelopathy).
- History of cervical spine surgery.
- Positive Sharp-Purser test or vertebral artery insufficiency test.
- History of whiplash injury.
- Neurological disorders affecting the cervical spine or upper extremities.
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 |
|---|---|---|
| Integrated Neuromuscular Inhibition Technique (INIT)Integrated Neuromuscular Inhibition Technique (INIT) is a multimodal manual therapy consisting of Muscle Energy Technique (MET), Strain-Counterstrain (SCS), and Ischemic Compression (IC). The intervention targets myofascial trigger points, muscle tightness, and neuromuscular dysfunction to reduce pain, improve cervical range of motion, and decrease functional disability. Participants received INIT in combination with cervical mobilization during five treatment sessions. | Procedure or surgery | Integrated Neuromuscular Inhibition Technique + Cervical Mobilization |
| Conventional PhysiotherapyConventional physiotherapy consisted of transcutaneous electrical nerve stimulation (TENS) applied for 15 minutes and hot pack therapy applied to the cervical and upper back region for 10-15 minutes. These modalities were provided together with cervical mobilization during each of the five treatment sessions. | Procedure or surgery | Conventional Physiotherapy + Cervical Mobilization |
| Cervical MobilizationCervical mobilization was performed using Maitland mobilization techniques applied to the cervical spine (C1-C7) to improve joint mobility, reduce pain, and restore cervical range of motion. Mobilization was administered in three sets of ten repetitions during each of the five treatment sessions. This intervention was provided to participants in both study groups. | Procedure or surgery | Conventional Physiotherapy + Cervical Mobilization, Integrated Neuromuscular Inhibition Technique + Cervical Mobilization |
Primary outcome
Pain Intensity
Time frame: Baseline and immediately after completion of five treatment sessions (approximately 1 week).
Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), an 11-point validated scale ranging from 0 (no pain) to 10 (worst imaginable pain). Lower scores indicate reduced pain intensity.
Neck-Related Disability
Time frame: Baseline and immediately after completion of five treatment sessions (approximately 1 week).
Neck-related disability will be evaluated using the Neck Disability Index (NDI), a validated 10-item questionnaire with total scores ranging from 0 to 50. Higher scores indicate greater disability, while lower scores indicate improvement in functional status.
Cervical Range of Motion
Time frame: Baseline and immediately after completion of five treatment sessions (approximately 1 week).
Active cervical extension and rotation will be measured using a universal goniometer. Changes in cervical range of motion will be compared between groups to evaluate improvements in cervical mobility following the 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 1 Sep 2026.
- Individual participant dataSharing planned: No. Individual participant data (IPD) will not be shared because participant consent did not include permission for public data sharing, and the study institution does not have a policy supporting external sharing of de-identified participant-level data. Results will be reported in aggregate form to protect participant confidentiality.
Related trials for Non-specific Mechanical Neck Pain
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Comparing Between Mulligan Technique and Active Release Technique in Treatment of Chronic Mechanical Neck Pain
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Effect of Attentional Focus Order in Home Exercise for Neck Pain
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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.
Dr Hafiz Masood Ahmad Tahir, MSPT principal investigator
Fauji Foundation Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Integrated Neuromuscular Inhibition Technique (INIT), Conventional Physiotherapy and Cervical Mobilization in people with Non-specific Mechanical Neck Pain, run by Ibadat International 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 8 inclusion and 8 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 1 Sep 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 immediately after completion of five treatment sessions (approximately 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 1 Sep 2026.