xml: <clinical_study>
    <!-- This xml conforms to an XML Schema at:
      https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
    <required_header>
      <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
      <link_text>Link to the current ClinicalTrials.gov record.</link_text>
      <url>https://clinicaltrials.gov/ct2/show/NCT06034223</url>
    </required_header>
    <id_info>
      <org_study_id>IRB # 0220-23</org_study_id>
      <nct_id>NCT06034223</nct_id>
    </id_info>
    <brief_title>Effect of Proprioceptive Training Using Head Mounted Laser in Chronic Mechanical Neck Pain</brief_title>
    <official_title>Effect of Proprioceptive Training Using Head Mounted Laser in Chronic Mechanical Neck Pain</official_title>
    <sponsors>
      <lead_sponsor>
        <agency>Shifa Tameer-e-Millat University</agency>
        <agency_class>Other</agency_class>
      </lead_sponsor>
    </sponsors>
    <source>Shifa Tameer-e-Millat University</source>
    <oversight_info>
      <has_dmc>No</has_dmc>
      <is_fda_regulated_drug>No</is_fda_regulated_drug>
      <is_fda_regulated_device>No</is_fda_regulated_device>
    </oversight_info>
    <brief_summary>
      <textblock>
        The purpose of this study is to compare the effect of conventional physical therapy with and&#xD;
        without cervical proprioceptive training using head mounted laser system on cervical joint&#xD;
        position sense error, pain, cervical range of motion and neck disability index.&#xD;
        Proprioception disturbs in any function and structural impairments that is mechanical neck&#xD;
        pain. Different studies has been done to find out the best therapy for pain management. our&#xD;
        aim is to give cost effective, not so time consuming, most effective physcial therapy&#xD;
        treatment. A literature gap exists on the effects of proprioceptive training combined with&#xD;
        conventional physical therapy, no studies have directly compared the effect of proprioceptive&#xD;
        training using head mounted laser with and without conventional physical therapy. In our&#xD;
        clinical setting, proprioceptive training for mechanical neck pain is not used as much as it&#xD;
        should be. It would be a new thing to add and it can be cost effective and better treatment&#xD;
        for symptoms resolution&#xD;
      </textblock>
    </brief_summary>
    <detailed_description>
      <textblock>
        Mechanical neck pain (MNP) is a common condition, affecting 30% to 50% of the general&#xD;
        population, and is most prevalent in middle age. It is responsible for reducing the quality&#xD;
        of life and one of the leading causes of disability worldwide with annual prevalence of&#xD;
        48.5%. Mechanical neck pain is characterized by several structural and functional features.&#xD;
        The causes of MNP include structural and functional impairment of cervical muscles,&#xD;
        degenerative changes of cervical spine, arthritis, inflammation, and trauma, abnormal&#xD;
        posture, and movements. Current studies have found that one of the main problems in patients&#xD;
        with MNP is the impairment of cervical proprioception. decreased range of motion (ROM) and&#xD;
        functional ability, greater muscle fatigability and a reduction in the strength and endurance&#xD;
        capacity of the muscles.&#xD;
  &#xD;
        In spite of neck disorders being so common in the population, little evidence supporting&#xD;
        effective interventions has been identified. Conservative treatments used to help manage MNP&#xD;
        are numerous and include usual medical care various forms of exercise, massage, and&#xD;
        acupuncture. Medications, manual therapies, and exercise are the most widely used treatment&#xD;
        modalities for MNP. 33% of individuals with neck pain sought care from physical therapy.&#xD;
        Physical therapy improves pain, function and patient satisfaction in adults suffering from&#xD;
        MNP, improves neck disability index. Physical therapy treatment includes cervical and&#xD;
        thoracic spine mobilization/manipulation techniques active and passive exercise, ultrasound,&#xD;
        transcutaneous electrical nerve stimulation, patient education. Spinal manipulative therapy&#xD;
        (SMT), trigger point dry needling and trigger point manual therapy.&#xD;
  &#xD;
        Proprioception is the sense of perceiving self-movement, action of parts of the body and&#xD;
        location. It is a term commonly used to describe the ascending information by the afferent&#xD;
        receptors towards the central nervous system contributing to the neuromuscular control of&#xD;
        movement and encompasses the sensation of joint movement (kinaesthesia) and joint position&#xD;
        (joint position sense). Cervical spine has a very delicate proprioceptive system, which&#xD;
        signals the position of the head relative to the trunk, coordinates the vestibular and visual&#xD;
        systems and it plays a crucial role in controlling posture and balance and is of great&#xD;
        importance for the spatial orientation. The deficits of Proprioception of cervical spine have&#xD;
        been associated with age, pain muscle fatigue, forward head posture, cervical spondylosis,&#xD;
        reduce balance control and abnormal posture, decreased neck muscle strength and altered motor&#xD;
        control in the cervical spine.&#xD;
  &#xD;
        In last two decades the interest in the assessment and treatment of proprioception of the&#xD;
        cervical spine has increased exponentially. Cervical joint position sense (JPS) is a major&#xD;
        component of proprioception, and mainly reflects the ascending input (afferent) of cervical&#xD;
        muscle, disc, capsule, and ligament receptors. Proprioception is evaluated using the Joint&#xD;
        Position Sense Error (JPSE), which reflects a person's ability to accurately return his head&#xD;
        to a predefined target after a cervical movement.&#xD;
  &#xD;
        Evidence to date suggests that the management of sensorimotor control disturbances due to&#xD;
        chronic neck pain may need to address the primary causes and secondary effects of alterations&#xD;
        in proprioceptive activity. A variety of treatments are available for cervical spine&#xD;
        proprioception. It includes proprioception training, retraining of deep cervical flexor and&#xD;
        extensor muscles, and etiological management of pain, strength training, cervical&#xD;
        manipulation and acupuncture and many other conventional therapy protocols. Cervical&#xD;
        proprioception training not only improves patient perceived pain and disability, but also has&#xD;
        an effect on other aspects of neuromuscular function, specifically the coordination between&#xD;
        the deep and superficial cervical flexors and balance.&#xD;
      </textblock>
    </detailed_description>
    <overall_status>Recruiting</overall_status>
    <start_date type="Actual">September 5, 2023</start_date>
    <completion_date type="Anticipated">November 10, 2023</completion_date>
    <primary_completion_date type="Anticipated">November 1, 2023</primary_completion_date>
    <phase>N/A</phase>
    <study_type>Interventional</study_type>
    <has_expanded_access>No</has_expanded_access>
    <study_design_info>
      <allocation>Randomized</allocation>
      <intervention_model>Parallel Assignment</intervention_model>
      <intervention_model_description>the participants are divided into two groups, control group will recieve conventional physical therapy and experimental group will recieve proprioceptive training with conventional physcial therapy.</intervention_model_description>
      <primary_purpose>Treatment</primary_purpose>
      <masking>Single (Participant)</masking>
      <masking_description>It is a single blinded study in which participants will be alocated in two groups using simple random sampling.</masking_description>
    </study_design_info>
    <primary_outcome>
      <measure>cervical joint position sense error</measure>
      <time_frame>4 weeks</time_frame>
      <description>use for assess proprioception</description>
    </primary_outcome>
    <primary_outcome>
      <measure>bubble inclinometer</measure>
      <time_frame>4 weeks</time_frame>
      <description>use to assess cervical range of motion</description>
    </primary_outcome>
    <primary_outcome>
      <measure>numerical pain rating scale</measure>
      <time_frame>4 weeks</time_frame>
      <description>used for assessment of pain</description>
    </primary_outcome>
    <primary_outcome>
      <measure>neck disability index</measure>
      <time_frame>4 weeks</time_frame>
      <description>used for pain related disability</description>
    </primary_outcome>
    <number_of_arms>2</number_of_arms>
    <enrollment type="Anticipated">36</enrollment>
    <condition>Mechanical Neck Pain</condition>
    <arm_group>
      <arm_group_label>Experimental Group</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Conventional physical therapy along with proprioceptive training, head relocation practice that is relocating the head back to the natural head posture and to pre determined postions in range with eyes open. Tracing figure of eight with eyes open.&#xD;
  3 days per week for 4 weeks, 15 repititions, 1 set.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Control Group</arm_group_label>
      <arm_group_type>Other</arm_group_type>
      <description>Conventional physical therapy, cervical range of motion (flexion, extension, lateral flexion and rotation), isometric exercises of neck muscles, stretching (scalene, trapezius, sternocleidomastoid), TENS, heating pad.&#xD;
  3 days per week for 4 weeks, 15 repitions, 1 set.</description>
    </arm_group>
    <intervention>
      <intervention_type>Other</intervention_type>
      <intervention_name>Proprioceptive training using head mounted laser</intervention_name>
      <description>Exercises include head relocation practice, i.e., relocating the head back to the natural head posture and to pre-determined positions in range with eyes open using feedback from a laser attached to their head. And then tracing the figure of eight with the help of laser.</description>
      <arm_group_label>Experimental Group</arm_group_label>
    </intervention>
    <intervention>
      <intervention_type>Other</intervention_type>
      <intervention_name>Conventional Physical therpay</intervention_name>
      <description>Conventional physical therapy for mechanical neck pain which includes cervical range of motion (flexion, extension, lateral rotation, and rotation), neck isometric exercises, stretching's (scalene, trapezius, SCM) and TENS with heating pad.</description>
      <arm_group_label>Control Group</arm_group_label>
      <arm_group_label>Experimental Group</arm_group_label>
    </intervention>
    <eligibility>
      <criteria>
        <textblock>
          Inclusion Criteria:&#xD;
  &#xD;
            -  Both genders&#xD;
  &#xD;
            -  Age: 45 to 55 years&#xD;
  &#xD;
            -  Mechanical neck pain more than 3 months (chronic stage)&#xD;
  &#xD;
            -  Individuals having cervical radiculopathy (Spurling Test A and Spurling test B +ve)&#xD;
  &#xD;
            -  Decreased Range of motion (Flexion 80 to 90*) (Extension 70*) (Lateral Flexion 20 TO&#xD;
               45*) (Rotation 90*)&#xD;
  &#xD;
            -  Numeric Pain Rating Scale: 5 to 08&#xD;
  &#xD;
            -  Cervical spondylosis on Xray&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
            -  Individuals having vascular pathology of neck.&#xD;
  &#xD;
            -  Previous surgery related to cervical spine.&#xD;
  &#xD;
            -  Individuals having structural deformity of spine (Adam's forward bend test)&#xD;
  &#xD;
            -  Spinal Cord Injury /Cervical Myelopathy&#xD;
  &#xD;
            -  Malignancy and tumor&#xD;
  &#xD;
            -  Infection&#xD;
  &#xD;
            -  Previous history of Cervical spine fractures&#xD;
        </textblock>
      </criteria>
      <gender>All</gender>
      <minimum_age>45 Years</minimum_age>
      <maximum_age>55 Years</maximum_age>
      <healthy_volunteers>No</healthy_volunteers>
    </eligibility>
    <overall_official>
      <last_name>Nida Waseem, MS-PT*</last_name>
      <role>Principal Investigator</role>
      <affiliation>Shifa Tameer-e-millet University</affiliation>
    </overall_official>
    <overall_contact>
      <last_name>Syed Ali Hussain, PhD*</last_name>
      <phone>03315191713</phone>
      <email>alihussain_dpt.ahs@stmu.edu.pk</email>
    </overall_contact>
    <location>
      <facility>
        <name>Shifa Tameer-e-Millat University Islamabad</name>
        <address>
          <city>Islamabad</city>
          <state>Fedral</state>
          <zip>44000</zip>
          <country>Pakistan</country>
        </address>
      </facility>
      <status>Recruiting</status>
      <contact>
        <last_name>Manan Haider</last_name>
        <phone>+923334839819</phone>
        <email>m_manan.drs@stmu.edu.pk</email>
      </contact>
      <investigator>
        <last_name>nida Waseem, MS-PT*</last_name>
        <role>Principal Investigator</role>
      </investigator>
    </location>
    <location_countries>
      <country>Pakistan</country>
    </location_countries>
    <reference>
      <citation>Celenay ST, Akbayrak T, Kaya DO. A Comparison of the Effects of Stabilization Exercises Plus Manual Therapy to Those of Stabilization Exercises Alone in Patients With Nonspecific Mechanical Neck Pain: A Randomized Clinical Trial. J Orthop Sports Phys Ther. 2016 Feb;46(2):44-55. doi: 10.2519/jospt.2016.5979. Epub 2016 Jan 11.</citation>
      <PMID>26755405</PMID>
    </reference>
    <reference>
      <citation>Peng B, Yang L, Li Y, Liu T, Liu Y. Cervical Proprioception Impairment in Neck Pain-Pathophysiology, Clinical Evaluation, and Management: A Narrative Review. Pain Ther. 2021 Jun;10(1):143-164. doi: 10.1007/s40122-020-00230-z. Epub 2021 Jan 12.</citation>
      <PMID>33464539</PMID>
    </reference>
    <reference>
      <citation>Ganesh GS, Mohanty P, Pattnaik M, Mishra C. Effectiveness of mobilization therapy and exercises in mechanical neck pain. Physiother Theory Pract. 2015 Feb;31(2):99-106. doi: 10.3109/09593985.2014.963904. Epub 2014 Sep 29.</citation>
      <PMID>25264016</PMID>
    </reference>
    <reference>
      <citation>Sarig-Bahat H. Evidence for exercise therapy in mechanical neck disorders. Man Ther. 2003 Feb;8(1):10-20. doi: 10.1054/math.2002.0480.</citation>
      <PMID>12586557</PMID>
    </reference>
    <reference>
      <citation>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.</citation>
      <PMID>28826164</PMID>
    </reference>
    <reference>
      <citation>Vincent K, Maigne JY, Fischhoff C, Lanlo O, Dagenais S. Systematic review of manual therapies for nonspecific neck pain. Joint Bone Spine. 2013 Oct;80(5):508-15. doi: 10.1016/j.jbspin.2012.10.006. Epub 2012 Nov 16.</citation>
      <PMID>23165183</PMID>
    </reference>
    <reference>
      <citation>Gross AR, Kay T, Hondras M, Goldsmith C, Haines T, Peloso P, Kennedy C, Hoving J. Manual therapy for mechanical neck disorders: a systematic review. Man Ther. 2002 Aug;7(3):131-49. doi: 10.1054/math.2002.0465.</citation>
      <PMID>12372310</PMID>
    </reference>
    <reference>
      <citation>Walker MJ, Boyles RE, Young BA, Strunce JB, Garber MB, Whitman JM, Deyle G, Wainner RS. The effectiveness of manual physical therapy and exercise for mechanical neck pain: a randomized clinical trial. Spine (Phila Pa 1976). 2008 Oct 15;33(22):2371-8. doi: 10.1097/BRS.0b013e318183391e.</citation>
      <PMID>18923311</PMID>
    </reference>
    <reference>
      <citation>Leininger B, McDonough C, Evans R, Tosteson T, Tosteson AN, Bronfort G. Cost-effectiveness of spinal manipulative therapy, supervised exercise, and home exercise for older adults with chronic neck pain. Spine J. 2016 Nov;16(11):1292-1304. doi: 10.1016/j.spinee.2016.06.014. Epub 2016 Jun 23.</citation>
      <PMID>27345747</PMID>
    </reference>
    <reference>
      <citation>Llamas-Ramos R, Pecos-Martin D, Gallego-Izquierdo T, Llamas-Ramos I, Plaza-Manzano G, Ortega-Santiago R, Cleland J, Fernandez-de-Las-Penas C. Comparison of the short-term outcomes between trigger point dry needling and trigger point manual therapy for the management of chronic mechanical neck pain: a randomized clinical trial. J Orthop Sports Phys Ther. 2014 Nov;44(11):852-61. doi: 10.2519/jospt.2014.5229. Epub 2014 Sep 30. Erratum In: J Orthop Sports Phys Ther. 2015 Feb;45(2):147.</citation>
      <PMID>25269764</PMID>
    </reference>
    <reference>
      <citation>Strimpakos N, Sakellari V, Gioftsos G, Kapreli E, Oldham J. Cervical joint position sense: an intra- and inter-examiner reliability study. Gait Posture. 2006 Jan;23(1):22-31. doi: 10.1016/j.gaitpost.2004.11.019.</citation>
      <PMID>16311191</PMID>
    </reference>
    <reference>
      <citation>Reddy RS, Tedla JS, Dixit S, Abohashrh M. Cervical proprioception and its relationship with neck pain intensity in subjects with cervical spondylosis. BMC Musculoskelet Disord. 2019 Oct 15;20(1):447. doi: 10.1186/s12891-019-2846-z.</citation>
      <PMID>31615495</PMID>
    </reference>
    <reference>
      <citation>Reddy RS, Meziat-Filho N, Ferreira AS, Tedla JS, Kandakurti PK, Kakaraparthi VN. Comparison of neck extensor muscle endurance and cervical proprioception between asymptomatic individuals and patients with chronic neck pain. J Bodyw Mov Ther. 2021 Apr;26:180-186. doi: 10.1016/j.jbmt.2020.12.040. Epub 2020 Dec 31.</citation>
      <PMID>33992242</PMID>
    </reference>
    <reference>
      <citation>Vuillerme N, Pinsault N, Bouvier B. Cervical joint position sense is impaired in older adults. Aging Clin Exp Res. 2008 Aug;20(4):355-8. doi: 10.1007/BF03324868.</citation>
      <PMID>18852550</PMID>
    </reference>
    <reference>
      <citation>de Vries J, Ischebeck BK, Voogt LP, van der Geest JN, Janssen M, Frens MA, Kleinrensink GJ. Joint position sense error in people with neck pain: A systematic review. Man Ther. 2015 Dec;20(6):736-44. doi: 10.1016/j.math.2015.04.015. Epub 2015 May 2.</citation>
      <PMID>25983238</PMID>
    </reference>
    <reference>
      <citation>Pinsault N, Vuillerme N. Degradation of cervical joint position sense following muscular fatigue in humans. Spine (Phila Pa 1976). 2010 Feb 1;35(3):294-7. doi: 10.1097/BRS.0b013e3181b0c889.</citation>
      <PMID>20075783</PMID>
    </reference>
    <reference>
      <citation>Heikkila H, Johansson M, Wenngren BI. Effects of acupuncture, cervical manipulation and NSAID therapy on dizziness and impaired head repositioning of suspected cervical origin: a pilot study. Man Ther. 2000 Aug;5(3):151-7. doi: 10.1054/math.2000.0357.</citation>
      <PMID>11034885</PMID>
    </reference>
    <reference>
      <citation>Soysal M, Kara B, Arda MN. Assessment of physical activity in patients with chronic low back or neck pain. Turk Neurosurg. 2013;23(1):75-80. doi: 10.5137/1019-5149.JTN.6885-12.0.</citation>
      <PMID>23344871</PMID>
    </reference>
    <verification_date>September 2023</verification_date>
    <study_first_submitted>September 5, 2023</study_first_submitted>
    <study_first_submitted_qc>September 5, 2023</study_first_submitted_qc>
    <study_first_posted type="Actual">September 13, 2023</study_first_posted>
    <last_update_submitted>September 5, 2023</last_update_submitted>
    <last_update_submitted_qc>September 5, 2023</last_update_submitted_qc>
    <last_update_posted type="Actual">September 13, 2023</last_update_posted>
    <responsible_party>
      <responsible_party_type>Principal Investigator</responsible_party_type>
      <investigator_affiliation>Shifa Tameer-e-Millat University</investigator_affiliation>
      <investigator_full_name>Nouman Khan</investigator_full_name>
      <investigator_title>Lecturer</investigator_title>
    </responsible_party>
    <keyword>proprioception</keyword>
    <keyword>joint position sense error</keyword>
    <keyword>head mounted laser</keyword>
    <keyword>cervical range of motion</keyword>
    <condition_browse>
      <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
      <mesh_term>Neck Pain</mesh_term>
    </condition_browse>
    <patient_data>
      <sharing_ipd>No</sharing_ipd>
    </patient_data>
    <!-- Results have not yet been posted for this study                                          -->
  </clinical_study>
  
  
text: download date: ClinicalTrials.gov processed this data on September 20, 2023
  link text: Link to the current ClinicalTrials.gov record.
  url: https://clinicaltrials.gov/ct2/show/NCT06034223
  org study id: IRB # 0220-23
  nct id: NCT06034223
  lead sponsor: 
  has dmc: No
  is fda regulated drug: No
  is fda regulated device: No
  The purpose of this study is to compare the effect of conventional physical therapy with and
        without cervical proprioceptive training using head mounted laser system on cervical joint
        position sense error, pain, cervical range of motion and neck disability index.
        Proprioception disturbs in any function and structural impairments that is mechanical neck
        pain. Different studies has been done to find out the best therapy for pain management. our
        aim is to give cost effective, not so time consuming, most effective physcial therapy
        treatment. A literature gap exists on the effects of proprioceptive training combined with
        conventional physical therapy, no studies have directly compared the effect of proprioceptive
        training using head mounted laser with and without conventional physical therapy. In our
        clinical setting, proprioceptive training for mechanical neck pain is not used as much as it
        should be. It would be a new thing to add and it can be cost effective and better treatment
        for symptoms resolution
  Mechanical neck pain (MNP) is a common condition, affecting 30% to 50% of the general
        population, and is most prevalent in middle age. It is responsible for reducing the quality
        of life and one of the leading causes of disability worldwide with annual prevalence of
        48.5%. Mechanical neck pain is characterized by several structural and functional features.
        The causes of MNP include structural and functional impairment of cervical muscles,
        degenerative changes of cervical spine, arthritis, inflammation, and trauma, abnormal
        posture, and movements. Current studies have found that one of the main problems in patients
        with MNP is the impairment of cervical proprioception. decreased range of motion (ROM) and
        functional ability, greater muscle fatigability and a reduction in the strength and endurance
        capacity of the muscles.
  
        In spite of neck disorders being so common in the population, little evidence supporting
        effective interventions has been identified. Conservative treatments used to help manage MNP
        are numerous and include usual medical care various forms of exercise, massage, and
        acupuncture. Medications, manual therapies, and exercise are the most widely used treatment
        modalities for MNP. 33% of individuals with neck pain sought care from physical therapy.
        Physical therapy improves pain, function and patient satisfaction in adults suffering from
        MNP, improves neck disability index. Physical therapy treatment includes cervical and
        thoracic spine mobilization/manipulation techniques active and passive exercise, ultrasound,
        transcutaneous electrical nerve stimulation, patient education. Spinal manipulative therapy
        (SMT), trigger point dry needling and trigger point manual therapy.
  
        Proprioception is the sense of perceiving self-movement, action of parts of the body and
        location. It is a term commonly used to describe the ascending information by the afferent
        receptors towards the central nervous system contributing to the neuromuscular control of
        movement and encompasses the sensation of joint movement (kinaesthesia) and joint position
        (joint position sense). Cervical spine has a very delicate proprioceptive system, which
        signals the position of the head relative to the trunk, coordinates the vestibular and visual
        systems and it plays a crucial role in controlling posture and balance and is of great
        importance for the spatial orientation. The deficits of Proprioception of cervical spine have
        been associated with age, pain muscle fatigue, forward head posture, cervical spondylosis,
        reduce balance control and abnormal posture, decreased neck muscle strength and altered motor
        control in the cervical spine.
  
        In last two decades the interest in the assessment and treatment of proprioception of the
        cervical spine has increased exponentially. Cervical joint position sense (JPS) is a major
        component of proprioception, and mainly reflects the ascending input (afferent) of cervical
        muscle, disc, capsule, and ligament receptors. Proprioception is evaluated using the Joint
        Position Sense Error (JPSE), which reflects a person's ability to accurately return his head
        to a predefined target after a cervical movement.
  
        Evidence to date suggests that the management of sensorimotor control disturbances due to
        chronic neck pain may need to address the primary causes and secondary effects of alterations
        in proprioceptive activity. A variety of treatments are available for cervical spine
        proprioception. It includes proprioception training, retraining of deep cervical flexor and
        extensor muscles, and etiological management of pain, strength training, cervical
        manipulation and acupuncture and many other conventional therapy protocols. Cervical
        proprioception training not only improves patient perceived pain and disability, but also has
        an effect on other aspects of neuromuscular function, specifically the coordination between
        the deep and superficial cervical flexors and balance.
  allocation: Randomized
  intervention model: Parallel Assignment
  intervention model description: the participants are divided into two groups, control group will recieve conventional physical therapy and experimental group will recieve proprioceptive training with conventional physcial therapy.
  primary purpose: Treatment
  masking: Single (Participant)
  masking description: It is a single blinded study in which participants will be alocated in two groups using simple random sampling.
  measure: cervical joint position sense error
  time frame: 4 weeks
  description: use for assess proprioception
  measure: bubble inclinometer
  time frame: 4 weeks
  description: use to assess cervical range of motion
  measure: numerical pain rating scale
  time frame: 4 weeks
  description: used for assessment of pain
  measure: neck disability index
  time frame: 4 weeks
  description: used for pain related disability
  arm group label: Experimental Group
  arm group type: Experimental
  description: Conventional physical therapy along with proprioceptive training, head relocation practice that is relocating the head back to the natural head posture and to pre determined postions in range with eyes open. Tracing figure of eight with eyes open.
  3 days per week for 4 weeks, 15 repititions, 1 set.
  arm group label: Control Group
  arm group type: Other
  description: Conventional physical therapy, cervical range of motion (flexion, extension, lateral flexion and rotation), isometric exercises of neck muscles, stretching (scalene, trapezius, sternocleidomastoid), TENS, heating pad.
  3 days per week for 4 weeks, 15 repitions, 1 set.
  intervention type: Other
  intervention name: Proprioceptive training using head mounted laser
  description: Exercises include head relocation practice, i.e., relocating the head back to the natural head posture and to pre-determined positions in range with eyes open using feedback from a laser attached to their head. And then tracing the figure of eight with the help of laser.
  arm group label: Experimental Group
  intervention type: Other
  intervention name: Conventional Physical therpay
  description: Conventional physical therapy for mechanical neck pain which includes cervical range of motion (flexion, extension, lateral rotation, and rotation), neck isometric exercises, stretching's (scalene, trapezius, SCM) and TENS with heating pad.
  arm group label: Control Group
  arm group label: Experimental Group
  criteria: 
  gender: All
  minimum age: 45 Years
  maximum age: 55 Years
  healthy volunteers: No
  last name: Nida Waseem, MS-PT*
  role: Principal Investigator
  affiliation: Shifa Tameer-e-millet University
  last name: Syed Ali Hussain, PhD*
  phone: 03315191713
  email: alihussain_dpt.ahs@stmu.edu.pk
  facility: 
  status: Recruiting
  contact: 
  investigator: 
  country: Pakistan
  citation: Celenay ST, Akbayrak T, Kaya DO. A Comparison of the Effects of Stabilization Exercises Plus Manual Therapy to Those of Stabilization Exercises Alone in Patients With Nonspecific Mechanical Neck Pain: A Randomized Clinical Trial. J Orthop Sports Phys Ther. 2016 Feb;46(2):44-55. doi: 10.2519/jospt.2016.5979. Epub 2016 Jan 11.
  PMID: 26755405
  citation: Peng B, Yang L, Li Y, Liu T, Liu Y. Cervical Proprioception Impairment in Neck Pain-Pathophysiology, Clinical Evaluation, and Management: A Narrative Review. Pain Ther. 2021 Jun;10(1):143-164. doi: 10.1007/s40122-020-00230-z. Epub 2021 Jan 12.
  PMID: 33464539
  citation: Ganesh GS, Mohanty P, Pattnaik M, Mishra C. Effectiveness of mobilization therapy and exercises in mechanical neck pain. Physiother Theory Pract. 2015 Feb;31(2):99-106. doi: 10.3109/09593985.2014.963904. Epub 2014 Sep 29.
  PMID: 25264016
  citation: Sarig-Bahat H. Evidence for exercise therapy in mechanical neck disorders. Man Ther. 2003 Feb;8(1):10-20. doi: 10.1054/math.2002.0480.
  PMID: 12586557
  citation: 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.
  PMID: 28826164
  citation: Vincent K, Maigne JY, Fischhoff C, Lanlo O, Dagenais S. Systematic review of manual therapies for nonspecific neck pain. Joint Bone Spine. 2013 Oct;80(5):508-15. doi: 10.1016/j.jbspin.2012.10.006. Epub 2012 Nov 16.
  PMID: 23165183
  citation: Gross AR, Kay T, Hondras M, Goldsmith C, Haines T, Peloso P, Kennedy C, Hoving J. Manual therapy for mechanical neck disorders: a systematic review. Man Ther. 2002 Aug;7(3):131-49. doi: 10.1054/math.2002.0465.
  PMID: 12372310
  citation: Walker MJ, Boyles RE, Young BA, Strunce JB, Garber MB, Whitman JM, Deyle G, Wainner RS. The effectiveness of manual physical therapy and exercise for mechanical neck pain: a randomized clinical trial. Spine (Phila Pa 1976). 2008 Oct 15;33(22):2371-8. doi: 10.1097/BRS.0b013e318183391e.
  PMID: 18923311
  citation: Leininger B, McDonough C, Evans R, Tosteson T, Tosteson AN, Bronfort G. Cost-effectiveness of spinal manipulative therapy, supervised exercise, and home exercise for older adults with chronic neck pain. Spine J. 2016 Nov;16(11):1292-1304. doi: 10.1016/j.spinee.2016.06.014. Epub 2016 Jun 23.
  PMID: 27345747
  citation: Llamas-Ramos R, Pecos-Martin D, Gallego-Izquierdo T, Llamas-Ramos I, Plaza-Manzano G, Ortega-Santiago R, Cleland J, Fernandez-de-Las-Penas C. Comparison of the short-term outcomes between trigger point dry needling and trigger point manual therapy for the management of chronic mechanical neck pain: a randomized clinical trial. J Orthop Sports Phys Ther. 2014 Nov;44(11):852-61. doi: 10.2519/jospt.2014.5229. Epub 2014 Sep 30. Erratum In: J Orthop Sports Phys Ther. 2015 Feb;45(2):147.
  PMID: 25269764
  citation: Strimpakos N, Sakellari V, Gioftsos G, Kapreli E, Oldham J. Cervical joint position sense: an intra- and inter-examiner reliability study. Gait Posture. 2006 Jan;23(1):22-31. doi: 10.1016/j.gaitpost.2004.11.019.
  PMID: 16311191
  citation: Reddy RS, Tedla JS, Dixit S, Abohashrh M. Cervical proprioception and its relationship with neck pain intensity in subjects with cervical spondylosis. BMC Musculoskelet Disord. 2019 Oct 15;20(1):447. doi: 10.1186/s12891-019-2846-z.
  PMID: 31615495
  citation: Reddy RS, Meziat-Filho N, Ferreira AS, Tedla JS, Kandakurti PK, Kakaraparthi VN. Comparison of neck extensor muscle endurance and cervical proprioception between asymptomatic individuals and patients with chronic neck pain. J Bodyw Mov Ther. 2021 Apr;26:180-186. doi: 10.1016/j.jbmt.2020.12.040. Epub 2020 Dec 31.
  PMID: 33992242
  citation: Vuillerme N, Pinsault N, Bouvier B. Cervical joint position sense is impaired in older adults. Aging Clin Exp Res. 2008 Aug;20(4):355-8. doi: 10.1007/BF03324868.
  PMID: 18852550
  citation: de Vries J, Ischebeck BK, Voogt LP, van der Geest JN, Janssen M, Frens MA, Kleinrensink GJ. Joint position sense error in people with neck pain: A systematic review. Man Ther. 2015 Dec;20(6):736-44. doi: 10.1016/j.math.2015.04.015. Epub 2015 May 2.
  PMID: 25983238
  citation: Pinsault N, Vuillerme N. Degradation of cervical joint position sense following muscular fatigue in humans. Spine (Phila Pa 1976). 2010 Feb 1;35(3):294-7. doi: 10.1097/BRS.0b013e3181b0c889.
  PMID: 20075783
  citation: Heikkila H, Johansson M, Wenngren BI. Effects of acupuncture, cervical manipulation and NSAID therapy on dizziness and impaired head repositioning of suspected cervical origin: a pilot study. Man Ther. 2000 Aug;5(3):151-7. doi: 10.1054/math.2000.0357.
  PMID: 11034885
  citation: Soysal M, Kara B, Arda MN. Assessment of physical activity in patients with chronic low back or neck pain. Turk Neurosurg. 2013;23(1):75-80. doi: 10.5137/1019-5149.JTN.6885-12.0.
  PMID: 23344871
  responsible party type: Principal Investigator
  investigator affiliation: Shifa Tameer-e-Millat University
  investigator full name: Nouman Khan
  investigator title: Lecturer
  mesh term: Neck Pain
  sharing ipd: No