Whiplash

This research aims to compare two manual therapy techniques, Active Release Technique and Strain-Counterstrain, in adults aged 18 to 45 years who experience non-specific neck pain. The study focuses on how these treatments affect pain levels, neck range of motion, the cranio-vertebral angle, and disability. Neck pain is a common problem worldwide and in Pakistan, often caused by muscle strain or poor posture, leading to discomfort and reduced quality of life. This trial seeks to provide insights into which technique may better improve symptoms and function in affected individuals. Participants will be randomly assigned to one of two groups. Group A will receive the Active Release Technique applied to the trapezius, levator scapulae, sternocleidomastoid, and suboccipital muscles for 15 minutes. Group B will receive the Strain-Counterstrain technique on the same muscles and for the same duration. Both groups will also receive hot packs, stretching of superficial neck muscles, and neck isometric exercises. Treatments will be given over four weeks, with assessments at the start and end of this period. During the study, participants will be evaluated for pain using the Numeric Pain Rating Scale, neck disability with the Neck Disability Index, neck posture by measuring the cranio-vertebral angle, and neck mobility with a goniometer. These measurements will be recorded at the beginning and after four weeks of treatment. The study will be conducted at Safi Teaching Hospital in Faisalabad, Pakistan, with ethical approval and informed consent. The findings aim to help improve clinical care for people with non-specific neck pain by identifying more effective manual therapy options.

This research aims to compare the immediate effects of single-session motor imagery exercises and motor control exercises on individuals who have chronic neck pain lasting at least 12 weeks. The study focuses on measuring changes in pain severity, pressure pain threshold, cervical proprioception, and motor imagery ability. Participants must have a pain severity score of at least 3 cm on the visual analog scale and meet cognitive screening criteria. Participants will be randomly assigned to one of two groups to receive either a single session of motor imagery exercise following the PETTLEP model or a single session of motor control exercise. Both interventions are designed to evaluate how these therapies affect pain and neck function in a controlled setting. The study is double-blinded and aims to assess outcomes immediately before and after the intervention session. During the study, participants will be assessed at baseline and immediately after the intervention for pain severity, pressure pain threshold, cervical proprioception, and motor imagery. These measures will help researchers understand the acute impact of each exercise type on neck pain and related functions. The entire participation involves one session of treatment and immediate evaluation of responses to the exercise.

Researchers are investigating the immediate effects of myofascial release therapy on neck pain, functional ability, and neck movement in people diagnosed with Text Neck Syndrome TNS. TNS is a condition caused by prolonged forward head posture from excessive use of smartphones and other digital devices, especially among young adults. The study aims to explore how a single session of myofascial release might influence symptoms like neck pain and disability in this population. The treatment involves one session of standardized myofascial release techniques applied to the neck and upper back areas. A trained physiotherapist will perform four specific techniques Single Arm Pull, Lateral Neck Shoulder Release, Thoracic Transverse Release, and Anterior Cervical Release. Each technique lasts about 90-120 seconds and is applied to both sides when appropriate. This study focuses on observing immediate changes before and after this therapy session. Participants will undergo assessments of neck pain intensity using the Numeric Rating Scale, functional disability using the modified Neck Disability Index, and cervical range of motion. These measurements will be taken right before and immediately after the intervention. The study includes volunteers aged 18 to 40 who use mobile devices for more than three hours daily and show symptoms of TNS. The findings will help inform future research and treatment approaches for posture-related neck problems.

This research focuses on chronic whiplash-associated disorder WAD, a condition caused by rapid neck movement leading to injury of bones or soft tissues and resulting in symptoms like pain and reduced neck movement. The study aims to evaluate the position and alignment of the Atlas C1 vertebra in people with chronic WAD compared to those with tension headaches and healthy individuals. It also explores how these factors relate to pain intensity, neck movement limits, daily activities, overall improvement, and quality of life. Participants include healthy controls, patients with chronic WAD grades 1 or 2, and individuals with tension headache. The study uses advanced MRI imaging to assess the Atlas and surrounding tissues without any intervention. It will measure the feasibility and repeatability of MRI in healthy controls and compare MRI findings among the three groups. The study also collects neurological exam results and patient-reported outcome questionnaires. Participants will undergo MRI scans and neurological exams at specified intervals up to 18 months, with some measures extending to 24 months. Researchers will evaluate repeatability of MRI measurements, alignment of the Atlas, neurological scores, quality of life, muscle volume, fat accumulation, and blood flow. The study includes healthy volunteers aged 18 to 75 years and monitors participants through questionnaires and imaging to understand the relationship between anatomical changes and symptoms in chronic WAD.

Researchers are investigating whether there is a connection between gum disease periodontal disease and chronic neck pain with related functional disability in adults aged 30 to 55 years. The study aims to understand if the severity of gum disease is linked to the intensity of neck pain and the level of disability experienced, potentially highlighting a relationship between oral health and musculoskeletal health. Participants will be grouped based on their gum health status into three categories healthy gums, gingivitis, or periodontitis, classified using clinical examinations and the 2017 World Workshop criteria. Neck pain intensity will be measured using the Visual Analog Scale VAS, while functional disability related to neck pain will be assessed using the Neck Disability Index NDI. This is a cross-sectional observational study, meaning data will be collected at a single time point without administering treatments. During the study, participants will undergo a dental examination including assessments of gingival inflammation, plaque, bleeding, probing depth, and bone loss. They will also complete questionnaires about their neck pain and disability. The researchers will analyze the relationship between gum disease severity and neck paindisability, considering other possible influencing factors. The study is expected to contribute to better understanding the link between oral and musculoskeletal health.

Researchers are studying adults aged 18 to 75 who have a history of long-term opioid use to see if a combined behavioral and drug treatment can reduce opioid use, improve pain recovery, and prevent opioid misuse after elective surgery. This clinical trial compares Motivational Interviewing with guided opioid tapering plus tizanidine against Motivational Interviewing with placebo and Enhanced Usual Care to understand which approach best helps patients return to their preoperative opioid use level or stop opioids faster. The study addresses an important need for better postoperative pain care for patients already using opioids long term. The trial has three groups one receiving Motivational Interviewing-guided opioid tapering with tizanidine another receiving the same counseling with placebo and a control group receiving Enhanced Usual Care focused on education about opioid use and pain management. Participants take the study medication tizanidine or placebo three times daily for five weeks if in the drug groups. Weekly phone or video visits with clinicians occur for six weeks starting two weeks after surgery, plus an additional follow-up call at week 11. Participants complete a phone assessment and baseline survey before surgery, then weekly online surveys for six months and monthly surveys up to one year after surgery to track opioid use, pain, and related outcomes. Researchers monitor time to return to baseline opioid use as the main outcome, along with opioid cessation, pain resolution, and opioid misuse. The study includes detailed assessments and follow-up over 12 months to understand how these interventions work and their potential for wider use.

This research aims to evaluate the safety and effectiveness of the CEM-Cage combined with the CEM-Plate in patients undergoing a two-level anterior cervical discectomy and fusion ACDF. It is a first-in-human, prospective, multi-center, non-randomized, single-arm study involving fifty patients with cervical spine conditions such as radiculopathy or myelopathy. The study is designed to provide important information about the devices performance in treating cervical degenerative disc disease. Participants will undergo a two-level ACDF surgery using the CEM-Plate Anterior Cervical Plating System and the CEM-Cage Cervical Interbody System. After surgery, patients will have follow-up visits at 4 weeks, 3 months, 6 months, 12 months, 18 months, and 24 months. These visits include assessments such as quality of life surveys and imaging tests like lateral cervical x-rays to check the device placement and spinal fusion progress. Throughout the study, researchers will monitor for fusion success and overall outcomes, including the absence of serious adverse events or need for additional surgeries at the treated levels. Safety and device-related complications will be tracked for up to 24 months. Participants quality of life and spine function will be regularly evaluated, helping to understand the long-term effects of the device.

Researchers are evaluating the combined effect of chiropractic care and Tai Chi training on reducing pain and disability in adults with chronic non-specific neck pain. This pilot study aims to assess the feasibility of recruiting, retaining, and safely monitoring participants, while also measuring clinical outcomes such as pain levels, disability, quality of life, self-efficacy, and psychological factors related to neck pain. The study is sponsored by Harvard University Faculty of Medicine and involves adults aged 18 to 65 with persistent neck pain. Participants will be randomly assigned to one of three groups one group will receive 10 chiropractic treatments over 16 weeks along with Tai Chi group training for 16 weeks and enhanced usual care, which includes educational materials a second group will receive chiropractic care plus enhanced usual care and a third group will receive only enhanced usual care with educational materials and biweekly check-in calls. Chiropractic care includes posture correction, soft tissue release, spinal manipulation, education, strengthening, and ergonomic advice. Tai Chi classes will be held weekly for 16 weeks. During the study, participants will be assessed at baseline, 16 weeks, and 24 weeks for pain intensity, pain on movement, disability, quality of life, self-efficacy, postural awareness, pain catastrophizing, fear of movement, and interoceptive awareness. Researchers will also monitor recruitment, retention, and adherence rates throughout the average 18-month study duration. Participants will be followed for 8 weeks after interventions end to evaluate longer-term outcomes and safety.

Researchers are examining the relationship between brain activity patterns and clinical features in adults with chronic non-specific neck pain. The study also evaluates how these clinical and brain function measures change after physiotherapy treatment. Additionally, a healthy control group without neck pain will be assessed to provide comparison data for interpreting brain function in those with chronic neck pain. Participants with chronic non-specific neck pain will receive a six-week physiotherapy program consisting of weekly sessions that include manual therapy targeting the cervical and thoracic spine, combined with a neck-specific home exercise plan focusing on neck flexor and extensor muscles. Baseline clinical, psychophysical, and 64-channel electroencephalographic EEG assessments will be conducted before treatment. These assessments will be repeated about one week after completing the intervention. Healthy controls will undergo similar baseline assessments but will not receive physiotherapy or post-treatment evaluations. Throughout the study, participants will complete questionnaires, pain mapping, sensory testing, and EEG recordings while seated comfortably. Clinical outcomes such as pain intensity, neck disability, psychological factors, and sleep quality will be monitored at baseline, shortly after treatment, and 12 weeks following the last physiotherapy session. The primary outcome is measured by the Global Rating of Change scale. This approach allows researchers to track both immediate and longer-term effects of physiotherapy on clinical symptoms and brain activity in chronic neck pain.

Forward Head Posture FHP is a common postural problem among young adults caused by prolonged screen use and poor sitting habits. This condition, where the head is positioned forward relative to the shoulders, can lead to neck pain, a smaller craniovertebral angle CVA, and muscle imbalances. The study evaluates the combined effect of Kendall exercises and wearable vibrotactile feedback sensors on correcting FHP, reducing neck pain, and improving CVA and muscle thickness in young adults aged 18 to 30 years. Participants are divided into two groups one group receives wearable vibrotactile feedback sensors along with Kendall exercises, and the other group performs Kendall exercises alone. The Kendall exercise program includes strengthening deep cervical flexors, stretching cervical extensors, strengthening shoulder retractors, and stretching pectoral muscles. Exercises are done three times a week for 30 minutes over a period of four weeks. During the 12-month study, participants will be assessed for neck pain and craniovertebral angle from baseline to the fourth week. Additional evaluations include the Neck Disability Index. The study uses randomized allocation and single masking. Data will be analyzed using SPSS software. Researchers will monitor postural improvements, pain reduction, and muscle changes to better understand the combined effect of exercises and wearable sensors on FHP correction.