Chronic Neck PainNCT07332845
Symmetrical Scapula-pelvis Proprioceptive Neuromuscular Facilitation and Superficial Back Line in Chronic Neck Pain With Hamstring Tightness
A study testing Suboccipital muscle inhibition technique, Symmetrical Scapula-Pelvis Patterns Exercises and Static stretching of hamstring muscle in people with Chronic Neck Pain and Hamstring Muscle Tightness, run by University of Karachi at 1 site in Pakistan.
Trial summary
A research study will be conducted at Physiotherapy department of the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan. Overall 156 patients with 18-40 years old individuals with neck pain will be eligible and they will be included through non-probability, purposive sampling technique. Read more about this study
- Who is it for?
- Ages 18 to 40 years
- Conditions the study is for
- Chronic Neck Pain, Hamstring Muscle Tightness, Neck Pain
- What is being tested?
- Suboccipital muscle inhibition technique, Symmetrical Scapula-Pelvis Patterns Exercises and Static stretching of hamstring muscle
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 156 participants
- Where
- 1 sitePakistan
- Study dates
- 16 Jan 2026to 26 Nov 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 40 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Individual with both male and female gender
- Individuals with chronic neck pain (pain for > 3 month) with hamstring tightness
Who cannot join
- Any history related to spinal surgery
- Previous administration of epidural injections
- Neck pain due to specific pathology
- Patients with radiculopathy or myelopathy
- Traumatic spinal cord injury
- Neck pain associated with progressive neurological deficit or loss of strength
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site, 1 recruiting
- Recruiting
Sindh Institute of Physical Medicine and Rehabilitation
Karachi, Sindh, 75300
Faizan Siddiqui, MSAPT, +923350352016, fs.dptrm@gmail.com
About this study
A research study will be conducted at Physiotherapy department of the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan. Overall 156 patients with 18-40 years old individuals with neck pain will be eligible and they will be included through non-probability, purposive sampling technique. The written informed consent will be taken from all the patients. They will be divided through Simple random sampling (computer generated software) method into two groups, 78 in each group. Group A (experimental group) will receive PNF Symmetrical Scapula-Pelvis Patterns (PNF-SSPP), group B (control group) will receive sub occipital muscle inhibition technique (SMI) and static stretching (SS) of hamstring muscle. All participants will be assessed using assessment form. Outcome measures will be Pain, disability, disability, neck range of motions, hamstring tightness, head posture, and levator scapulae index. An independent assessor blinded to the treatment will assess all the patients for treatment outcome assessment at baseline, after first session and post treatment. Treatment sessions will be given thrice a week for 6 weeks.
Read the detailed description
A maximum drop-out rate of 20% is expected. The Statistical package for the social sciences (SPSS) 23 version will be used for data analysing. The Mean ± SD will be calculated for quantitative variables like age. The qualitative variables will be shown through calculated frequencies and percentages. The outcome results of the study (decrease pain intensity, improve disability, improve ROM and improve muscle tightness) taken before, after 1st session and after 18th session will be compared and analyzed. The repeated measure of ANOVA will be used as the statistical test. The p-value of 0.05 will be considered as level of significant.
- Conditions
- Chronic Neck Pain, Hamstring Muscle Tightness, Neck Pain
- Being tested
- Suboccipital muscle inhibition technique, Symmetrical Scapula-Pelvis Patterns Exercises, Static stretching of hamstring muscle
- Keywords
- neck ache, Exercise, Muscle Stretching, Muscle Inhibition, PNF
- Medical subject headings
- Neck Pain, Motor Activity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Suboccipital muscle inhibition techniqueOther
The Suboccipital Muscle Inhibition technique is a manual therapy method used by practitioners to relieve tension in the suboccipital muscles, which are located at the base of the skull.
Symmetrical Scapula-Pelvis Patterns ExercisesOther
Symmetrical scapula-pelvis patterns refer to a balanced, aligned posture and movement of the shoulder blades and pelvis which is often a therapeutic goal in physical rehabilitation with proprioceptive neuromuscular facilitation.
Static stretching of hamstring muscleOther
Static stretching for hamstrings involves holding a position that creates tension in the back of the thigh for 30 seconds.
| Study group | Role | What they receive |
|---|---|---|
| Symmetrical Scapula-Pelvis Pattern Exercises | Experimental | This arm will receive PNF Dynamic Reversal of Antagonists using Symmetrical Scapula-Pelvis Patterns Receives: Other: Symmetrical Scapula-Pelvis Patterns Exercises |
| Control Treatment | Active comparator | This arm will receive evidence based treatment, the suboccipital muscle inhibition with static stretching of the hamstrings. Receives: Other: Suboccipital muscle inhibition technique; Other: Static stretching of hamstring muscle |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in pain intensity with visual analogue scale for pain at Day 1
The Visual Analogue Scale is a 10 cm line used to measure pain intensity, where the patient marks a point on the line to indicate their pain level, with 0 representing "no pain" and 10 representing "pain as bad as it could possibly be". A score is obtained by measuring the distance from the "no pain" end to the patient's mark, which can be done in centimeters (0-10) or millimeters (0-100). Higher scores indicate greater pain intensity, and this score helps healthcare providers assess severity, which can be categorized as mild (1-3), moderate (4-6), or severe (7-10)
Measured: From enrolment to the end of the first treatment session at Day 1.
Change in pain intensity with visual analogue scale for pain at 6 weeks
The Visual Analogue Scale (VAS) is a 10 cm line used to measure pain intensity, where the patient marks a point on the line to indicate their pain level, with 0 representing "no pain" and 10 representing "pain as bad as it could possibly be". A score is obtained by measuring the distance from the "no pain" end to the patient's mark, which can be done in centimeters (0-10) or millimeters (0-100). Higher scores indicate greater pain intensity, and this score helps healthcare providers assess severity, which can be categorized as mild (1-3), moderate (4-6), or severe (7-10).
Measured: From enrolment to the end of 18 treatment session at 6 weeks
Change in range of motion with goniometry at Day 1
Goniometry measures the change in range of motion of a joint in degrees by using a goniometer to calculate the joint's angle. The increase in degrees suggests increase in range of motion and decrease suggests decrease in range of motion.
Measured: From enrolment to the end of first treatment at Day 1
Change in range of motion with goniometry at 6 weeks
Goniometry measures the change in range of motion of a joint in degrees by using a goniometer to calculate the joint's angle. The increase in degrees suggests increase in range of motion and decrease suggests decrease in range of motion.
Measured: From enrolment to the end of 18 treatment sessions at 6 weeks.
Change in neck disability with Neck Disability Index at day 1
A change in the Neck Disability Index score indicates a change in a patient's self-reported neck disability. A higher score means greater disability.The NDI is scored from 0 to 50, or 0% to 100%. A score of 0 indicates no limitation, while a score of 50 represents complete limitation.
Measured: From enrolment to the end of first treatment session at Day 1.
Change in neck disability with Neck Disability Index at 6 weeks
A change in the Neck Disability Index score indicates a change in a patient's self-reported neck disability. A higher score means greater disability.The NDI is scored from 0 to 50, or 0% to 100%. A score of 0 indicates no limitation, while a score of 50 represents complete limitation.
Measured: From enrolment to the end of 18 treatment sessions at 6 weeks.
Change in hamstring tightness with Sit and Reach (SR) test at Day 1
A low Sit and Reach test score in centimetre indicates tight hamstrings, while a higher score shows better hamstring flexibility. When a person with tight hamstrings performs the Sit and Reach test, the muscles pull the pelvis into a posterior tilt, which limits the ability to reach as far and can cause the lower back to round instead of the spine flexing naturally. As hamstring tightness decreases through stretching, the SR score increases, signifying greater flexibility and improved superficial back line.
Measured: From enrolment to the end of first treatment session at Day 1.
Change in hamstring tightness with Sit and Reach (SR) test at 6 weeks
A low Sit and Reach test score in centimetre indicates tight hamstrings, while a higher score shows better hamstring flexibility. When a person with tight hamstrings performs the Sit and Reach test, the muscles pull the pelvis into a posterior tilt, which limits the ability to reach as far and can cause the lower back to round instead of the spine flexing naturally. As hamstring tightness decreases through stretching, the SR score increases, signifying greater flexibility and improved superficial back line.
Measured: From enrolment to the end of 18 treatment sessions at 6 weeks.
Secondary outcomes (4)
Change in head posture with goniometry at Day 1
Goniometry can measure changes in forward head posture by using a goniometer to calculate the craniovertebral angle. This involves placing the goniometer's base on the C7 spinous process and the moving arm on the tragus of the ear, with a smaller CVA angle indicating a greater degree of forward head posture and vice versa. Changes are tracked by taking repeated measurements over time to see if the CVA increases (improving posture) or decreases (worsening posture).
Measured: From enrolment to the end of first treatment session at Day 1
Change in head posture with goniometry at 6 weeks
Goniometry can measure changes in forward head posture by using a goniometer to calculate the craniovertebral angle. This involves placing the goniometer's base on the C7 spinous process and the moving arm on the tragus of the ear, with a smaller CVA angle indicating a greater degree of forward head posture and vice versa. Changes are tracked by taking repeated measurements over time to see if the CVA increases (improving posture) or decreases (worsening posture).
Measured: From enrolment to the end of 18 treatment sessions at 6 weeks
Change in levator scapulae index with vernier caliper at Day 1
The levator scapulae index is a measurement technique used to assess the relative length of the levator scapulae muscle. It provides a normalized value by comparing the muscle's length to an individual's total body height, which accounts for variations in size between patients. A vernier caliper is the tool used for this measurement due to its accuracy. A normal levator scapulae index range is greater than or equal to 7.44. Decrease in score suggests decrease in muscle length and increase suggests increase in length.
Measured: From enrolment to the end of first treatment session at Day 1
Change in levator scapulae index with vernier caliper at 6 weeks
The levator scapulae index is a measurement technique used to assess the relative length of the levator scapulae muscle. It provides a normalized value by comparing the muscle's length to an individual's total body height, which accounts for variations in size between patients. A vernier caliper is the tool used for this measurement due to its accuracy. A normal levator scapulae index range is greater than or equal to 7.44. Decrease in score suggests decrease in muscle length and increase suggests increase in length.
Measured: Time Frame: From enrolment to the end of 18 treatment sessions at 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Jan 2026
- Study start16 Jan 2026
- Primary completion26 Oct 2026 (estimated)
- Study completion26 Nov 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Chronic Neck PainStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 156 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Karachi
- Sponsor type
- University, hospital or other
- Collaborators
- Sindh Institute of Physical Medicine and Rehabilitation
- Responsible party
- Principal investigator, Aftab Ahmed Mirza Baig,DPT, MSAPT, University of Karachi
- Investigators
- Aftab Ahmed Mirza Baig, PhD, Principal investigator, University of KarachBasit Ansari, PhD, Study director, University of Karachi
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07332845
- Sponsor's protocol ID
- IBC KU-544/2025
- Status last verified
- Mar 2026
- First submitted
- 30 Dec 2025
- Last updated
- 10 Mar 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 10 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Symmetrical Scapula-pelvis Proprioceptive Neuromuscular Facilitation and Superficial Back Line in Chronic Neck Pain With Hamstring Tightness
- ClinicalTrials.gov ID
- NCT07332845
- Acronym / sponsor ID
- IBC KU-544/2025
- Conditions
- Chronic Neck Pain, Hamstring Muscle Tightness, Neck Pain
- Keywords
- neck ache, Exercise, Muscle Stretching, Muscle Inhibition, PNF
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 156 participants (estimated)
- Lead sponsor
- University of KarachiUniversity, hospital or other
- Collaborators
- Sindh Institute of Physical Medicine and Rehabilitation
- Study start
- 16 Jan 2026 (actual)
- Primary completion
- 26 Oct 2026 (estimated)
- Study completion
- 26 Nov 2026 (estimated)
- First posted
- 12 Jan 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
A research study will be conducted at Physiotherapy department of the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan. Overall 156 patients with 18-40 years old individuals with neck pain will be eligible and they will be included through non-probability, purposive sampling technique. The written informed consent will be taken from all the patients. They will be divided through Simple random sampling (computer generated software) method into two groups, 78 in each group. Group A (experimental group) will receive PNF Symmetrical Scapula-Pelvis Patterns (PNF-SSPP), group B (control group) will receive sub occipital muscle inhibition technique (SMI) and static stretching (SS) of hamstring muscle. All participants will be assessed using assessment form. Outcome measures will be Pain, disability, disability, neck range of motions, hamstring tightness, head posture, and levator scapulae index. An independent assessor blinded to the treatment will assess all the patients for treatment outcome assessment at baseline, after first session and post treatment. Treatment sessions will be given thrice a week for 6 weeks.
Detailed description
A maximum drop-out rate of 20% is expected. The Statistical package for the social sciences (SPSS) 23 version will be used for data analysing. The Mean ± SD will be calculated for quantitative variables like age. The qualitative variables will be shown through calculated frequencies and percentages. The outcome results of the study (decrease pain intensity, improve disability, improve ROM and improve muscle tightness) taken before, after 1st session and after 18th session will be compared and analyzed. The repeated measure of ANOVA will be used as the statistical test. The p-value of 0.05 will be considered as level of significant.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Symmetrical Scapula-Pelvis Pattern Exercises | Experimental | Other: Symmetrical Scapula-Pelvis Patterns ExercisesThis arm will receive PNF Dynamic Reversal of Antagonists using Symmetrical Scapula-Pelvis Patterns |
| Control Treatment | Active comparator | Other: Suboccipital muscle inhibition technique, Other: Static stretching of hamstring muscleThis arm will receive evidence based treatment, the suboccipital muscle inhibition with static stretching of the hamstrings. |
Who may qualify
- Ages
- 18 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (2 listed)
- Individual with both male and female gender
- Individuals with chronic neck pain (pain for > 3 month) with hamstring tightness
Key exclusion criteria (6 listed)
- Any history related to spinal surgery
- Previous administration of epidural injections
- Neck pain due to specific pathology
- Patients with radiculopathy or myelopathy
- Traumatic spinal cord injury
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 |
|---|---|---|
| Suboccipital muscle inhibition techniqueThe Suboccipital Muscle Inhibition technique is a manual therapy method used by practitioners to relieve tension in the suboccipital muscles, which are located at the base of the skull. | Other | Control Treatment |
| Symmetrical Scapula-Pelvis Patterns ExercisesSymmetrical scapula-pelvis patterns refer to a balanced, aligned posture and movement of the shoulder blades and pelvis which is often a therapeutic goal in physical rehabilitation with proprioceptive neuromuscular facilitation. | Other | Symmetrical Scapula-Pelvis Pattern Exercises |
| Static stretching of hamstring muscleStatic stretching for hamstrings involves holding a position that creates tension in the back of the thigh for 30 seconds. | Other | Control Treatment |
Primary outcome
Change in pain intensity with visual analogue scale for pain at Day 1
Time frame: From enrolment to the end of the first treatment session at Day 1.
The Visual Analogue Scale is a 10 cm line used to measure pain intensity, where the patient marks a point on the line to indicate their pain level, with 0 representing "no pain" and 10 representing "pain as bad as it could possibly be". A score is obtained by measuring the distance from the "no pain" end to the patient's mark, which can be done in centimeters (0-10) or millimeters (0-100). Higher scores indicate greater pain intensity, and this score helps healthcare providers assess severity, which can be categorized as mild (1-3), moderate (4-6), or severe (7-10)
Change in pain intensity with visual analogue scale for pain at 6 weeks
Time frame: From enrolment to the end of 18 treatment session at 6 weeks
The Visual Analogue Scale (VAS) is a 10 cm line used to measure pain intensity, where the patient marks a point on the line to indicate their pain level, with 0 representing "no pain" and 10 representing "pain as bad as it could possibly be". A score is obtained by measuring the distance from the "no pain" end to the patient's mark, which can be done in centimeters (0-10) or millimeters (0-100). Higher scores indicate greater pain intensity, and this score helps healthcare providers assess severity, which can be categorized as mild (1-3), moderate (4-6), or severe (7-10).
Change in range of motion with goniometry at Day 1
Time frame: From enrolment to the end of first treatment at Day 1
Goniometry measures the change in range of motion of a joint in degrees by using a goniometer to calculate the joint's angle. The increase in degrees suggests increase in range of motion and decrease suggests decrease in range of motion.
Change in range of motion with goniometry at 6 weeks
Time frame: From enrolment to the end of 18 treatment sessions at 6 weeks.
Goniometry measures the change in range of motion of a joint in degrees by using a goniometer to calculate the joint's angle. The increase in degrees suggests increase in range of motion and decrease suggests decrease in range of motion.
Change in neck disability with Neck Disability Index at day 1
Time frame: From enrolment to the end of first treatment session at Day 1.
A change in the Neck Disability Index score indicates a change in a patient's self-reported neck disability. A higher score means greater disability.The NDI is scored from 0 to 50, or 0% to 100%. A score of 0 indicates no limitation, while a score of 50 represents complete limitation.
Change in neck disability with Neck Disability Index at 6 weeks
Time frame: From enrolment to the end of 18 treatment sessions at 6 weeks.
A change in the Neck Disability Index score indicates a change in a patient's self-reported neck disability. A higher score means greater disability.The NDI is scored from 0 to 50, or 0% to 100%. A score of 0 indicates no limitation, while a score of 50 represents complete limitation.
Change in hamstring tightness with Sit and Reach (SR) test at Day 1
Time frame: From enrolment to the end of first treatment session at Day 1.
A low Sit and Reach test score in centimetre indicates tight hamstrings, while a higher score shows better hamstring flexibility. When a person with tight hamstrings performs the Sit and Reach test, the muscles pull the pelvis into a posterior tilt, which limits the ability to reach as far and can cause the lower back to round instead of the spine flexing naturally. As hamstring tightness decreases through stretching, the SR score increases, signifying greater flexibility and improved superficial back line.
Change in hamstring tightness with Sit and Reach (SR) test at 6 weeks
Time frame: From enrolment to the end of 18 treatment sessions at 6 weeks.
A low Sit and Reach test score in centimetre indicates tight hamstrings, while a higher score shows better hamstring flexibility. When a person with tight hamstrings performs the Sit and Reach test, the muscles pull the pelvis into a posterior tilt, which limits the ability to reach as far and can cause the lower back to round instead of the spine flexing naturally. As hamstring tightness decreases through stretching, the SR score increases, signifying greater flexibility and improved superficial back line.
4 secondary outcomes
Change in head posture with goniometry at Day 1
Time frame: From enrolment to the end of first treatment session at Day 1
Change in head posture with goniometry at 6 weeks
Time frame: From enrolment to the end of 18 treatment sessions at 6 weeks
Change in levator scapulae index with vernier caliper at Day 1
Time frame: From enrolment to the end of first treatment session at Day 1
Change in levator scapulae index with vernier caliper at 6 weeks
Time frame: Time Frame: From enrolment to the end of 18 treatment sessions at 6 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Mar 2026.
- Individual participant dataSharing planned: No
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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.
Aftab Ahmed Mirza Baig, PhD principal investigator
University of Karach
Basit Ansari, PhD study director
University of Karachi
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Suboccipital muscle inhibition technique, Symmetrical Scapula-Pelvis Patterns Exercises and Static stretching of hamstring muscle in people with Chronic Neck Pain and Hamstring Muscle Tightness, run by University of Karachi 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 2 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: looking for participants now, as of the sponsor's last update on 10 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Aftab Ahmed Mirza Baig, PhD (+923002739920, ab.dptrm@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in pain intensity with visual analogue scale for pain at Day 1 (time frame: From enrolment to the end of the first treatment session at Day 1.). The study lists 8 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 10 Mar 2026.