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Neck Pain MusculoskeletalEIH-CNNPNCT07546838

Effects of Aerobic and Combined Exercise on Pain and Fatigue in Workers With Chronic Neck Pain

A study testing Aerobic Exercise and Combined Exercise in people with Neck Pain Musculoskeletal and Work Related Musculoskeletal Disorders, run by Hacettepe University at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This randomized controlled trial investigated the acute effects of aerobic exercise (AE) and combined aerobic and cervical-upper extremity resistance exercise (CE) on the pressure pain threshold (PPT), pain perception, and fatigue in workers with high ergonomic risk and chronic non-specific neck pain (CNNP). Read more about this study

Who is it for?
Ages 20 to 65 years
What is being tested?
Aerobic Exercise and Combined Exercise
Could I receive a placebo?
No, everyone receives an active treatment
How many people
78 participants
Where
1 siteTurkey (Türkiye)
Study dates
22 May 2025to 30 Oct 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Aged 20-65 years
  • Diagnosed with chronic non-specific neck pain within the past year
  • Neck pain intensity ≥4 on a numerical rating scale for at least 3 months
  • Actively employed for at least 1 year in similar occupational conditions
  • High ergonomic risk (Rapid Upper Limb Assessment - RULA score ≥3)

Who cannot join

  • Neurological, cardiopulmonary, or rheumatological disorders
  • History of cervical surgery or traumatic injury
  • Specific cervical or lumbar pathology
  • Whiplash injury, or any traumatic musculoskeletal injury
  • Recent physical therapy or regular exercise in the past six months
  • Neck pain unresponsive to conservative treatment
Show all 10Show fewer
  • Diagnosed thoracic outlet syndrome, rotator cuff pathology, vertebrobasilar insufficiency, or frozen shoulder
  • Pregnancy
  • Use of antidepressant medication
  • Positive clinical tests (Spurling, cervical distraction, Valsalva, radial, ulnar, and median nerve tension tests)

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Faculty of Physical Therapy adn Rehabilitation, Hacettepe University

    Ankara, Çankaya, 06100

Other trials in Turkey (Türkiye)

About this study

Official title: Acute Effects of Aerobic Versus Combined Aerobic and Cervical-Upper Extremity Resistance Exercise on Pressure Pain Threshold, Pain Perception, and Fatigue in Workers Exposed to High Ergonomic Risk With Chronic Non-specific Neck Pain: a Randomized Controlled Trial

This randomized controlled trial investigated the acute effects of aerobic exercise (AE) and combined aerobic and cervical-upper extremity resistance exercise (CE) on the pressure pain threshold (PPT), pain perception, and fatigue in workers with high ergonomic risk and chronic non-specific neck pain (CNNP).

A total of 78 workers were randomly assigned to AE, CE, or control groups. The AE and CE groups completed single 40-minute sessions, while the control group received a 30-minute educational session with additional seated rest periods before and after the session. PPT was assessed bilaterally at multiple anatomical sites using a digital pressure algometer. Neck pain, overall pain perception, and fatigue were evaluated using a numerical rating scale (NRS) before, immediately after, and 20 minutes after exercise.

The study focused on exercise-induced hypoalgesia (EIH) and was intended to inform brief, workplace-compatible exercise strategies to reduce pain, fatigue, and work-related musculoskeletal risks in this population.

Read the detailed description

This randomized controlled trial investigated the acute effects of aerobic exercise and combined aerobic and cervical-upper extremity resistance exercise on pain sensitivity, pain perception, and fatigue in workers with chronic non-specific neck pain exposed to high ergonomic risk.

Participants were recruited from occupational groups with high ergonomic risk and were assessed in two sessions. The first session was conducted in the workplace and included eligibility screening, demographic data collection, and ergonomic risk assessment. Participants were then randomly assigned to aerobic exercise, combined exercise, or control groups.

The second session was conducted in a university laboratory setting. Baseline assessments were performed, followed by the intervention. Outcome measures were collected before the intervention (T0), immediately after (T1), and 20 minutes after the intervention (T2).

The aerobic exercise group performed moderate-intensity cycling using a recumbent ergometer (64-76% of maximum heart rate), consisting of a 5-minute warm-up, 30 minutes of exercise, and a 5-minute cool-down. The combined exercise group performed aerobic exercise at the same intensity, followed by cervical and upper-extremity resistance exercises focusing on motor control and scapular stabilization. This protocol included a 5-minute warm-up, 15 minutes of aerobic exercise, 15 minutes of resistance exercise, and a 5-minute cool-down. The control group received a 30-minute educational session on exercise and workplace ergonomics.

Pain sensitivity was assessed using pressure pain threshold measurements obtained with a digital algometer at the C2, C5, and upper trapezius regions. Neck pain, overall body pain perception, and fatigue were evaluated using numerical rating scales (0-10).

Sample size was calculated using G*Power (v3.1.9.6) based on a previous study (effect size = 0.165 for a three-group design), with an alpha level of 0.05 and power of 0.80, resulting in a required sample of 78 participants. Considering a 20% drop-out rate, 95 participants were targeted.

Statistical analyses were performed using SPSS. Data normality was assessed using the Shapiro-Wilk test. Baseline differences between groups were analyzed using ANOVA and chi-squared tests. The primary analysis evaluated group × time interactions using repeated-measures ANOVA (T0, T1, T2), with Bonferroni post-hoc tests applied when appropriate. Statistical significance was set at p < 0.05.

The study focused on exercise-induced hypoalgesia (EIH) and aimed to compare the immediate and short-term responses to different exercise modalities in a working population with chronic neck pain.

Being tested
Aerobic Exercise, Combined Exercise, Informed Control
Keywords
Exercise-induced hypoalgesia, Acute effect of exercise, Chronic Neck Pain, Pressure Pain Threshold, Aerobic Exercise, Resistance Exercise, Ergonomic Risk

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Aerobic ExerciseBehavioural

    Moderate-intensity aerobic exercise performed using a recumbent cycle ergometer in a single 40-minute session. The protocol included a 5-minute warm-up, 30 minutes of continuous cycling, and a 5-minute cool-down. Exercise intensity was maintained at 64-76% of maximum heart rate and adjusted individually throughout the session. No resistance or strength training exercises were included.

  • Combined ExerciseBehavioural

    Participants performed a combination of aerobic and resistance exercises in a single 40-minute session. The protocol included a 5-minute warm-up, 15 minutes of moderate-intensity aerobic exercise (64-76% HRmax, Borg RPE 11-14), 15 minutes of resistance exercises targeting cervical and upper-extremity muscles, and a 5-minute cool-down. The resistance program focused on cervical motor control and scapular stabilization, including chin tuck, cervical retraction with extension, scapular retraction, vertical pulling, horizontal shoulder abduction, scapular plane abduction, and shoulder elevation. Each exercise was performed for 8-10 repetitions in two sets with 30-second rest intervals. All exercises were supervised and performed with proper postural alignment.

  • Informed ControlBehavioural

    Participants attended a 30-minute educational session on exercise benefits, workplace ergonomics, and postural recommendations. Participants remained seated for 5 minutes before and after the session.

Study groups in NCT07546838
Study groupRoleWhat they receive
Aerobic ExerciseExperimentalParticipants performed moderate-intensity cycling using a recumbent ergometer in a single 40-minute session, including a 5-minute warm-up, 30 minutes of aerobic exercise, and a 5-minute cool-down.
Receives: Behavioral: Aerobic Exercise
Combined ExerciseExperimentalParticipants performed a combination of aerobic and resistance exercises in a single 40-minute session, including a 5-minute warm-up, 15 minutes of aerobic exercise, 15 minutes of resistance training targeting cervical and upper-extremity muscles, and a 5-minute cool-down.
Receives: Behavioral: Combined Exercise
Informed ControlActive comparatorA 30-minute educational session on exercise benefits, workplace ergonomics, and postural recommendations. Participants remained seated for 5 minutes before and after the session.
Receives: Behavioral: Informed Control

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pressure Pain Threshold

    Pressure pain threshold is assessed using a digital algometer to evaluate pain sensitivity. The value at which the sensation of pressure first becomes painful is recorded in lbf/cm². Three consecutive measurements are obtained at each site, and the mean value is used for analysis.

    Measurements are obtained bilaterally at the C2 region, C5 region, and upper trapezius muscle.

    Measured: Three time points: before the intervention (T0), immediately after the intervention (T1), and 20 minutes after the intervention (T2).

Secondary outcomes (3)
  1. Acute Neck Pain Perception

    Acute neck pain intensity is assessed using a numerical rating scale (0-10), a simple and widely used tool for evaluating pain. Participants are asked to select the number that best represents their pain intensity. Zero indicates no pain, and 10 represents the worst imaginable pain.

    Measured: Assessments are performed at three time points: before the intervention (T0), immediately after the intervention (T1), and 20 minutes after the intervention (T2).

  2. Acute Overall Body Pain Perception

    Acute overall body pain perception is assessed using a numerical rating scale (0-10), a simple and widely used tool for evaluating pain. Participants are asked to select the number that best represents their pain intensity. Zero indicates no pain, and 10 represents the worst imaginable pain.

    Measured: Assessments are performed at three time points: before the intervention (T0), immediately after the intervention (T1), and 20 minutes after the intervention (T2).

  3. Acute Fatigue

    Acute fatigue is assessed using a numerical rating scale (0-10), a simple and widely used tool for evaluating fatigue. Participants are asked to select the number that best represents their fatigue intensity. Zero indicates no fatigue, and 10 represents the worst imaginable fatigue.

    Measured: Assessments are performed at three time points: before the intervention (T0), immediately after the intervention (T1), and 20 minutes after the intervention (T2).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Apr 2026
  2. Study start22 May 2025
  3. Primary completion1 Oct 2025
  4. Study completion30 Oct 2025

Resources

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
None (open label)
Enrolment
78 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07546838
Sponsor's protocol ID
EA-CNNP-RCT-2025
Acronym
EIH-CNNP
Status last verified
Apr 2026
First submitted
17 Apr 2026
Last updated
23 Apr 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Rice D, Nijs J, Kosek E, Wideman T, Hasenbring MI, Koltyn K, Graven-Nielsen T, Polli A. Exercise-Induced Hypoalgesia in Pain-Free and Chronic Pain Populations: State of the Art and Future Directions. J Pain. 2019 Nov;20(11):1249-1266. doi: 10.1016/j.jpain.2019.03.005. Epub 2019 Mar 21.

    PubMed 30904519
  • Senarath ID, Chen KK, Weerasekara I, de Zoete RMJ. Exercise-induced hypoalgesic effects of different types of physical exercise in individuals with neck pain: A systematic review and meta-analysis. Pain Pract. 2023 Jan;23(1):110-122. doi: 10.1111/papr.13150. Epub 2022 Aug 2.

    PubMed 35869789
  • Anarte-Lazo E, Bernal-Utrera C, Lopez-Amor M, Porras-Valencia E, Ruy-Diaz-Rojas FJ, Falla D, Rodriguez-Blanco C. Exercise-induced hypoalgesia after aerobic versus neck-specific exercise in people with acute/subacute whiplash-associated disorders: protocol for a randomised controlled trial. BMJ Open. 2022 Sep 22;12(9):e061679. doi: 10.1136/bmjopen-2022-061679.

    PubMed 36137629
  • Acikalin E, Atasavun Uysal S. Acute effects of aerobic versus combined aerobic and cervical-upper extremity resistance exercise on pressure pain threshold, pain perception, and fatigue in workers exposed to high ergonomic risk with chronic non-specific neck pain: a randomized controlled trial. BMC Musculoskelet Disord. 2026 Jul 14;27(1):610. doi: 10.1186/s12891-026-10182-8.

    PubMed 42449286

Questions about this trial

What is this clinical trial studying?

A study testing Aerobic Exercise and Combined Exercise in people with Neck Pain Musculoskeletal and Work Related Musculoskeletal Disorders, run by Hacettepe University at 1 site in Turkey (Türkiye).

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 5 inclusion and 10 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 23 Apr 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 Turkey (Türkiye). 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?

Pressure Pain Threshold (time frame: Three time points: before the intervention (T0), immediately after the intervention (T1), and 20 minutes after the intervention (T2).). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07546838, which also lists 4 linked publications.

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 23 Apr 2026.

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