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RECRUITING Not applicable ClinicalTrials.gov

Effects of Physiotherapy Approaches on Biopsychosocial Outcomes in Chronic Non-Specific Neck Pain

Sponsor: Istanbul Medipol University Hospital • ClinicalTrials.gov ID: NCT07784504

Registry updated: 2026-09-15
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Description

Chronic non-specific neck pain (CNSNP) is a widespread musculoskeletal condition leading to pain, disability, and impaired quality of life. Due to its multifactorial nature involving biomechanical, sensorimotor, and psychosocial aspects, various rehabilitation interventions have been recommended. However, there is a lack of direct evidence comparing structured exercise, sensorimotor training, and pain neuroscience education within a comprehensive biopsychosocial framework. The primary objective of this randomized controlled trial is to evaluate and compare the effectiveness of structured exercise, sensorimotor training, and pain neuroscience education on disability, pain intensity, sensorimotor control, and psychosocial outcomes in individuals with CNSNP. Participants aged 18-65 with chronic non-specific neck pain will be randomly allocated into three intervention groups: Structured Exercise Group (SEG): Cervical stabilization, isometric/isotonic exercises, stretching, and range of motion training. Sensorimotor Training Group (SMTG): Cervical joint position sense retraining, oculomotor exercises, and balance training. Pain Neuroscience Education Group (PNEG): Online educational sessions focused on pain neurophysiology, central sensitization, and cognitive-behavioral strategies. Outcomes will be assessed at baseline (T0), completion of 8 weeks of intervention (T1), and 4 weeks post-intervention follow-up (T2, 12th week).

Interventions

  • Structured Exercise Program (Other)
    Participants will receive a structured exercise program consisting of 24 supervised sessions over 8 weeks (3 sessions/week, 20-30 mins/session). The program includes active cervical ROM exercises, stretching for neck muscles, progressive isometric/isotonic elastic band exercises monitored via Borg RPE scale, and craniocervical flexion stabilization using a pressure biofeedback unit.
  • Sensorimotor Training (Other)
    Participants will receive sensorimotor training consisting of 24 supervised sessions over 8 weeks (3 sessions/week, 20-30 mins/session) following a 3-minute ROM warm-up. The protocol includes joint position sense retraining using laser feedback, oculomotor exercises (smooth pursuit, gaze stability, eye-head coordination), and static/dynamic balance training under varied visual conditions and support surfaces.
  • Pain Neuroscience Education (Other)
    Participants will receive online pain neuroscience education delivered in 10 group sessions via Zoom over 8 weeks. In addition to the pain neuroscience education curriculum covering pain neurophysiology, peripheral and central sensitization, neuroplasticity, descending inhibition, and cognitive modification, 1 session will be dedicated to demonstrating home-based neck exercises. Participants will be encouraged to perform these home exercises 3 days a week for 10 minutes per session. While exercise engagement is encouraged as part of the education, no forced compliance or routine exercise reminders will be provided. Patient exercise diaries will be requested at the end of each month throughout the intervention period.

Eligibility criteria

Inclusion Criteria: * Diagnosis of chronic non-specific neck pain lasting for more than 90 days * Age between 18 and 65 years (inclusive) * History of receiving standard physical therapy in a clinical setting in Turkey, yet experiencing persistent neck pain * Numeric Pain Rating Scale (NPRS) score ≥ 3/10 at rest and during active cervical movement * Neck Disability Index (NDI) score ≥ 5/50 * Voluntary agreement to participate and signing of the informed consent form Exclusion Criteria: * Neck pain associated with nerve root involvement or radiculopathy * History of prior cervical spine surgery * Physical therapy interventions received within the last 3 months * Severe spinal pathologies (e.g., fracture, tumor, infection, structural instability) * Systemic conditions (e.g., rheumatic, neurological, metabolic diseases) * Presence of vertigo or sensory loss * History of cancer within the last 5 years

Conditions

Chronic Non-specific Neck Pain

Locations

  • Istanbul Medipol University — Istanbul, Beykoz, Turkey (Türkiye)
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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

View Official Record