Efficacy of Scapular Functional and Cervical Isometric Exercises in the Management of Chronic Mechanical Neck Pain: A Randomized Comparative Trial.

Abstract

Background: The global rise in work-related musculoskeletal ailments has led to issues like neck discomfort, scapular muscle dysfunction, reduced neck mobility, and functional limitations. This study aimed to evaluate the effectiveness of scapular functional exercises (SFE) and cervical isometric exercises (CIE) on pain, cervical range of motion (CROM), and functional limitations in individuals with chronic mechanical neck pain (CMNP). Methods: A two-arm, parallel group pretest-post-test randomized comparative trial was conducted. Thirty participants (21 females, 9 males; average age 28.94 ± 3.77 years) were randomly divided into two groups, 1 and 2 (n = 15/group). Both groups received common treatments of CIE and hot packs, while Group 1 was given SFE additionally. To assess the outcomes, which included pain, cervical range of motion (CROM), and functional limitations, measurements were taken using a numeric pain rating scale (NPRS), a standard universal goniometer, and a neck disability index (NDI) questionnaire at the beginning of the study and 4 weeks after the interventions. A one-way multivariate followed by univariate analysis of covariance (MANCOVA and ANCOVA) was applied to examine the outcomes disparities within-group and between-group, with a significance level at 95% (i.e., p < 0.05). Results: MANCOVA analysis revealed a significant impact of interventions on CROM in all directions, NPRS, and NDI scores, even after adjusting for initial scores (F (8, 13) = 90.1; p=0.001). Univariate ANCOVA showed significant improvements in outcomes for Group 1 compared to Group 2. Conclusions: Adding SFE to CIE and conventional physiotherapy was more effective than just using CIE and conventional physiotherapy alone. This approach better alleviated neck pain, improved CROM (particularly in forward and left-side flexion), and reduced functional limitations in individuals with CMNP. Trial Registration: ClinicalTrials.gov Identifier: NCT05624021.