Aug 16, 2025

Public workspaceBiomechanical Therapy in Neck Pain Management

DOI
https://dx.doi.org/10.17504/protocols.io.3byl46qqjgo5/v1
  • Sadia Nowshin1,
  • Dr. Md. Feroz Kabir2
  • 1Jashore University of Science and Technology;
  • 2Jashore University of Science & Technology
Sadia Nowshin
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DOI: https://dx.doi.org/10.17504/protocols.io.3byl46qqjgo5/v1
Protocol Citation: Sadia Nowshin, Dr. Md. Feroz Kabir 2025. Biomechanical Therapy in Neck Pain Management. protocols.io https://dx.doi.org/10.17504/protocols.io.3byl46qqjgo5/v1
License: This is an open access protocol distributed under the terms of the Creative Commons Attribution License,  which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Protocol status: Working
We use this protocol and it's working
Created: August 15, 2025
Last Modified: August 16, 2025
Protocol Integer ID: 224789
Keywords: Function Induced Biomechanical Correction Therapy (FIBCT), Mechanical Neck Pain, Pressure Pain Threshold, Neck Disability Index (NDI) and Patient Specific Functional Scale (PSFS), biomechanical therapy in neck pain management, conventional physiotherapy for mechanical neck pain, management of mechanical neck pain, neck pain management, mechanical neck pain, neck disability index, effectiveness of function induced biomechanical correction therapy, function induced biomechanical correction therapy, conventional physiotherapy, pain sensitivity, biomechanical therapy, pain intensity, term efficacy of fibct, physiotherapy, pressure pain threshold, such as exercise therapy, exercise therapy, electrotherapy, fibct, pain
Abstract
This multi-centre, double-blinded randomized controlled trial will evaluate the effectiveness of Function Induced Biomechanical Correction Therapy (FIBCT) compared to conventional physiotherapy for mechanical neck pain. Eighty patients aged 18–50 years who are diagnosed with mechanical neck pain, will be recruited from three hospitals in Bangladesh and randomly allocated (1:1) to either FIBCT or conventional physiotherapy (such as exercise therapy and electrotherapy). Both groups will receive treatment twice a week for six weeks (12 sessions each lasting for 30–40 min). Primary outcomes include pain intensity (Visual Analogue Scale) and pain sensitivity (Pressure Pain Threshold). Secondary outcomes include Cervical Range of Motion (digital inclinometer), functional disability (Neck Disability Index), and patient-specific functional status (Patient-Specific Functional Scale). Data will be assessed at baseline and post-intervention by blinded evaluators. This trial aims to generate evidence on the short-term efficacy of FIBCT, supporting evidence-based management of mechanical neck pain in diverse clinical settings.
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Guidelines
Guidelines for Protocol Execution This multi-centre RCT will evaluate Function Induced Biomechanical Correction Therapy (FIBCT) versus conventional physiotherapy for mechanical neck pain.
  • Study Oversight: Conduct at Jashore University of Science and Technology and three Dhaka hospitals. Use computer-generated randomization with sealed envelope allocation concealment.
  • Blinding: Outcome assessors blinded; participants/therapists unblinded due to intervention nature.
  • Training: Certified physiotherapists for FIBCT and conventional therapy; trained assessors for VAS, algometry, digital inclinometer, NDI, PSFS.
  • Screening: Adults 18–50 with mechanical neck pain ≥4 weeks, VAS ≥3, no neurological deficits or structural pathology.
  • Interventions:
Control: 6-week conventional physiotherapy (heat, TENS, stretching, posture exercises), 12 sessions + daily home program.
Experimental: FIBCT with manual correction, proprioceptive retraining, strengthening; 12 sessions + daily home program.
  • Safety: Certified delivery to prevent injury, monitor for adverse effects, and report events to trial safety officer.
  • Ethics: Written consent, ICH-GCP adherence, confidentiality, voluntary participation, right to withdraw, emergency contact provided.
Materials
1. Biomechanical Therapy
o Equipment: Treatment plinth, pillows/bolsters, resistance bands, posture grid or plumb line, mobilization wedges (if applicable), mirror for visual feedback.
o Monitoring: Timer, attendance log sheets.
2. Conventional Physiotherapy
o Heat Therapy: Hot packs, hydrocollator unit, towels.
o Electrotherapy: TENS unit, electrodes, conductive gel, alcohol swabs.
o Exercise: Exercise mats, stretching straps/belts.
3. Outcome Assessments
o Pain: Visual Analogue Scale (VAS) forms, pressure algometer.
o Range of Motion: Digital inclinometer.
o Disability: Neck Disability Index (NDI) forms, Patient-Specific Functional Scale (PSFS) forms.
4. Data Management
o Forms: Data collection sheets (VAS, PPTs, ROM, NDI, PSFS), adverse event reporting forms.
o Storage: Computer with database software, secure filing cabinet, external hard drive or secure cloud storage.
5. Safety/Emergency
o Sharps container (for TENS electrodes), first aid kit, hand sanitizer, disinfectant wipes, emergency contact list.
6. Participant Materials
o Consent forms, study information sheets (English/Bengali).
Troubleshooting
Before start
  • Obtain ethical approval and trial registration.
  • Train physiotherapists and assessors in intervention protocols and measurement tools (VAS, algometry, inclinometer, NDI, PSFS).
  • Prepare randomization sequence and sealed opaque envelopes.
  • Screen participants for eligibility (mechanical neck pain ≥4 weeks, VAS ≥3, age 18–50, no neurological deficits/structural pathology).
  • Obtain written informed consent and explain procedures, benefits, risks, and withdrawal rights.
  • Set up treatment areas with required equipment (heat packs, TENS unit, FIBCT tools, exercise mats).
  • Establish safety monitoring and adverse event reporting procedures.
Protocol references
  1. Masaracchio, M., Kirker, K., States, R., & Cleland, J. A. (2019). Thoracic spine manipulation for the management of mechanical neck pain: A systematic review and meta-analysis. PLOS ONE, 14(2), e0211877. https://doi.org/10.1371/journal.pone.0211877
  2. GBD 2021 Neck Pain Collaborators. Global, regional, and national burden of neck pain, 1990–2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2024 Mar;6(3):e142-e155.
  1. Falco FJ, Erhart S, Wargo BW, Bryce DA, Atluri S, Datta S, et al. Systematic review of diagnostic utility and therapeutic effectiveness of cervical facet joint interventions. Pain Physician. 2009;12(2):323-44.
4. Bernal-Utrera, Carlos, Juan Jose Gonzalez-Gerez, Ernesto Anarte-Lazo, and Cleofas Rodriguez-Blanco. 2020. “Manual Therapy versus Therapeutic Exercise in Non-Specific Chronic Neck Pain: A Randomized Controlled Trial.” Trials 21 (1): 682. https://doi.org/10.1186/s13063-020-04610-w
  1. Safiri, S., Kolahi, A. A., Hoy, D., Buchbinder, R., Mansournia, M. A., Bettampadi, D., Ashrafi-Asgarabad, A., Almasi-Hashiani, A., Smith, E., Sepidarkish, M., Cross, M., Qorbani, M., Moradi-Lakeh, M., Woolf, A. D., March, L., Collins, G., & Ferreira, M. L. (2020). Global, regional, and national burden of neck pain in the general population, 1990-2017: systematic analysis of the Global Burden of Disease Study 2017. BMJ (Clinical research ed.), 368, m791. https://doi.org/10.1136/bmj.m791
  2. March L, Smith EU, Hoy DG, Cross MJ, Sanchez-Riera L, Blyth F, et al. Burden of disability due to musculoskeletal (MSK) disorders. Best Pract Res Clin Rheumatol. 2014;28(3):353–66. https://doi.org/10.1016/j.berh.2014.08.002
  3. Childress, M. A., & Stuek, S. J. (2020). Neck Pain: Initial Evaluation and Management. American family physician, 102(3), 150–156.
  1. Teles, J. C. de M. A., Oliveira, D. N. de, Mota, A. V. S., Gomes, P. X. L., & Santos-Júnior, F. F. U. (2016). Effect of manipulative treatment in patients with mechanical neck pain: a systematic review. Manual Therapy, Posturology & Rehabilitation Journal, 1–7. https://doi.org/10.17784/mtprehabjournal.2016.14.318
  1. Buckle PW, Devereux JJ. The nature of work-related neck and upper limb musculoskeletal disorders. Appl Ergon. 2002;33(3):207-17.
  1. Strimpakos N. The assessment of the cervical spine. Part 1: Range of motion and proprioception. J Bodyw Mov Ther. 2011;15(1):114-24.
Acknowledgements
The authors sincerely acknowledge the support of the Department of Physiotherapy & Rehabilitation, Jashore University of Science and Technology, Bangladesh, and the collaborating hospitals for facilitating participant recruitment and study implementation. We also thank all physiotherapists, research staff, and participants for their valuable contributions. This study received partial funding from the Department of Physiotherapy & Rehabilitation (PTR), JUST.