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CTRI Number  CTRI/2026/02/104667 [Registered on: 24/02/2026] Trial Registered Prospectively
Last Modified On: 22/02/2026
Post Graduate Thesis  Yes 
Type of Trial  Interventional 
Type of Study   Physiotherapy (Not Including YOGA) 
Study Design  Randomized, Parallel Group, Placebo Controlled Trial 
Public Title of Study   Effect Of First Rib Mobilization Combined With Scapular Stabilization Exercises In Non-specific Chronic Neck Pain 
Scientific Title of Study   Effect Of First Rib Mobilization Combined With Scapular Stabilization Exercises On Pain, Range And Disability In Non-specific Chronic Neck Pain: A Randomized Controlled Trial 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Priyanka R Murkumbi 
Designation  Postgraduate student (OMT) 
Affiliation  KLE institute of Physiotherapy Belgavi 
Address  KLES Dr. Prabhakar Kore Hospital and MRC, Advanced Physiotherapy Centre Orthopaedic Physiotherapy Department Room Nagar, Belagavi, Karnataka-590010 Belgaum KARNATAKA 590010 India

Belgaum
KARNATAKA
590010
India 
Phone  09449242854  
Fax    
Email  priyankarmdhr@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr Anand Hegganavar 
Designation  Professor and Head of Department, Orthopaedic Manual Therapy 
Affiliation  KLE institute of Physiotherapy Belgavi 
Address  KLES Dr. Prabhakar Kore Hospital and MRC, Advanced Physiotherapy Centre Orthopaedic Physiotherapy Department Room Nagar, Belagavi, Karnataka-590010 Belgaum KARNATAKA 590010 India

Belgaum
KARNATAKA
590010
India 
Phone  9945282896  
Fax    
Email  anandheggannavar@klekipt.edu.in   
 
Details of Contact Person
Public Query
 
Name  Dr Anand Hegganavar 
Designation  Professor and Head of Department, Orthopaedic Manual Therapy 
Affiliation  KLE institute of Physiotherapy Belgavi 
Address  KLES Dr. Prabhakar Kore Hospital and MRC, Advanced Physiotherapy Centre Orthopaedic Physiotherapy Department Room Nagar, Belagavi, Karnataka-590010 Belgaum KARNATAKA 590010 India

Belgaum
KARNATAKA
590010
India 
Phone  9945282896  
Fax    
Email  anandheggannavar@klekipt.edu.in   
 
Source of Monetary or Material Support  
NIL 
 
Primary Sponsor  
Name  Priyanka R Murkumbi 
Address  KAHER Institute of Physiotherapy, Belagavi, Karnataka, India 590010 
Type of Sponsor  Other [self] 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
DrAnand Heggannavar  Priyanka R Murkumbi  KLES Dr. Prabhakar Kore Hospital and MRC, Advanced Physiotherapy Centre Orthopaedic manualtherapy Department Room number. 13 Nehru Nagar, Belagavi, Karnataka-590010
Belgaum
KARNATAKA 
09449242854

priyankarmdhr@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
Research and Ethical Committe, KLEU Institute of Physiotherapy, Belagavi  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Healthy Human Volunteers  Non-specific Chronic Neck Pain 
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Conventional Physiotherapy With Sham First Rib Technique  Participants will receive conventional physiotherapy including moist hot pack therapy for ten minutes, interferential therapy with four electrodes placed over the cervical and upper trapezius region for fifteen minutes, neck isometric exercises, cervical range of motion exercises and upper trapezius and levator scapulae stretching. A sham first rib mobilization technique will be applied without therapeutic oscillatory pressure. The intervention will be given four sessions per week for three weeks. 
Intervention  First Rib Mobilization Combined With Scapular Stabilization Exercises  Participants will receive first rib mobilization using postero anterior and caudal directed oscillatory technique along the plane of the rib combined with scapular stabilization exercises including scapular retraction, depression and protraction using resistance bands, prone Y T W exercises for lower trapezius strengthening and serratus anterior activation using wall push ups plus. Conventional physiotherapy including moist hot pack therapy, interferential therapy, neck isometric exercises, cervical range of motion exercises and stretching will also be given. The intervention will be provided four sessions per week for three weeks. 
 
Inclusion Criteria  
Age From  20.00 Year(s)
Age To  45.00 Year(s)
Gender  Both 
Details  Willingness to participate and provide informed consent.
All genders are included.
Between age of 20–45 years.
Non-specific chronic neck pain lasting more than or equal to 3 months.
Pain intensity more than or equal to 3 on Numerical Pain Rating Scale (NPRS). 
 
ExclusionCriteria 
Details  History of cervical trauma, fracture or surgery.
Any congenital anomalies of cervical spine like cervical rib, fusion of spine.
Cervical radiculopathy and myelopathy.
Shoulder related pathology.
Systemic or inflammatory disorders.
Neurological or vestibular dysfunctions.
Neck related structural deformity. 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   Sequentially numbered, sealed, opaque envelopes 
Blinding/Masking   Outcome Assessor Blinded 
Primary Outcome  
Outcome  TimePoints 
Pain intensity measured using Numerical Pain Rating Scale.  Pre assessment and post assessment of outcome measures will be done immediately post intervention (3 weeks)  
 
Secondary Outcome  
Outcome  TimePoints 
Cervical range of motion measured using Dual Inclinometer.  Pre assessment & post assessment of outcome measures will be done immediately post intervention (3 weeks)  
Functional disability measured using Neck Disability Index.  Pre assessment & post assessment of outcome measures will be done immediately post intervention (3 weeks)  
 
Target Sample Size   Total Sample Size="38"
Sample Size from India="38" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   06/03/2026 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="1"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary  

This study aims to evaluate the effect of first rib mobilization combined with scapular stabilization exercises on pain intensity, cervical range of motion and functional disability in individuals with non specific chronic neck pain. Chronic neck pain is commonly associated with altered cervicothoracic biomechanics, first rib dysfunction and scapular muscle imbalance. Although first rib mobilization and scapular stabilization exercises have shown individual benefits, the combined effect of these interventions has not been adequately explored. In this randomized parallel group placebo controlled trial, thirty eight participants aged twenty to forty five years with non specific chronic neck pain lasting three months or more will be randomly allocated into two groups. The control group will receive conventional physiotherapy with sham first rib mobilization. The experimental group will receive first rib mobilization combined with scapular stabilization exercises along with conventional physiotherapy. The intervention will be provided four sessions per week for three weeks. Primary outcome will be pain intensity measured using Numerical Pain Rating Scale. Secondary outcomes will include cervical range of motion measured using Dual Inclinometer and functional disability measured using Neck Disability Index. Outcomes will be assessed at baseline and after completion of three weeks of intervention. The findings of this study may help establish an effective biomechanically oriented physiotherapy approach for managing chronic neck pain.

 
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