Effect of Attentional Focus Order in Home Exercise for Neck Pain

Summary

According to the International Association for the Study of Pain's 2017 terminology, neck pain is described as an unpleasant sensory and emotional experience originating in the cervical region and potentially radiating toward the scapular area, typically linked to actual or potential tissue injury. Although research on how attentional focus instructions influence postural control remains limited, existing findings suggest that the sequence in which these instructions are delivered can impact sensory processing during postural control assessments. These observations raise compelling questions about the potential benefits of using attentional focus strategies in a structured, sequential manner during neck pain treatment. To date, however, no study has investigated how varying the order of attentional focus cues within a home exercise program affects individuals with non-specific neck pain. This study aimed to fill that gap by evaluating the clinical effectiveness of a home-based exercise protocol utilizing attentional focus instructions in different sequences. The primary outcome was disability level, measured by the Neck Disability Index (NDI). Secondary outcomes included pain intensity assessed via the Visual Analog Scale (VAS), craniovertebral angle (CVA) via photogrammetry, pressure pain threshold (PPT), cervical joint range of motion, dizziness-related disability (Dizziness Handicap Inventory), and the endurance of neck flexor and extensor muscles.

Conditions

• Neck Pain
• Motor Learning
• Home Exercise Program

Interventions

OTHER

Internal focus of attention instructions- First

Participants first received internal focus instructions, directing their attention to their own body, followed by external focus instructions.

OTHER

External focus of attention instructions- First

Participants first received internal focus instructions, directing their attention to their own body, followed by external focus instructions.

OTHER

Home exercises

Participants' home exercise program includes cervical and scapulothoracic stabilization exercises and self-mobilization exercises with the self-sustained natural apophyseal glide (SNAG) method.

Sponsors & Collaborators

• Istanbul Nisantasi University

  collaborator OTHER

• Büşra Tamgüç

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

40 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-05-01

Primary Completion

2025-11-30

Completion

2025-12-31

Countries

• Turkey (Türkiye)

Study Locations