Effect of Integrated Neuromuscular Inhibition Technique on Patients With Non-Specific Neck Pain

Summary

Non-specific mechanical neck pain (NSNP) is a common musculoskeletal condition that causes neck pain, reduced movement, and difficulty performing daily activities. Manual therapy techniques are frequently used to manage this condition; however, evidence regarding the combined use of Integrated Neuromuscular Inhibition Technique (INIT) and cervical mobilization remains limited.

This randomized controlled trial aims to compare the effectiveness of INIT combined with cervical mobilization versus cervical mobilization with conventional physiotherapy in adults with non-specific mechanical neck pain. Forty-two participants aged 30-60 years will be allocated to one of two treatment groups. The experimental group will receive INIT, consisting of muscle energy technique, strain-counterstrain, and ischemic compression, in addition to cervical mobilization. The control group will receive cervical mobilization with conventional physiotherapy modalities. Both groups will receive five treatment sessions.

The primary outcomes are pain intensity, neck-related disability, and cervical range of motion. Outcomes will be assessed before treatment and after completion of the intervention using the Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), and cervical range of motion measurements. The findings of this study are expected to determine whether adding INIT to cervical mobilization provides greater improvements in pain, cervical mobility, and functional ability than conventional physiotherapy alone, thereby supporting evidence-based management of non-specific mechanical neck pain.

Conditions

• Non-specific Mechanical Neck Pain

Interventions

PROCEDURE

Integrated Neuromuscular Inhibition Technique (INIT)

Integrated Neuromuscular Inhibition Technique (INIT) is a multimodal manual therapy consisting of Muscle Energy Technique (MET), Strain-Counterstrain (SCS), and Ischemic Compression (IC). The intervention targets myofascial trigger points, muscle tightness, and neuromuscular dysfunction to reduce pain, improve cervical range of motion, and decrease functional disability. Participants received INIT in combination with cervical mobilization during five treatment sessions.

PROCEDURE

Conventional Physiotherapy

Conventional physiotherapy consisted of transcutaneous electrical nerve stimulation (TENS) applied for 15 minutes and hot pack therapy applied to the cervical and upper back region for 10-15 minutes. These modalities were provided together with cervical mobilization during each of the five treatment sessions.

PROCEDURE

Cervical Mobilization

Cervical mobilization was performed using Maitland mobilization techniques applied to the cervical spine (C1-C7) to improve joint mobility, reduce pain, and restore cervical range of motion. Mobilization was administered in three sets of ten repetitions during each of the five treatment sessions. This intervention was provided to participants in both study groups.

Sponsors & Collaborators

• Ibadat International University, Islamabad

  lead OTHER

Principal Investigators

• Zahid Mehmood, DPT, MSPT · Ibadat International University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

30 Years

Max Age

60 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-01-10

Primary Completion

2026-07-01

Completion

2026-07-02

Countries

• Pakistan

Study Locations