Efficacy of tuina versus PNF technique in patients with NCNP:study protocol for a randomized controlled trial (Preprint)

BACKGROUND Background Nonspecific chronic neck pain (NCNP) is characterised by a long course, a high recurrence rate and a young age of onset causing a huge economic burden. Much scientific evidence supports the efficacy of tuina for NCNP. However, there is a lack of evidence of the effectiveness of the Proprioceptive Neuromuscular Facilitation (PNF) technique in the treatment of this condition, let alone the effectiveness of the combination of the two methods. This trial will allow valuable and high-quality data to be collected to evaluate the efficacy of PNF technique combined with tuina versus tuina or PNF technique for treating NCNP. OBJECTIVE The purpose of this study is to compare the effects of PNF technique, tuina and their combination in patients with NCNP. METHODS The trial design is a randomized, controlled, parallel, double-blind, three-arm clinical trial of treatment conducted at the Beijing University of Chinese Medicine and its affiliated hospitals. It employs a blinded method, with assessors and analysts unaware of treatment assignments. Patients will be recruited and randomly assigned to the PNF group, the tuina group, and the combined group in a 1:1:1 ratio. The intervention in the PNF technique group lasts 30 min each time including both PNF stretching and PNF plyometrics. The tuina group will receive TCM tuina therapy for 30 min. The PNF and tuina combined group will receive 30 minutes of PNF technique followed by 30 minutes of tuina therapy. Participants will receive 4 weeks of treatment, 3 times per week, for a total of 12 treatments. The visual analogue scale(VAS) and the neck disability index(NDI) will be used as the primary outcome measure. Cervical active joint mobility measured by the MicroFET3 Portable Muscle Strength Test & Joint Mobility Meter, together with muscle physical properties testing measured by the Myoton Muscle Tester will be used as secondary outcome measures. The data will be analyzed at the baseline, at the end of the intervention, and during the 1 month of follow-up by repeated measures analysis of variance. The significance level is 5%. The safety of tuina and PNF technique will be evaluated after each treatment session. The results of this trial will help clarify the value of tuina, PNF technique and their combination as treatments for NCNP and will highlight any differences in the efficacy of the treatments. RESULTS This enrollment of the study is ongoing. The first results are expected to be submitted for publication in 2025. CONCLUSIONS The purpose of this trial is to determine whether PNF technique is more effective than tuina in adults with NCNP. This trial will, therefore, contribute to providing a solid foundation for clinical treatment of NCNP. CLINICALTRIAL Trials registration number This trial has been registered in the International Traditional Medicine Clinical Trial Registry (registration number: ITMCTR2023000061).