Comparison of joint mobilization vs. strengthening exercises for improving cervical proprioception in individuals with nonspecific neck pain: a randomized clinical trial

Patients with neck pain often experience proprioceptive dysfunction and other impairments. Although strengthening exercises and cervical joint mobilization effectively improve proprioception, their comparative effects remain unclear. This study compared cervical joint mobilization and strengthening exercises in patients with neck pain to assess their effects on proprioception and other outcomes, namely pain, muscle strength, ROM, and disability, and to explore correlations among these outcomes. This assessor-blinded randomized clinical trial (IRB-14-2024-06-07-95/IRB-PGS-2024-03-574) registered at ClinicalTrials.gov (NCT06960525). This study included 26 patients with chronic neck pain divided into two groups: (1) joint mobilization plus standardized care and (2) strengthening exercise plus standardized care. Both groups underwent 12 sessions over 4 weeks. Outcome measures included active cervical movement sense, joint position error, visual analog scale, hand-held dynamometer, inclinometer, and neck disability index. Outcomes were measured immediately after the 1st and 12th sessions. Patients in both groups showed significant improvements in all outcome measures, particularly at the 12th session. However, no significant differences were found between the groups for any outcome. Both cervical joint mobilization and strengthening exercises, delivered alongside standardized care, were associated with improvements in proprioception and other outcomes in patients with chronic neck pain in the short term, with no statistically significant between-group difference detected.