Core Stability vs Scapular Stabilization on Hand Grip Strength in Chronic Myofascial Neck Pain

Chronic myofascial neck pain (CMNP) is a painful non-articular musculoskeletal neck syndrome that is a persistent and prevalent with a high incidence of recurrence rate range 30-93%.Management of myofascial trigger points were directed at its deactivation, and prevention of its recurrence. Based on mechanical kinetic chain, the upper extremity functions as a unique system of connected segments those collaborated in a harmony in order to perform daily life activities. Core stability exercises maximize motor pathways mechanoreceptors' activities, as well scapular stabilization exercises are generally recommended based on reported benefits in terms of chronic neck pain. The relationship between chronic myofascial neck pain, and hand disability is quite strong. From mechanical point of view, core stability exercises improve trunk stability in line to enhance upper extremity efficiency that facilitates hand, and pinch grasping. In addition, scapular stabilization exercises could improve both hand, and pinch grasp strength and dexterity. Therefore, this randomized clinical trial will be conducted in line to clarify the superiority of the therapeutic effects between core stability exercises, scapular stabilization exercises, and conventional physical therapy program on hand grip strength, pinch grip strength, neck pain intensity level, pain pressure threshold, and whole upper extremity functional level in patients with chronic myofascial neck pain.

Inclusion Criteria: 1. Patients diagnosed with chronic myofascial neck pain depending on referral, and physical examination. 2. Sixty patients diagnosed with chronic myofascial neck pain for more than six months. 3. Patients age range will 25-45 years 4. Patients body mass index (BMI) will be 18.5-24.9 kg/m2 5. Each patient suffering from all active MTrPs in the upper trapezius muscle with painful/ tender nodule. 6. Patients have a constant neck pain with positive jump sign when palpating the upper trapezius muscle. 7. Patients have referred pain, and symptoms of ipsilateral hand muscle weakness. 8. No history of undergoing physiotherapy modalities or corticosteroid injection therapies in the past six months before the study Exclusion Criteria: 1. Presence of signs of severe pathology such as malignancies, mainly of the cervical region. 2. Fracture of the cervical spine. 3. Cervical radiculopathy or myelopathy. 4. Diabetes mellitus. 5. Trauma, cognitive anomalies, and surgery around neck, shoulders, or hand. 6. Fibromyalgia or vascular syndromes such as vertebral basilar insufficiency. 7. Pregnancy. 8. Having undergone physical therapy within the past three months before the study. 9. Having corticosteroid injection therapies in the past 3 months before the study.