Additional Effects of Semispinalis Cervicis Strengthening With Craniocervical Flexion Training on Chronic Neck Pain

"10-minute hot pack treatment before starting the protocol. Week 1: Muscle Activation, • Hold for 5-10 seconds.~* Perform in supine with a sphygmomanometer device.~* Nod head gently as if saying yes, aiming for 20-22 mmHg. Week 2: Endurance Training Goal: • Hold for 10-15 seconds. Increase holding time and precision.~Exercise:~• Maintain the contraction at 24-26 mmHg on the device. Week 3: Strength and Postural Training •Hold for 15 seconds.~Exercise:~* Perform CCFT in sitting or standing. Week 4: Functional Integration~* Maintain contraction during functional tasks (e.g., desk work).~* Hold for 15-20 seconds.~* Sets/Reps: 3 sets of 8-12 repetitions."

"Craniocervical flexion training will be same as given to group A.~Week 1: Semispinalis Cervicis Activation:~* Patient sits upright with neutral spine.~* Therapist applies gentle manual resistance at C2 vertebra while the patient resists backward motion.~* Hold for 3-5 seconds, then relax.~Week 2: Progressive Activation with Increased Resistance:~* Apply moderate manual resistance at C2.~* Hold for 5 seconds, focusing on controlled movement.~Week 3: Strength and Functional Coordination with Dynamic Resistance:~* Introduce light movement (e.g., slight backward head tilt) under resistance.~* Therapist adjusts resistance dynamically.~Week 4: Advanced Endurance and Functional Integration with Functional Movements:~* Combine resistance training with controlled head rotations or slight lateral flexion.~* Maintain resistance and stability.~* Reps/Sets: 3-4 sets of 12 reps."