Muscle Energy Technique and Facet Joint Mobilization in Chronic Neck Pain.

NCT ID: NCT05040477

Last Updated: 2023-07-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

105 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-08-30

Study Completion Date

2021-07-31

Brief Summary

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The purpose of the study is to compare the muscle energy technique, facet joint mobilization and conventional physical therapy in individuals with chronic neck pain on cervical lordosis, cervical range of motions, numeric pain rating scale and NDI. A randomized control trial was conducted at physiotherapy department of HIT hospital, Taxila Cantt. The sample size was 105 calculated through open-epi tool. The participants were divided into three interventional groups, experimental group (1), experimental group (2), and control group (3) each having 35 participants. The study duration was six months. Sampling technique applied was Purposive sampling for recruitment and group randomization using sealed envelope method. Only 35 to 50 years participants with 4-8 pain intensity on NPRS in cervical region were included in the study. Goniometer, Posterior tangent method on lateral radiographs for cervical curve and Self structured Questionnaire. Data was collected at baseline then 2 and 4 weeks after the application of interventions. Data analyzed through SPSS version 21.

Detailed Description

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Conditions

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Chronic Neck Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Experimental Group (1): Muscle energy techniques,Moist Hot pack and TENS.

Experimental group included Moist Hot pack of 14/15' over cervical region for 15 mins. Hydro collator Temperature according to standardized hot pack is 40-45C.Conventional TENS applied for 10 mins.

Baseline NPRS, NDI, Cervical ROMs, and posterior tangent angle.These pre and post intervention values were mentioned in questionnaire. The participants were administered with muscle energy technique (PIR) and data was collected again 2 and 4 weeks after the interventions.

Group Type EXPERIMENTAL

Muscle energy Technique

Intervention Type OTHER

Muscle Energy technique was used to increase the strength of weak muscles,relaxation of tightened muscles in result mobilizes the restricted joint segments.MET's group received 3-5 repetition of post isometric relaxation (PIR).

Treatment through Facet Joint Mobilization based on 3 sets of 15 repetitions of unilateral poster-anterior glide (UPA) using initially grade I \& II mobilizations followed by grade III of mitland glides on selected tender segments and 5 repetitions of extension sustained natural apophyseal glides (SNAGs) on hypo mobile segments.

Conventional therapy comprising of stretching and isometric strengthening exercises in combination with TENS and heat therapy.

Experimental Group (2): Facets joint mobilizations, Moist Hot pack and TENS.

Experimental group includedMoist Hot pack of 14/15' over cervical region for 15 mins. Hydro collator Temperature according to standardized hot pack is 40-45οC.Conventional TENS applied for 10 mins.

Baseline NPRS, NDI, Cervical ROMs, and posterior tangent angle. These pre and post intervention values were mentioned in questionnaire. The participants were administered with Facet joint mobilization (UPA \& SNAGS) and data was collected again 2 and 4 weeks after the interventions.

Group Type EXPERIMENTAL

Muscle energy Technique

Intervention Type OTHER

Muscle Energy technique was used to increase the strength of weak muscles,relaxation of tightened muscles in result mobilizes the restricted joint segments.MET's group received 3-5 repetition of post isometric relaxation (PIR).

Treatment through Facet Joint Mobilization based on 3 sets of 15 repetitions of unilateral poster-anterior glide (UPA) using initially grade I \& II mobilizations followed by grade III of mitland glides on selected tender segments and 5 repetitions of extension sustained natural apophyseal glides (SNAGs) on hypo mobile segments.

Conventional therapy comprising of stretching and isometric strengthening exercises in combination with TENS and heat therapy.

Control Group:Conventional Therapy (Stretching, strengthening , Moist Hot pack and TENS)

Control group includedMoist Hot pack of 14/15' over cervical region for 15 mins. Hydro collator Temperature according to standardized hot pack is 40-45οC.Conventional TENS applied for 10 mins.

Baseline NPRS, NDI, Cervical ROMs, and posterior tangent angle. These pre and post intervention values were mentioned in questionnaire. The participants were administered with Conventional (sustained stretching and isometric strengthening) physical therapy and data was collected again 2 and 4 weeks after the interventions.

Group Type ACTIVE_COMPARATOR

Muscle energy Technique

Intervention Type OTHER

Muscle Energy technique was used to increase the strength of weak muscles,relaxation of tightened muscles in result mobilizes the restricted joint segments.MET's group received 3-5 repetition of post isometric relaxation (PIR).

Treatment through Facet Joint Mobilization based on 3 sets of 15 repetitions of unilateral poster-anterior glide (UPA) using initially grade I \& II mobilizations followed by grade III of mitland glides on selected tender segments and 5 repetitions of extension sustained natural apophyseal glides (SNAGs) on hypo mobile segments.

Conventional therapy comprising of stretching and isometric strengthening exercises in combination with TENS and heat therapy.

Interventions

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Muscle energy Technique

Muscle Energy technique was used to increase the strength of weak muscles,relaxation of tightened muscles in result mobilizes the restricted joint segments.MET's group received 3-5 repetition of post isometric relaxation (PIR).

Treatment through Facet Joint Mobilization based on 3 sets of 15 repetitions of unilateral poster-anterior glide (UPA) using initially grade I \& II mobilizations followed by grade III of mitland glides on selected tender segments and 5 repetitions of extension sustained natural apophyseal glides (SNAGs) on hypo mobile segments.

Conventional therapy comprising of stretching and isometric strengthening exercises in combination with TENS and heat therapy.

Intervention Type OTHER

Other Intervention Names

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Facet Joint Mobilization Conventional Therapy

Eligibility Criteria

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Inclusion Criteria

* Chronic patients (more than 12 weeks)
* Male and female patients
* Patients having recurrence of neck pain at least once in the last month.
* Patients from the age group of 35-50 years.
* Patients having mechanical neck pain ranging from 4-8 on Numeric Pain Rating Scale (NPRS).
* Cervical straightening on X-rays.
* Limited \&painful cervical Rang of motion (ROMs)

Exclusion Criteria

* Any recent history of trauma, active inflammation, Tumor, vertebra-basilar insufficiency and cervical myelopathy \& radiculopathy.
* No history of serious underlying pathology, nerve root compromise, structural changes and deformities, genetic spinal disorders or previous spinal surgery
Minimum Eligible Age

35 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Riphah International University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lal Gul Khan, MS

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

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HIT Taxila Cantt Hospital

Rawalpindi, Punjab Province, Pakistan

Site Status

Countries

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Pakistan

References

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Borisut S, Vongsirinavarat M, Vachalathiti R, Sakulsriprasert P. Effects of strength and endurance training of superficial and deep neck muscles on muscle activities and pain levels of females with chronic neck pain. J Phys Ther Sci. 2013 Sep;25(9):1157-62. doi: 10.1589/jpts.25.1157. Epub 2013 Oct 20.

Reference Type BACKGROUND
PMID: 24259936 (View on PubMed)

Akhter S, Khan M, Ali SS, Soomro RR. Role of manual therapy with exercise regime versus exercise regime alone in the management of non-specific chronic neck pain. Pak J Pharm Sci. 2014 Nov;27(6 Suppl):2125-8.

Reference Type BACKGROUND
PMID: 25410083 (View on PubMed)

3. Gautam R, Dhamija JK, Puri A, Trivedi P, Sathiyavani D, Nambi G. Comparison of Maitland and Mulligan mobilization in improving neck pain, ROM and disability. Int J Physiother Res. 2014;2(3):561-6.

Reference Type BACKGROUND

Andersen LL, Saervoll CA, Mortensen OS, Poulsen OM, Hannerz H, Zebis MK. Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: randomised controlled trial. Pain. 2011 Feb;152(2):440-446. doi: 10.1016/j.pain.2010.11.016. Epub 2010 Dec 21.

Reference Type BACKGROUND
PMID: 21177034 (View on PubMed)

5. Sutjana IDP, Erg M, PFK S, Erg A, Sutjana IDP, Irfan M, et al. Pemberian Teknik Mulligan Dan Soft Tissue Mobilization Lebih Baik Daripada Hanya Soft Tissue Mobilization Dalam Meningkatkan Lingkup Gerak Sendi Ekstensi, Rotasi, Lateral Fleksi Cervical Pada Mechanical Neck Pain. Sport and Fitness Journal. 2013;1(2).

Reference Type BACKGROUND

Yoon SY, Moon HI, Lee SC, Eun NL, Kim YW. Association between cervical lordotic curvature and cervical muscle cross-sectional area in patients with loss of cervical lordosis. Clin Anat. 2018 Jul;31(5):710-715. doi: 10.1002/ca.23074. Epub 2018 Apr 14.

Reference Type BACKGROUND
PMID: 29575212 (View on PubMed)

Scheer JK, Tang JA, Smith JS, Acosta FL Jr, Protopsaltis TS, Blondel B, Bess S, Shaffrey CI, Deviren V, Lafage V, Schwab F, Ames CP; International Spine Study Group. Cervical spine alignment, sagittal deformity, and clinical implications: a review. J Neurosurg Spine. 2013 Aug;19(2):141-59. doi: 10.3171/2013.4.SPINE12838. Epub 2013 Jun 14.

Reference Type BACKGROUND
PMID: 23768023 (View on PubMed)

Page P. Current concepts in muscle stretching for exercise and rehabilitation. Int J Sports Phys Ther. 2012 Feb;7(1):109-19.

Reference Type BACKGROUND
PMID: 22319684 (View on PubMed)

9. Chaitow L, Crenshaw K. Muscle energy techniques: Elsevier Health Sciences; 2006

Reference Type BACKGROUND

10. Kage V, Bootwala F, Kudchadkar G. Effect of Bowen Technique versus Muscle Energy Technique on Asymptomatic Subjects with Hamstring Tightness: A Randomized Clinical Trial. International Journal of Medical Research & Health Sciences. 2017;6(4):102-8.

Reference Type BACKGROUND

Peng B, Pang X, Li D, Yang H. Cervical spondylosis and hypertension: a clinical study of 2 cases. Medicine (Baltimore). 2015 Mar;94(10):e618. doi: 10.1097/MD.0000000000000618.

Reference Type BACKGROUND
PMID: 25761188 (View on PubMed)

Buyukturan O, Buyukturan B, Sas S, Kararti C, Ceylan I. The Effect of Mulligan Mobilization Technique in Older Adults with Neck Pain: A Randomized Controlled, Double-Blind Study. Pain Res Manag. 2018 May 15;2018:2856375. doi: 10.1155/2018/2856375. eCollection 2018.

Reference Type BACKGROUND
PMID: 29861800 (View on PubMed)

13. Hing W, Hall T, Rivett DA, Vicenzino B, Mulligan B. The Mulligan Concept of Manual Therapy-eBook: Textbook of Techniques: Elsevier Health Sciences; 2015.

Reference Type BACKGROUND

14. Maitland G, Bank K. Vertebral manipulation 2002. Butterworth Heinemann, Oxford

Reference Type BACKGROUND

Osama M, Tassadaq N, Malik RJ. Effect of muscle energy techniques and facet joint mobilization on spinal curvature in patients with mechanical neck pain: A pilot study. J Pak Med Assoc. 2020 Feb;70(2):344-347. doi: 10.5455/JPMA.14189.

Reference Type BACKGROUND
PMID: 32063632 (View on PubMed)

16. Gupta S, Jaiswal P, Chhabra D. A comparative study between postisometric relaxation and isometric exercises in non-specific neck pain. Journal of exercise science and physiotherapy. 2008;4(2):88-94.

Reference Type BACKGROUND

17. Sharma A, Angusamy R, Kalra S, Singh S. Efficacy of post-isometric relaxation versus integrated neuromuscular ischaemic technique in the treatment of upper trapezius trigger points. Indian Journal of Physiotherapy and Occupational Therapy. 2010;4(3):1-5.

Reference Type BACKGROUND

18. Sharmila B. Isometric muscle energy technique and non-specific neck pain in secondary school teachers-results of an experimental study. Indian Journal of Physiotherapy and Occupational Therapy. 2014;8(2):58.

Reference Type BACKGROUND

19. Mahajan R, Kataria C, Bansal K. Comparative effectiveness of muscle energy technique and static stretching for treatment of subacute mechanical neck pain. Int J Health Rehabil Sci. 2012;1(1):16-21.

Reference Type BACKGROUND

20. Rana AA, Ahmad A, Gillani SA, Idrees MQ, Awan I. Effects of conventional physical therapy with and without muscle energy techniques for treatment of Upper Cross Syndrome. Rawal Medical Journal. 2020;45(1):127-32

Reference Type BACKGROUND

21. Pragassame SA, Kurup VM, Kour J. Efficacy of sustained natural apophyseal glides mulligan technique on mobility and function in patients with cervical spondylosis: An experimental study. Journal of Natural Science, Biology and Medicine. 2020;11(2):128

Reference Type BACKGROUND

22. Al Shehri A, Khan S, Shamsi S, Almureef SS. COMPARATIVE STUDY OF MULLIGAN (SNAGS) AND MAITLAND MOBILIZATION IN NECK PAIN. European Journal of Physical Education and Sport Science. 2018

Reference Type BACKGROUND

Tabassum H, Mariam M, Gondal KS. Comparison of muscle energy technique and facet joint mobilisation in the patient with chronic neck pain: A randomized controlled trial. J Pak Med Assoc. 2024 Jan;74(1):10-15. doi: 10.47391/JPMA.9206.

Reference Type DERIVED
PMID: 38219157 (View on PubMed)

Other Identifiers

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REC/00868 Huma Tabassum

Identifier Type: -

Identifier Source: org_study_id

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