Effect of Mulligan Snag and Diaphragmatic Release on Thoracic Kyphosis

NCT ID: NCT05458206

Last Updated: 2023-07-25

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-10-20
• Study Completion Date: 2023-03-20

Brief Summary

the aim of this study is to investigate the efficacy of mulligan snag mobilisation and diaphragmatic release on upper crossed syndrome

Detailed Description

Acquired postural disorders can be a consequence, to a large extent, of contemporary living and working conditions. Some of the most typical factors include continuous use of mobile phones and computers, working in sedentary jobs. Prolonged incorrect posture and reduced physical activity present a dis-balance in the musculature . It can also lead to vision issues, as well as headaches, musculoskeletal issues, and pain, as well as a multitude of other symptoms.

Upon the available research studies, there is not study conducted to investigate the effect of mulligan SNAG mobilization and diaphragmatic release in upper crossed syndrome patients this trial has four groups; one will receive diaphragmatic release + conventional, the second will receive mulligan SNAG mobilization, and conventional, the third will receive mulligan SNAG mobilization+diaphragmatic release+conventional, the fourth subjects will receive conventional

Conditions

Postural Kyphosis, Cervicothoracic Region

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

diaphragmatic release, and conventional

Diaphragmatic release:

The patients will be positioned in the supine position. The therapist stood at the head of the patient. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ) with hypothenar regions of the hands and the last three fingers. During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally, while elevating the ribs simultaneously. During exhalation, the therapist will deepen hand contact toward the inner coastal margins for 5 to 7 minute conventional therapy: the patient will receive chin-in, interscapular exercises, and pectoralis stretch

Group Type: EXPERIMENTAL

mulligan snag mobilization and diaphragmatic release

Intervention Type: OTHER

The patients will be in the supine position. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ). During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally. During exhalation, the therapist will deepen hand contact toward the inner coastal margins.

mulligan snag, Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement

mulligan SNAG mobilization, and conventional

mulligan snag: Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement and then sustains it at the end range position for a few seconds. (3 sets,10 repetitions) conventional therapy: the patient will receive chin-in, interscapular exercises, and pectoralis stretch

Group Type: EXPERIMENTAL

mulligan snag mobilization and diaphragmatic release

Intervention Type: OTHER

The patients will be in the supine position. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ). During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally. During exhalation, the therapist will deepen hand contact toward the inner coastal margins.

mulligan snag, Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement

mulligan SNAG mobilization, diaphragmatic release, and conventional

Diaphragmatic release:

The patients will be positioned in the supine position. The therapist stood at the head of the patient. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ) with hypothenar regions of the hands and the last three fingers. During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally, while elevating the ribs simultaneously. During exhalation, the therapist will deepen hand contact toward the inner coastal margins. (5 to 7 minutes) mulligan snag: Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement and then sustains it at the end range position for a few seconds(3 sets,10 repetitions) conventional therapy: the patient will receive chin-in, interscapular exercises, and pectoralis stretch

Group Type: EXPERIMENTAL

mulligan snag mobilization and diaphragmatic release

Intervention Type: OTHER

The patients will be in the supine position. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ). During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally. During exhalation, the therapist will deepen hand contact toward the inner coastal margins.

mulligan snag, Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement

the conventional therapy

the patient will receive chin-in, inter-scapular exercises, and pectoralis stretch (3 sets,10 repetitions)

Group Type: ACTIVE_COMPARATOR

mulligan snag mobilization and diaphragmatic release

Intervention Type: OTHER

The patients will be in the supine position. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ). During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally. During exhalation, the therapist will deepen hand contact toward the inner coastal margins.

mulligan snag, Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement

Interventions

mulligan snag mobilization and diaphragmatic release

The patients will be in the supine position. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ). During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally. During exhalation, the therapist will deepen hand contact toward the inner coastal margins.

mulligan snag, Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Age ranged from 17 to 22 years .
• Body Mass Index from 20 to 25 kg/m² .
• All participants have an intensity of neck pain on VAS (4-8) (moderate cases) .
• The subjects were chosen from both sexes.
• All participants have kyphosis angle ≥42°
• All participants have mechanical neck pain and FHP (craniovertebral angle CVA < 49) CVA of < 49) .

Exclusion Criteria

• Malignancy
• Fractures of the cervical spine
• Cervical radiculopathy or myelopathy
• Vascular syndromes such as vertebrobasilar insufficiency
• Rheumatoid arthritis
• Neck or upper back surgery
• Taking anticoagulants
• Local infection
• Whiplash injury

• Minimum Eligible Age: 17 Years
• Maximum Eligible Age: 22 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Mariam omran Grase

lecturer at basic science department, faculty of physical therapy cairo university

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Faculty of physical therapy Cairo university

Cairo, Giza Governorate, Egypt

Faculty of physical therapy

Cairo, Giza Governorate, Egypt

Countries

Egypt

Other Identifiers

p.t.REC/012/003548

Identifier Type: -

Identifier Source: org_study_id