Mulligan Mobilizations and McKenzie Exercises Along With Neural Mobilizations in Cervical Spondylosis

NCT ID: NCT05768438

Last Updated: 2023-03-14

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 80 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-12-05
• Study Completion Date: 2024-01-05

Brief Summary

Cervical pain is one of the common problem among general population. However, cervical spondylosis may cause unavoidable neck pain and range limitations due to wear and tear changes in the cervical spine. This condition can further lead to dysfunction and neuro musculoskeletal symptoms. Literature suggests the use of Mulligan therapy, McKenzie exercises and Neural mobilizations in spondylosis. According to author's knowledge there is limited evidence regarding effects of specific treatment approach.

Detailed Description

A randomized control trial will be conducted among 80 patients with cervical spondylosis having age group 40 to 60 years. The non-probability purposive sampling technique will be used to recruit on the basis of study criteria. The study settings will be Dow University of health sciences, Karachi Pakistan. After taking informed consent all the patients will be randomized into two groups (A, B). Group A will receive mulligan with upper limb movement of involved side, group B will receive McKenzie exercises and neural mobilizations. Patients will be evaluated at baseline and after four weeks of treatment by using a goniometer, numerical pain rating scale (NPRS), and neck disability index (NDI) for cervical range of motions, pain intensity and neck disability respectively. There will be twelve sessions of treatment with thrice a week.

Duration of each session will be thirty minutes. All the data will be entered and analyzed through statistical package of social sciences version 24. Descriptive analysis will be performed for both continuous and categorical data. Inferential statistics will be performed to compare pain, disability index and range of motion between group and within group. The level of significance will be considered as 0.05.

Conditions

Spondylosis

Study Design

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

Study Groups

Mulligan with upper limb movement

This study arm will receive following therapy

.) Mulligan with upper limb movement.

Group Type: EXPERIMENTAL

Mulligan with upper limb movement

Intervention Type: OTHER

Group A subjects will receive mulligan mobilizations with upper limb movement of the involved side. The patient will be in a sitting position and the therapist will stand beside the patient. The therapist will place one thumb overlapped by the other on one of the selected cervical and then the therapist will push down the spinous process of that specific vertebrae, the pressure will be sustained and the patient will actively abduct his/her arm, assistance will be provided if needed. Initially it will start from 10 repetitions and 1 set which will further progress up to 2 or 3 sets as per patient's tolerance with 60 seconds rest in between each set.

Mckenzie exercises with neural mobilizations

This study arm will receive following therapy

.) McKenzie exercises with neural mobilizations

Group Type: EXPERIMENTAL

McKenzie exercises with neural mobilizations

Intervention Type: OTHER

The subjects of Group B will receive McKenzie exercises. Initially, it will start with retraction exercises. The frequency of exercises will be 10 to 15 repetitions followed by three to four sets with one second hold. On the second or third day, the cervical extension will be added. While in the second week the same set of exercises will be administered with the patient in a sitting position combined with application of over pressure at the end range by therapist. In the third week, extension and retraction exercises will be performed along with traction which will be applied by the therapist. Finally, in the fourth week all retraction and lateral flexion then neck rotation and the last one retraction with neck flexion will be added. Neural mobilizations will be given to patients in group B in supine lying. From proximal to distal, 20 oscillations (1 oscillation/ 1 second)

Interventions

Mulligan with upper limb movement

Group A subjects will receive mulligan mobilizations with upper limb movement of the involved side. The patient will be in a sitting position and the therapist will stand beside the patient. The therapist will place one thumb overlapped by the other on one of the selected cervical and then the therapist will push down the spinous process of that specific vertebrae, the pressure will be sustained and the patient will actively abduct his/her arm, assistance will be provided if needed. Initially it will start from 10 repetitions and 1 set which will further progress up to 2 or 3 sets as per patient's tolerance with 60 seconds rest in between each set.

Intervention Type: OTHER

McKenzie exercises with neural mobilizations

The subjects of Group B will receive McKenzie exercises. Initially, it will start with retraction exercises. The frequency of exercises will be 10 to 15 repetitions followed by three to four sets with one second hold. On the second or third day, the cervical extension will be added. While in the second week the same set of exercises will be administered with the patient in a sitting position combined with application of over pressure at the end range by therapist. In the third week, extension and retraction exercises will be performed along with traction which will be applied by the therapist. Finally, in the fourth week all retraction and lateral flexion then neck rotation and the last one retraction with neck flexion will be added. Neural mobilizations will be given to patients in group B in supine lying. From proximal to distal, 20 oscillations (1 oscillation/ 1 second)

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• 40 - 60 years old adults.
• Diagnosed and referred cases of cervical spondylosis and both males and females are included.
• Unilateral radiculopathy pain C5-C8 and T1.
• Individuals whose Spurling's and distraction test is positive.
• Patients with NPRS > 3/10 score.
• Patients with ipsilateral cervical rotation less than 60 degrees.

Exclusion Criteria

Individuals with history of;

• cervical or shoulder girdle trauma.
• any specific pathology or red flags (diplopia, dizziness, drop attacks, dysarthria, dysphagia)
• cervical myelopathy
• neoplastic lesions
• vertebral artery insufficiency
• upper cervical ligamentous instability,
• spondylolisthesis
• hypermobile cervical spine
• cervical fracture inflammatory
• cardiac or severe psychiatric disease.

• Minimum Eligible Age: 40 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Dow University of Health Sciences

OTHER

Sponsor Role: lead

Responsible Party

Hafsa Shehzadi

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Hafsa Shehzadi, DPT

Role: PRINCIPAL_INVESTIGATOR

DOW university

Locations

Hafsa Shehzadi

Karachi, Sindh, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

Hafsa Shehzadi, DPT

Role: CONTACT

hafsashehzadi96@gmail.com

03112497040

Saba A Ali, MSAPT

Role: CONTACT

saba.aijaz@duhs.edu.pk

030028867690

Facility Contacts

Hafsa Shehzadi, DPT

Role: primary

hafsashehzadi96@gmail.com

03112497040

Saba A Ali, MSAPT

Role: backup

saba.aijaz@duhs.edu.pk

0300-2886769

Other Identifiers

1136

Identifier Type: -

Identifier Source: org_study_id