Effects of Mulligan Mobilization With and Without Sling Exercises in Non-specific Neck Pain

NCT ID: NCT06241014

Last Updated: 2024-10-15

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 46 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-03-10
• Study Completion Date: 2024-10-10

Brief Summary

Neck pain is one of the common musculoskeletal problems. People with neck pain can have difficulties with daily activities and be limited in work and social participation. Main symptoms of people with neck pain include pain, decreased range of motion (ROM), muscle weakness and dysfunction. Common neck pain causes include degenerative disc disease, herniated disc disease, cervical radiculopathies, myofascial pain syndrome and viral infections. Muscular strains, postural and ergonomics are also related to neck pain and whiplash injuries. The onset of pain may be insidious or may follow trauma, and it may be recurrent or persistent in nature. Ideally, the pain goes away in 1-3 weeks, but in some cases it persists and become chronic neck pain. The aim of this study is to compare the effects of mulligan mobilization with and without sling exercises on pain, and disability in non-specific neck pain. Non-specific neck pain reduces range of motion which may be linked to mechanical restriction between two or more vertebrae and muscular spasm.

Detailed Description

Participants who will meet the inclusion criteria will be recruited by convenience sampling technique and will be allocated to groups by simple randomization process by sealed opaque enveloped labeled as 1 for Group A and 2 for Group B.

After taking consent from the participants with non-specific neck pain of both genders will be randomized into two equal groups. Subjects from physical therapy department will be assessed with neck disability index, goniometer and Numeric pain rating scale. At start of study, a formal educational session, lasting about 30 min will be given by physiotherapist.

Group A: In this group, Subjects will be treated with Mulligan mobilizations along with sling exercises. Mulligan mobilizations include SNAGs. Participants will receive 3 sets of mulligan mobilization techniques per session, each set involving 10 times repetition of the exercise. The interval between the sets will be 15 to 20 seconds. The technique will be repeated total of six times having two sessions per week for 3 weeks.

For the sling exercise, the sling exercise program will also be applied for 3 weeks, 2 times a week for 20 minutes per day. To perform the exercise, the subjects will be instructed with a demonstration and explanation. In supine position, the head will be supported by an inelastic sling and the therapist will hold the cervical vertebral portion softly with two hands. Therapist will pull the cervical vertebral portion and back of the head softly. The subjects will maintain this for 6-7 seconds and relax slowly. In the second technique, Subjects will be positioned in supine lying position with the cervical spine in a neutral position on the sling device. One hand of the therapist contacts and fixes the transverse process of C1 (both), while the other hand grabs the occiput and applies mobilization in the dorsal direction. Subjects in this group will be applied with passive mobilization for 3 min to the segment (occiput-C1). In the same posture the subjects will be instructed to perform a flexion motion at (occiput-C1). The therapist will guide the optimal segmental movement through the hand. This intervention will also be performed 3 times for 1 min, with an interval of 1 min. Similarly, In prone position the forehead will be placed on an inelastic sling. The therapist will hold the cervical vertebral portion with two hands softly. The therapist will pull the cervical vertebral portion toward the upper direction at the same time. The patient will maintain this for 6-7 seconds and relax slowly. Each movement will be repeated 10 times

Conditions

Neck Pain

Study Design

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

Study Groups

Group A: Group A will be treated with mulligan mobilizations and Sling exercises.

Group A: In this group, Subjects will be treated with Mulligan mobilizations along with sling exercises. Mulligan mobilizations include SNAGs. Participants will receive 3 sets of mulligan mobilization techniques per session, each set involving 10 times repetition of the exercise. The interval between the sets will be 15 to 20 seconds. The technique will be repeated total of six times, having two sessions per week for 3 weeks. The sling exercise program will also be applied for 3 weeks, 2 times a week for 20 minutes per day.

Group Type: EXPERIMENTAL

Mulligan Mobilization and Sling Exercises

Intervention Type: OTHER

Mulligan mobilizations along with sling exercises. Mulligan mobilizations include SNAGs. Participants will receive 3 sets of mulligan mobilization techniques per session, each set involving 10 times repetition of the exercise. The interval between the sets will be 15 to 20 seconds. The technique will be repeated total of six times having two sessions per week for 3 weeks. For the sling exercise, the sling exercise program will also be applied for 3 weeks, 2 times a week for 20 minutes per day. To perform the exercise, the subjects will be instructed with a demonstration and explanation.

Group B: Group B will be treated with mulligan mobilizations alone.

Group B: In this group, Subjects will be treated with Mulligan mobilizations and sling exercises. Mulligan mobilizations include SNAGs. Participants will receive 3 sets of mulligan mobilization techniques per session, each set involving 10 times repetition of the exercise. The interval between the sets will be 15 to 20 seconds. The technique will be repeated a total of six times, having two sessions per week for 3 weeks.

Group Type: ACTIVE_COMPARATOR

Mulligan Mobilization

Intervention Type: OTHER

Mulligan Mobilization

Interventions

Mulligan Mobilization and Sling Exercises

Mulligan mobilizations along with sling exercises. Mulligan mobilizations include SNAGs. Participants will receive 3 sets of mulligan mobilization techniques per session, each set involving 10 times repetition of the exercise. The interval between the sets will be 15 to 20 seconds. The technique will be repeated total of six times having two sessions per week for 3 weeks. For the sling exercise, the sling exercise program will also be applied for 3 weeks, 2 times a week for 20 minutes per day. To perform the exercise, the subjects will be instructed with a demonstration and explanation.

Intervention Type: OTHER

Mulligan Mobilization

Mulligan Mobilization

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Age between 25-50 years.
• Having neck pain for at least 2 weeks
• Pain intensity of at least 2 on NPRS
• Greater than or equal to 15 points on the neck disability index (NDI)
• Having primary complaint of non-specific neck pain

Exclusion Criteria

• History of Cervical surgery
• Cervicogenic headache
• Previous cervical spine surgery
• Serious Spinal pathology (like tumor, infection, and dislocation)
• Traumatic injuries (e.g., contusion, fracture, and whiplash injury)
• Vascular diseases and Neurologic disorders (e.g., trigeminal neuralgia)
• Concomitant medical diagnosis of any primary headache (vertigo, VBI or migraine)
• And clinical diagnosis of cervical radiculopathy, Spinal stenosis or myelopathy.

• Minimum Eligible Age: 25 Years
• Maximum Eligible Age: 50 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Abu Zar, MS

Role: PRINCIPAL_INVESTIGATOR

Riphah International University,Lahore

Locations

Pro Care Health Clinic

Faisalābad, Punjab Province, Pakistan

Countries

Pakistan

References

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Reference Type: BACKGROUND

PMID: 29861800 (View on PubMed)

Kim SY, An CM, Cha YS, Kim DH. Effects of sling-based manual therapy on cervicothoracic junction in patients with neck pain and forward head posture: A randomized clinical trial. J Bodyw Mov Ther. 2021 Jul;27:447-454. doi: 10.1016/j.jbmt.2021.03.007. Epub 2021 Mar 19.

Reference Type: BACKGROUND

PMID: 34391270 (View on PubMed)

Lin KY, Tsai YJ, Hsu PY, Tsai CS, Kuo YL. Effects of Sling Exercise for Neck Pain: A Systematic Review and Meta-Analysis. Phys Ther. 2021 Aug 1;101(8):pzab120. doi: 10.1093/ptj/pzab120.

Reference Type: BACKGROUND

PMID: 33929540 (View on PubMed)

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Reference Type: BACKGROUND

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Reference Type: BACKGROUND

PMID: 34111066 (View on PubMed)

He Y, Sun W, Zhao X, Ma M, Zheng Z, Xu L. Effects of core stability exercise for patients with neck pain: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2019 Nov;98(46):e17240. doi: 10.1097/MD.0000000000017240.

Reference Type: BACKGROUND

PMID: 31725601 (View on PubMed)

Kim YW, Kim NY, Chang WH, Lee SC. Comparison of the Therapeutic Effects of a Sling Exercise and a Traditional Stabilizing Exercise for Clinical Lumbar Spinal Instability. J Sport Rehabil. 2018 Jan 1;27(1):47-54. doi: 10.1123/jsr.2016-0083. Epub 2018 Jan 17.

Reference Type: BACKGROUND

PMID: 27992296 (View on PubMed)

Mun D-J, Oh H-J, Lee S-H. Effects of sling exercise on pain, trunk strength, and balance in patients with chronic low back pain. The Journal of Korean Physical Therapy. 2022;34(3):110-5.

Reference Type: BACKGROUND

Other Identifiers

REC/RCR & AHS/23/0157

Identifier Type: -

Identifier Source: org_study_id