Mobilization With Movement Technique on the Stiffness of Cervical Muscles in Individuals With Mechanical Neck Pain

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

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-10

Study Completion Date

2024-06-30

Brief Summary

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Mobilisation with movement (Mulligan Sustained Natural Apophyseal Glides (SNAG)). method has been shown to have significant effects on pain, joint range of motion, and functionality in patients with neck pain. However, there is a lack of studies examining the effects of this technique on muscle stiffness associated with neck pain. Considering the immediate effects of a single session of lumbar SNAG application on lumbar muscle stiffness in patients with low back pain, it raises curiosity about the effects it would have on cervical spinal segments and surrounding muscles. The aim of this study is to investigate the immediate effects of Mulligan SNAG application on muscle stiffness, pain, and joint range of motion in patients with mechanical neck pain.

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Detailed Description

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This study is designed as a parallel double-blind randomized controlled trial. Patients will be divided into two groups: the Mobilization with Movement Group (MMG) and the Sham Group (SG). The MMG will receive cervical mobilization (SNAG) treatment. The SG, on the other hand, will receive active joint movements without the 'sliding' motion applied to the spinal segment. Prior to and immediately after the intervention, participants will undergo myometric evaluation of neck muscles, joint range of motion measurements, and pressure pain threshold measurements bilaterally, followed by assessment of the individual's pain and level of disability using questionnaires related to pain and pain-associated disability. A 2-minute break will be provided after the intervention before reassessment is conducted. Patients will not be followed up.

Conditions

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Neck Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A Parallel, double blind, randomised controlled trial

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

The physiotherapist who will apply the evaluation methods to be used in our study will be blind to the group distribution of the patients. Additionally, patients will be blind to the procedure.

Study Groups

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Mobilization with movement group

Group Type EXPERIMENTAL

Mobilisation with movement

Intervention Type OTHER

The physiotherapist places the medial edge of the thumb of one hand on the upper facet joint of the relevant segment, then applies superior-anterior slide to the facet joint by providing support with the thumb of the other hand. The 'gliding' movement is maintained while the patient actively performs the unilateral neck rotation movement and maintains it for a few seconds at the end of the movement. If joint movement is painful, attempts are made on the other facet joint of the same segment or on the spinous process. If this attempt does not immediately improve the patient's active joint motion, Mulligan Sustained Natural Apophyseal Glides (SNAG) will be applied to the upper part of the left zygapophysial joint, and in case of failure again, application will be made through the superior spinous process of the relevant segment. Painless joint movement will be applied in 6 repetitions and 3 sets.

Sham group

Group Type SHAM_COMPARATOR

Sham mobilisation

Intervention Type OTHER

While the patients are sitting in a chair with a supported back, the spinal segment where pain is felt in neck joint movements will be determined. Without applying a sliding movement to this segment over the facet joint, only sensory input will be given and the patient will be asked to continue the active rotation movement and wait a few seconds at the end of the movement. The application will be completed as 6 repetitions and 3 sets.

Interventions

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Mobilisation with movement

The physiotherapist places the medial edge of the thumb of one hand on the upper facet joint of the relevant segment, then applies superior-anterior slide to the facet joint by providing support with the thumb of the other hand. The 'gliding' movement is maintained while the patient actively performs the unilateral neck rotation movement and maintains it for a few seconds at the end of the movement. If joint movement is painful, attempts are made on the other facet joint of the same segment or on the spinous process. If this attempt does not immediately improve the patient's active joint motion, Mulligan Sustained Natural Apophyseal Glides (SNAG) will be applied to the upper part of the left zygapophysial joint, and in case of failure again, application will be made through the superior spinous process of the relevant segment. Painless joint movement will be applied in 6 repetitions and 3 sets.

Intervention Type OTHER

Sham mobilisation

While the patients are sitting in a chair with a supported back, the spinal segment where pain is felt in neck joint movements will be determined. Without applying a sliding movement to this segment over the facet joint, only sensory input will be given and the patient will be asked to continue the active rotation movement and wait a few seconds at the end of the movement. The application will be completed as 6 repetitions and 3 sets.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Having widespread neck pain lasting more than 3 months
* Pain symptoms that increase with neck movements or palpation
* Volunteering to participate in the study

Exclusion Criteria

* History of neck trauma
* Previous cervical surgery
* Cervical radiculopathy or myelopathy
* Fibromyalgia syndrome diagnosis
* Any physiotherapy intervention in the previous 12 months
* Sign of vertebrobasilar insufficiency
* Upper cervical spine ligament instability
* Those using steroids or muscle relaxants

Minimum Eligible Age

20 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No