Effect of Mulligan on Cervical Radiculopathy

NCT ID: NCT06653543

Last Updated: 2025-04-27

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 40 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-01-01
• Study Completion Date: 2025-08-10

Brief Summary

The goal of this clinical trial is to investigate the effect of Mulligan mobilization with arm movement on nerve conduction velocity in patients with unilateral cervical radiculopathy. The main questions it aims to answer are :

1. Is there a statistical significant effect of mobilization with arm movement on NCV velocity in treatment of cervical radiculopathy ?

2. Is there a statistical significant effect of mobilization with arm movement on pain level in treatment of cervical radiculopathy ?

3. Is there a statistical significant effect of mobilization with arm movement on cervical ROM in treatment of cervical radiculopathy ?

4. Is there a statistical significant effect of mobilization with arm movement on neck disability level in treatment of cervical radiculopathy ?

The course of treatment involves 6 sessions over the course of 3 weeks participants will be divided into 2 groups : Control group : recieves only Conventional treatment Experimental group : recieves Conventional treatment and Mulligan mobilization with arm movement .

Detailed Description

the aim of our study is to examine the effect of Mulligan mobilization with arm movement on cervical radiculopathy using nerve conduction studies , in addition to the original measures of previous studies (pain level, cervical ROM and neck disability scale) .

Delimitations :

Inclusion Criteria

Individuals will be enrolled into the study if they are :

• diagnosed with cervical radiculopathy .
• Age group between 20-60 years
• Unilateral radiating pain through the course of median nerve .
• Subject having positive upper limb tension test (ULTT 1)
• either gender male and female
• Subjects who can understand the instructions and are willing to participate in the study.

Exclusion Criteria .

• History of trauma, dislocation and subluxation of upper extremity
• Rheumatoid Arthritis
• Malignancy
• Spinal canal stenosis .
• Cervical instability/Spondylolisthesis
• VBI (Vertebral-Basillar Insufficiency)
• Referred pain in patients with cardiac ischemia
• Cervical or thoracic spine surgeries
• systemic causes like diabetic neuropathy.
• recent fracture or surgery in and around the shoulder
• carpal tunnel syndrome .
• thoracic outlet syndrome .

Outcome measure would include:

A) The primary outcome measure will be NCV velocity, for the median nerve (latency, amplitude, Duration , F-wave and nerve conduction velocity of motor nerve action potentials and sensory nerve action potentials (SNAPs)) .

B) Secondary outcome measures will include:

• Pain intensity, assessed using the Visual Analog Scale (VAS) .
• Functional disability, evaluated using the Neck Disability Index (NDI) .
• Cervical range of motion, measured using a CROM goniometer to assess flexion, extension, lateral flexion, and rotation.
• The course of treatment involves 6 sessions over the course of 3 weeks .
• pre-treatment for both groups :

1. affected nerve conduction velocity will be measured using nerve conduction study .

2. neck disability level will be measured using neck disability index .

3. cervical ROM measurement will be taken in all directions using CROM goniometer .

4. pain will be assessed using Visual analog scale .

participants will be divided into 2 groups :

Group A- Control group:

During each session : only Conventional treatment will be provided , includes : hot pack for 10 minutes, active ranges of motion (AROMs) with 3 sets of 10 repetitions and isometrics for each movement repeated 20 times with the hold of 6 to 10 seconds in each repetition.

Group B- Experimental group- Mulligan mobilization group:

• During each session :

1. Conventional treatment will be provided .

2. Mulligan mobilization will be applied in the form of : sustained passive accessory joint mobilization to a specific spinal vertebra level while simultaneously guiding the patient through an active, pain-free movement pattern involving the affected limb :

• Patient position : Sitting upright on chair
• Therapist position : Standing behind the patient .
• Hand placement : Approach the desired level of spinous process from medial aspect of the thumb of one hand, which may be reinforced by the index finger of the other hand.
• Mobilization Pure transverse glide is performed from affected to unaffected side. While the glide is sustained, patient performs the offending movements (flexion/abduction/horizontal adduction/horizontal abduction)

Conditions

Cairo University

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

mulligan group

20 participants recieving conventional therapy in addition to mulligan mobilization with arm movement

Group Type: EXPERIMENTAL

Mulligan mobilization with arm movement

Intervention Type: OTHER

mulligan mobilization applied on cervical spine with arm movement

conventional therapy of cevical radiculopathy

Intervention Type: OTHER

hot pack for 10 minutes, active ranges of motion (AROMs) with 3 sets of 10 repetitions and isometrics for each movement repeated 20 times with the hold of 6 to 10 seconds in each repetition

control group

control group that revieves only the conventional therapy

Group Type: SHAM_COMPARATOR

conventional therapy of cevical radiculopathy

Intervention Type: OTHER

hot pack for 10 minutes, active ranges of motion (AROMs) with 3 sets of 10 repetitions and isometrics for each movement repeated 20 times with the hold of 6 to 10 seconds in each repetition

Interventions

Mulligan mobilization with arm movement

mulligan mobilization applied on cervical spine with arm movement

Intervention Type: OTHER

conventional therapy of cevical radiculopathy

hot pack for 10 minutes, active ranges of motion (AROMs) with 3 sets of 10 repetitions and isometrics for each movement repeated 20 times with the hold of 6 to 10 seconds in each repetition

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• • diagnosed with cervical radiculopathy .

• Age group between 20-60 years
• Unilateral radiating pain through the course of median nerve .
• Subject having positive upper limb tension test (ULTT 1)
• either gender male and female
• Subjects who can understand the instructions and are willing to participate in the study.

Exclusion Criteria

• • History of trauma, dislocation and subluxation of upper extremity

• Rheumatoid Arthritis
• Malignancy
• Spinal canal stenosis .
• Cervical instability/Spondylolisthesis
• VBI (Vertebral-Basillar Insufficiency)
• Referred pain in patients with cardiac ischemia
• Cervical or thoracic spine surgeries .
• systemic causes like diabetic neuropathy .
• recent fracture or surgery in and around the shoulder .
• carpal tunnel syndrome .
• thoracic outlet syndrome .

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Tawfik Mohamed Tawfik Elgazar

teaching assistant at the department of basic science

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Kafr El-Sheikh university

Kafr El-Sheikh Governorate, Kafr el-Sheikh Governorate, Egypt

Site Status: RECRUITING

Countries

Egypt

Central Contacts

Elgazar

Role: CONTACT

tawfiq.algazar_a010@pt.kfs.edu.eg

201013863820

Facility Contacts

university

Role: primary

tawfiq.algazar_a010@pt.kfs.edu.eg

047 3109590

Other Identifiers

P.T.REC/012/005110

Identifier Type: -

Identifier Source: org_study_id