Muscle Energy Versus Mulligan Techniques in Treating Patients With Cervical Spondylosis
NCT ID: NCT06664931
Last Updated: 2025-07-16
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
2024-11-05
Study Completion Date
2025-02-01
Brief Summary
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This study will be aimed to answer the following questions:
Which technique, MET or MMT, is more effective in reducing pain, increasing range of motion (ROM), improving proprioception, and enhancing functional ability in individuals with CS?
It will be assumed that:
1. All participants will adhere to study instructions and procedures.
2. All participants will be evaluated under standardized conditions.
Which technique, MET or MMT, is more effective in reducing pain, increasing range of motion (ROM), improving proprioception, and enhancing functional ability in individuals with CS?
It will be assumed that:
1. All participants will adhere to study instructions and procedures.
2. All participants will be evaluated under standardized conditions.
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Detailed Description
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Cervical spondylosis (CS) is a highly prevalent age-related condition (95%), that affects the joints and discs of the cervical spine. By age 65, nearly all individuals experience some degree of degeneration, characterized by disc breakdown and enlarged facet joints. While aging is the primary cause, injuries can accelerate this process in younger populations.
Significance of the Study Age-related degenerative spinal changes are almost widespread. Population-based studies have shown that approximately 80 to 90% of people have disk degeneration on magnetic resonance imaging (MRI) by the age of 50 years.
A global burden review estimates that over 300 million people worldwide had mechanical neck pain lasting at least 3 months in 2015.
Clinical features of spondylosis are more common in men than in women, with a peak incidence between the ages of 40 and 60 years for both men and women.
Cervical spondylosis commonly affects the middle and lower cervical vertebrae (C5-C6 and C6-C7), although higher levels may also be involved. Neck pain is the most prominent symptom. CS can affect all cervical components (i.e., the spinal cord, spinal vasculature, and nerve roots). Cervical spondylosis Symptoms include cervical instability (abnormal movement or laxity between vertebrae). This instability can lead to various symptoms such as neck pain, muscle imbalance between cervical and shoulder girdle muscles (weakness in cervical flexors, lower trapezius, and anterior serratus; tightness in the upper trapezius, scapular lift, and pectoralis major), disc herniation and osteophyte formation. These can compromise proprioception (accurate sensory feedback) and limit neck mobility, significantly impacting function and daily activities.
Muscle energy techniques is a form of manual therapy frequently used by physical therapists to improve musculoskeletal function and alleviate pain. MET aims to adjust abnormal muscle tone by training specific muscles, enhancing strength and stability, improving the musculoskeletal function, and ultimately improving quality of life.
Another treatment technique is MMT that is now an integral component of many manual physiotherapists' clinical practice. MMT involves sustained passive accessory force/glide to a joint while the participant actively performs a problematic movement.
This study aims to address this gap in knowledge by investigating whether MET or MMT is more effective in improving pain, ROM, proprioception, and functional ability in individuals with cervical spondylosis. The findings from this study can provide valuable insights for physical therapists in selecting the most appropriate treatment approach for their patients with cervical spondylosis. By determining the more effective technique, physical therapists can optimize treatment plans and potentially improve patient outcomes.
This Triple-blinded (the examiner, statistician, and the participants will be blinded, while the therapist will be aware of treatment procedures) randomized controlled trial (RCT) will investigate the effectiveness of Muscle Energy Techniques (MET) compared to Mulligan Mobilization Techniques (MMT) on cervical spine pain, ROM, and function in participants with Cervical Spondylosis (CS). The study will be conducted at the outpatient physical therapy clinic of Horus University in New Damietta, Egypt.
Significance of the Study Age-related degenerative spinal changes are almost widespread. Population-based studies have shown that approximately 80 to 90% of people have disk degeneration on magnetic resonance imaging (MRI) by the age of 50 years.
A global burden review estimates that over 300 million people worldwide had mechanical neck pain lasting at least 3 months in 2015.
Clinical features of spondylosis are more common in men than in women, with a peak incidence between the ages of 40 and 60 years for both men and women.
Cervical spondylosis commonly affects the middle and lower cervical vertebrae (C5-C6 and C6-C7), although higher levels may also be involved. Neck pain is the most prominent symptom. CS can affect all cervical components (i.e., the spinal cord, spinal vasculature, and nerve roots). Cervical spondylosis Symptoms include cervical instability (abnormal movement or laxity between vertebrae). This instability can lead to various symptoms such as neck pain, muscle imbalance between cervical and shoulder girdle muscles (weakness in cervical flexors, lower trapezius, and anterior serratus; tightness in the upper trapezius, scapular lift, and pectoralis major), disc herniation and osteophyte formation. These can compromise proprioception (accurate sensory feedback) and limit neck mobility, significantly impacting function and daily activities.
Muscle energy techniques is a form of manual therapy frequently used by physical therapists to improve musculoskeletal function and alleviate pain. MET aims to adjust abnormal muscle tone by training specific muscles, enhancing strength and stability, improving the musculoskeletal function, and ultimately improving quality of life.
Another treatment technique is MMT that is now an integral component of many manual physiotherapists' clinical practice. MMT involves sustained passive accessory force/glide to a joint while the participant actively performs a problematic movement.
This study aims to address this gap in knowledge by investigating whether MET or MMT is more effective in improving pain, ROM, proprioception, and functional ability in individuals with cervical spondylosis. The findings from this study can provide valuable insights for physical therapists in selecting the most appropriate treatment approach for their patients with cervical spondylosis. By determining the more effective technique, physical therapists can optimize treatment plans and potentially improve patient outcomes.
This Triple-blinded (the examiner, statistician, and the participants will be blinded, while the therapist will be aware of treatment procedures) randomized controlled trial (RCT) will investigate the effectiveness of Muscle Energy Techniques (MET) compared to Mulligan Mobilization Techniques (MMT) on cervical spine pain, ROM, and function in participants with Cervical Spondylosis (CS). The study will be conducted at the outpatient physical therapy clinic of Horus University in New Damietta, Egypt.
Conditions
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Cervical Spondylosis
Mulligan Mobilization
SNAGs
Muscle Energy Technique
Post Isometric Relaxation
Study Design
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Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
Model Description
Primary Study Purpose
TREATMENT
Blinding Strategy
DOUBLE
Investigators
Outcome Assessors
Study Groups
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Group (A) Muscle Energy Technique (MET).
These participants will receive METs, in addition to a standard physical therapy program consisting of deep neck flexor strengthening exercises, isometric exercise, and range of motion exercises (3 sessions per week for 4 weeks).
Group Type
EXPERIMENTAL
Group (A) Muscle Energy Technique (MET)
Intervention Type
OTHER
MET will be applied to three key muscles commonly associated with neck pain:
upper trapezius, levator scapulae, and anterior scalenus.
Group (B) Mulligan Mobilization Technique group (MMT).
Participants will receive MMT interventions alongside the standard physical therapy program deep neck flexor strengthening exercises, isometric exercise, and range of motion exercises 3 sessions per week for 4 weeks.
Group Type
EXPERIMENTAL
Group (B) Mulligan Mobilizations Techniques (MMT).
Intervention Type
OTHER
Participants in Group (B) will receive MMT alongside the traditional treatment. MMT utilizes a specific technique called Sustained Natural Apophyseal Glides (SNAGs) to improve joint mobilization.
Interventions
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Group (A) Muscle Energy Technique (MET)
MET will be applied to three key muscles commonly associated with neck pain:
upper trapezius, levator scapulae, and anterior scalenus.
Intervention Type
OTHER
Group (B) Mulligan Mobilizations Techniques (MMT).
Participants in Group (B) will receive MMT alongside the traditional treatment. MMT utilizes a specific technique called Sustained Natural Apophyseal Glides (SNAGs) to improve joint mobilization.
Intervention Type
OTHER
Other Intervention Names
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Post Isometric Relaxation
SNAGs
Eligibility Criteria
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Inclusion Criteria
1. Participants of both genders aged 40 - 60 years old, diagnosed with clinically and medically stable CS.
2. All participants will be assessed and referred by orthopedic surgeons before starting the study.
3. Mechanical neck pain localized to the cervical.
4. Neck pain lasting more than 3 months, local tenderness of the upper fibers of the trapezius, limitation in cervical ROM and muscle spasm.
5. Moderate pain intensity (45-74 mm on VAS).
6. Participants with Moderate pain intensity NDI (30 - 48%).
7. All participants are free from any pathological conditions that might influence the results.
2. All participants will be assessed and referred by orthopedic surgeons before starting the study.
3. Mechanical neck pain localized to the cervical.
4. Neck pain lasting more than 3 months, local tenderness of the upper fibers of the trapezius, limitation in cervical ROM and muscle spasm.
5. Moderate pain intensity (45-74 mm on VAS).
6. Participants with Moderate pain intensity NDI (30 - 48%).
7. All participants are free from any pathological conditions that might influence the results.
Exclusion Criteria
1. Participants with systemic diseases like rheumatoid arthritis, metabolic diseases, or osteoporosis.
2. History of trauma or accidental injuries to the cervical spine.
3. Cervical myelopathy, inflammatory arthritis, tumors, infections involving the cervical spine, or vertebrobasilar artery insufficiency.
4. Cervical spine injury, dizziness, vertigo, or any other musculoskeletal complaints.
2. History of trauma or accidental injuries to the cervical spine.
3. Cervical myelopathy, inflammatory arthritis, tumors, infections involving the cervical spine, or vertebrobasilar artery insufficiency.
4. Cervical spine injury, dizziness, vertigo, or any other musculoskeletal complaints.
Minimum Eligible Age
40 Years
Maximum Eligible Age
60 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
Yes
Sponsors
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Cairo University
OTHER
Sponsor Role
lead
Responsible Party
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Mohamed Ahmed Badier Elkomy
Teaching Assistant
Responsibility Role
PRINCIPAL_INVESTIGATOR
Locations
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Faculty of Physical Therapy, Horus University - Egypt
Cairo, , Egypt
Site Status
Countries
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Egypt
References
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BACKGROUND
Yang J, Lee B, Kim C. Changes in proprioception and pain in patients with neck pain after upper thoracic manipulation. J Phys Ther Sci. 2015 Mar;27(3):795-8. doi: 10.1589/jpts.27.795. Epub 2015 Mar 31.
Reference Type
BACKGROUND
Young IA, Michener LA, Cleland JA, Aguilera AJ, Snyder AR. Manual therapy, exercise, and traction for patients with cervical radiculopathy: a randomized clinical trial. Phys Ther. 2009 Jul;89(7):632-42. doi: 10.2522/ptj.20080283. Epub 2009 May 21.
Reference Type
BACKGROUND
Zaidi F, Ahmed I. Effectiveness of muscle energy technique as compared to Maitland mobilisation for the treatment of chronic sacroiliac joint dysfunction. J Pak Med Assoc. 2020 Oct;70(10):1693-1697. doi: 10.5455/JPMA.43722.
Reference Type
BACKGROUND
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
P.T.REC/012/005271
Identifier Type: -
Identifier Source: org_study_id
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