Mulligan vs Maitland With Home-Based Exercise for Non-Specific Neck Pain

NCT ID: NCT06858124

Last Updated: 2025-04-16

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

43 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-27

Study Completion Date

2025-04-05

Brief Summary

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Non-specific neck pain (NSNP) is a prevalent musculoskeletal condition with multiple contributing factors. The aim of this clinical study is to investigate the short-term effects of Mulligan in comparison to Maitland mobilization techniques in conjunction with a home-based therapeutic exercise program. 43 adults with non-specific neck pain will be randomly divided into three groups of 14,14 and 15 participants each. In the participants of the first group, a therapeutic protocol of Mulligan mobilizations in the cervical region will be applied and a protocol of exercises will be performed. To the participants of the second group, a therapeutic protocol od Maitland mobilizations in the cervical region will be applied and the same exercise program with the first group will be performed. The third group participants will perform only the same exercise protocol as the other groups. The first two groups will receive four mobilization treatments over two weeks. All three groups will perform the home-based exercise protocol daily for two weeks. Pain in the last 24 hours with the Numeric Pain Rating Scale (NPRS), Pressure Pain Threshold (PPT) in the cervical region with an algometer, functional ability with the Neck Disability Index (NDI), Range of Motion (ROM) with a digital goniometer, pain catastrophizing with the Pain Catastrophizing Scale (PCS) and kinesiophobia with the Tampa Scale of Kinesiophobia (TSK) will be evaluated before and after the intervention. For the statistical analysis of the results, a two-way repeated measures analysis of variance (ANOVA) will be applied using SPSS program, while the statistical significance index will be set at p \< .05.

Detailed Description

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Background: Non-specific neck pain (NSNP) is a prevalent musculoskeletal condition with multiple contributing factors. Various manual therapy approaches, such as Mulligan and Maitland mobilizations, are commonly applied to alleviate pain and enhance function.

Aim: The purpose of this clinical study is to investigate the short-term effects of Mulligan in comparison to Maitland mobilization techniques in conjunction with a home-based therapeutic exercise (TE) program.

Method: 43 participants with non-specific neck pain will be randomly assigned to three groups of 14, 14 and 15 participants each. In the participants of the first group, a therapeutic protocol of mulligan mobilizations will be applied to the cervical region. In addition, the participants will perform a home-based therapeutic exercise program. To the participants of the second group, a therapeutic protocol of maitland mobilizations will be applied to the cervical region and they will perform the same home-based exercise protocol with the first group. The third group participants will perform only the same home-based exercise protocol with the other groups. The first two groups will receive four mobilization treatments over two weeks. All three groups will perform the home-based exercise protocol daily for two weeks. Pain in the last 24 hours with the Numeric Pain Rating Scale (NPRS), Pressure Pain Threshold (PPT) in the cervical region with an algometer, functional ability with the Neck Disability Index (NDI), Range of Motion (ROM) with a digital goniometer, pain catastrophizing with the Pain Catastrophizing Scale (PCS) and kinesiophobia with the Tampa Scale of Kinesiophobia (TSK) will be evaluated before and after the intervention. For the statistical analysis of the results, a two-way repeated measures analysis of variance (ANOVA) will be applied using SPSS program, while the statistical significance index will be set at p \< .05. Expected results: The protocol proposed in this clinical study combines the benefits of applying manual therapy mobilizations with the beneficial effects of therapeutic exercise. Previous research shows Mulligan mobilizations may be slightly more beneficial in improving patients' symptoms with non-specific neck pain. For this reason, we expect that the combination of Mulligan mobilizations and home-based therapeutic exercise will be more effective than the combination of Maitland mobilizations and home-based therapeutic exercise only in improving the clinical symptoms of young adults with non-specific neck pain.

Conditions

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Neck Pain

Study Design

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Allocation Method

NA

Intervention Model

PARALLEL

43 participants with non-specific neck pain pain will be randomly assigned to three groups of 14, 14 and 15 participants each. The allocation of the sample to the groups will be performed using the randomization app Randomiser (Rob Sammons, Apple Store) by an independent researcher. In the first group, a mulligan mobilization protocol will be applied and the practitioners will follow a daily therapeutic exercise program at home, in the second group, a maitland mobilization protocol will be applied and the practitioners will follow a daily therapeutic exercise program at home, while the third group will follow only a daily therapeutic exercise program at home. Participants of the two intervention groups will follow a total of four treatments over a period of two weeks. The therapeutic home-based exercise program will be performed daily over the same period of two weeks.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Caregivers
A masked assessor will conduct the measurements

Study Groups

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Mulligan+TE

Participants allocated to this group will receive four sessions of Mulligan mobilizations and will perform a home-based therapeutic exercise program for two weeks.

Group Type EXPERIMENTAL

Mulligan+TE

Intervention Type OTHER

Mulligan Mobilizations plus Home Therapeutic Exercise

The protocol will last 25 minutes (Mulligan protocol: 5 minutes and Home Therapeutic Exercise protocol: 20 minutes) and will include the application of the following mulligan techniques and home exercises:

* Mulligan sustained natural apophyseal glide SNAG mobilizations with overpressure with the patients in seated position.
* 4 home-based therapeutic exercises: isometric exercises for cervical regions, head retractions, thoracic spine rotation mobility exercise and diagonal cervical mobility exercise pattern.

Maitland +TE

Participants allocated to this group will receive four sessions of Maitland mobilizations and will perform a home-based therapeutic exercise program for two weeks.

Group Type EXPERIMENTAL

Maitland+TE

Intervention Type OTHER

The participants of this group will perform the same 4 home-based therapeutic exercises as the first group. In addition, they will receive a 5-minute maitland mobilization protocol.

Maitland mobilizations will include posterioranterior glides with oscillations with the patients in prone position.

Active Comparator: "TE group".

Participants in this group will only perform the same 4 home-based therapeutic exercises as the first group.

Group Type ACTIVE_COMPARATOR

No interventions assigned to this group

Interventions

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Mulligan+TE

Mulligan Mobilizations plus Home Therapeutic Exercise

The protocol will last 25 minutes (Mulligan protocol: 5 minutes and Home Therapeutic Exercise protocol: 20 minutes) and will include the application of the following mulligan techniques and home exercises:

* Mulligan sustained natural apophyseal glide SNAG mobilizations with overpressure with the patients in seated position.
* 4 home-based therapeutic exercises: isometric exercises for cervical regions, head retractions, thoracic spine rotation mobility exercise and diagonal cervical mobility exercise pattern.

Intervention Type OTHER

Maitland+TE

The participants of this group will perform the same 4 home-based therapeutic exercises as the first group. In addition, they will receive a 5-minute maitland mobilization protocol.

Maitland mobilizations will include posterioranterior glides with oscillations with the patients in prone position.

Intervention Type OTHER

Control

Participants in this group will only perform the same 4 home-based therapeutic exercises as the first group.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Acute-subacute-chronic neck pain
* Women - Men
* Age range between 18 and 30 years
* NPRS score \>2
* Written consent to participate in the study

Exclusion Criteria

* • Previous cervical/thoracic surgery

* Recent whiplash (≤6 months)
* Upper cervical pathology
* Osteoporosis
* Pregnancy
* Cancer
* Systemic diseases or spinal disorders
* Neurological symptoms
* Severe medical conditions, positive red flags (Spurling test, Hoffmann's sign, Babinski reflex, clonus)
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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International Hellenic University

OTHER

Sponsor Role lead

Responsible Party

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Dimitrios Lytras

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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International Hellenic University

Thessaloniki, , Greece

Site Status

Countries

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Greece

Other Identifiers

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EC-5/2025

Identifier Type: -

Identifier Source: org_study_id

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