Effect of Neck vs. Combined Neck-Lumbar Mobilization on Pain and Motion in Cervical Disc Herniation

NCT ID: NCT06858605

Last Updated: 2025-03-05

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 33 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-06-15
• Study Completion Date: 2023-04-10

Brief Summary

Background To assess the effectiveness of Kaltenborn-Evjenth Orthopedic Manual Therapy (KEOMT) applied to cervical-only mobilization versus both lumbar and cervical regions on pain intensity and range of motion (ROM) in individuals with cervical disc herniation, Methods: Thirty three participants were enrolled in the study. The patients were randomly assigned to two groups. Group A received cervical-only KEOMT while Group B received combined lumbar and cervical KEOMT, Interventions were administered three times a week for four weeks. Pain was measured using the Visual Analog Scale (VAS), ROM was assessed for flexion and lateral flexion, and Neck Pain and Disability Index (NPDI) and Short-Form 36 Health Survey (SF-36) were used for evaluation.

Conditions

Cervical Disc Herniation

Study Design

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

Study Groups

Group A (Cervical mobilization group)

Cervical mobilizations were performed with patients in a supine position. This setup facilitated accurate application of manual therapy techniques. Techniques included Grade 1 mobilizations (pain relief) and Grade 2 mobilizations (soft tissue relaxation). The concave-convex rule guided gliding and translatory movements for optimizing joint mechanics. Manual traction and segmental mobilization were performed with patients in a supine position. The KEOMT included cervical segmental traction and cervical segmental mobilization-flexion and gliding therapy in grade 3. The Convex/Concave Rule was consistently applied in all cases.

Group Type: EXPERIMENTAL

Kaltenborn-Evjenth Orthopedic Manual Therapy (KEOMT)

Intervention Type: OTHER

Kaltenborn's biomechanical approach to diagnosis and treatment emphasizes ergonomic principles and trial-based techniques. His mobilization methods, classified into Grades I-III, target pain relief (Grades I-II) and joint hypomobility (Grade III) by enhancing glide and tissue elasticity. The Kaltenborn-Evjenth Orthopedic Manual Therapy (KEOMT) further refines this approach using arthrokinematic principles to restore physiological joint motion based on the concave-convex rule.

Group B (Combined cervical and lumbar mobilization group)

For segmental flexion mobilization, the patient is positioned on their side with their hips and knees flexed. The therapist places one hand on the vertebrae, positioning the fingers on either the transverse or spinous processes, and the other hand on the sacrum in a similar manner. To facilitate movement, the therapist's chest makes contact with the patient's knees, allowing the pelvis to be guided in a caudal or ventral direction. This technique can be effectively adapted for both cervical and lumbar regions, maintaining consistent application across various spinal segments. For segmental traction, the patient also lies on their side, with their knees flexed toward the abdomen. The therapist hooks their fingers over the proximal transverse processes or the soft tissues in the paravertebral region and applies traction by pulling in opposite directions.

Group Type: EXPERIMENTAL

Kaltenborn-Evjenth Orthopedic Manual Therapy (KEOMT)

Intervention Type: OTHER

Kaltenborn's biomechanical approach to diagnosis and treatment emphasizes ergonomic principles and trial-based techniques. His mobilization methods, classified into Grades I-III, target pain relief (Grades I-II) and joint hypomobility (Grade III) by enhancing glide and tissue elasticity. The Kaltenborn-Evjenth Orthopedic Manual Therapy (KEOMT) further refines this approach using arthrokinematic principles to restore physiological joint motion based on the concave-convex rule.

Interventions

Kaltenborn-Evjenth Orthopedic Manual Therapy (KEOMT)

Kaltenborn's biomechanical approach to diagnosis and treatment emphasizes ergonomic principles and trial-based techniques. His mobilization methods, classified into Grades I-III, target pain relief (Grades I-II) and joint hypomobility (Grade III) by enhancing glide and tissue elasticity. The Kaltenborn-Evjenth Orthopedic Manual Therapy (KEOMT) further refines this approach using arthrokinematic principles to restore physiological joint motion based on the concave-convex rule.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Diagnosed with cervical disc herniation at least 8 weeks but not more than 5 years prior.
• Cervical disc herniation verified by magnetic resonance imaging (MRI) at 1 or 2 segmental levels, consistent with clinical findings.
• Neck Disability Index (NDI) score greater than 5.
• No use of analgesic medication other than the prescribed treatment before or during the study period.

Exclusion Criteria

• History of myelopathy, whiplash-associated disorder, generalized myalgia, malignant tumor, or inflammatory disease.
• Painful back problems or neurological symptoms within the past year.
• Psychiatric disorders or drug abuse.
• Contraindications to physical therapy or inability to return to work or perform physical therapy due to other diseases or disabilities.
• Inability to communicate effectively.
• Participation in any additional interventions outside the prescribed treatment during the study period.

• Minimum Eligible Age: 25 Years
• Maximum Eligible Age: 55 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Fenerbahce University

OTHER

Sponsor Role: lead

Responsible Party

Başar Öztürk

Assoc. Prof.

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Fenerbahçe University Faculty of Health Sciences Physiotherapy Department

Istanbul, , Turkey (Türkiye)

Countries

Turkey (Türkiye)

References

Ozdincler A, Aktas D, Aktar Reyhanioglu D, Ozturk B. The effect of neck mobilization Vs. combined neck and lumbar mobilization on pain and range of motion in people with cervical disc herniation: A randomized controlled study. J Bodyw Mov Ther. 2025 Sep;43:188-195. doi: 10.1016/j.jbmt.2025.04.032. Epub 2025 Apr 26.

Reference Type: DERIVED

PMID: 40483122 (View on PubMed)

Other Identifiers

fztduygu

Identifier Type: -

Identifier Source: org_study_id