Spinal Mobilization and PNF Comparison on Pain, Disability in Patients With Cervical Radiculopathy

NCT ID: NCT06866821

Last Updated: 2025-03-12

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 38 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-01-12
• Study Completion Date: 2025-02-21

Brief Summary

As in this modern era of digitalization; mobile phones, touch pads and computers devices use is increasing, neck pain that radiates into upper limb is also becoming common due to such devices long term use in bad postures or positions for more workload. The resulted findings could significantly contribute to the refinement of rehabilitation interventions, offering a more holistic and tailored approach for addressing cervical radiculopathy sensory and motor symptoms, ultimately improving individuals daily living activities and life quality. It will be helpful for physiotherapists to find evidence about comparison of mulligan's spinal mobilization along with arm movement with proprioceptive neuromuscular facilitation technique on pain, disability and range of motion in patients with cervical radiculopathy. It will be beneficial for patients also to improve pain, activities of daily living and working tasks in a comfortable position.

Detailed Description

Cervical radiculopathy is a clinical situation in which reflex, motor, and sensory alterations e.g. radicular pain, paresthesia, or numbness might be present and might be increased by neck bad postures and movements. Due to sustained forward head and neck posture and repetitive movements, cervical pain and numbness is becoming common in office, bank and online workers. The cervical radiculopathy new cases report yearly is almost 107.3 per 1 lac for men and 63.5 per 1 lac for women. It is essential to find new efficient methods of cervical radiculopathy physical therapy management.

Males and females of age 21-50 years old added in this study. Screening tests will include upper limb tension tests (ULTT), spurling (compression) test and distraction test. Subjects randomly assigned into two groups by lottery method. Experimental group (N=19) received Mulligan's spinal mobilization with arm movements (SMWAMs) and proprioceptive neuromuscular facilitation (PNF) contract-relax technique and control group (N=19) received Proprioceptive neuromuscular facilitation (PNF) contract-relax technique and standard physical therapy protocol including passive stretching exercises (3 sets of 10 repetitions) and isometric strengthening exercises (2 sets of 10 repetitions). Outcome measures included numeric pain rating scale (NPRS) for pain, neck disability index (NDI) for functional disability and goniometer for range of motion (ROM). Data analyzed by statistical package for social sciences (SPSS 26) software.

Conditions

Cervical Radiculopathy

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Experimental Group (SMWAM's and PNF C-R Technique)

Experimental group received Mulligan's Spinal Mobilization with Arm Movements and Proprioceptive Neuromuscular Facilitation contract-relax technique.

Group Type: EXPERIMENTAL

SMWAM's and PNF C-R Technique

Intervention Type: OTHER

Treatment provided 3 days every week in 6 total weeks with 1 meeting per day, 3 bunches of 10 times repeat and resting period of one minute among bunches. This group received Mulligan's spinal mobilization with arm movement and proprioceptive neuromuscular facilitatin contract-relax technique. Previous to mobilization, all patients got hot pack (10 minutes) and active range of motion warm up exercises (2 sets of 10 repetitions) and did isometric neck exercise as a home plan of care.

Mobilisation (22) was done depending on the side of involvement, the corresponding spinous process would be mobilised combined with different movements of shoulder (flexion/ abduction/ horizontal abduction/ horizontal adduction).

Proprioceptive neuro-muscular facilitation contract relax technique performed with 3 repetitions in each cervical movement (flexion, extension, lateral flexion and rotation) (27).

Control Group (PNF C-R Technique and PT Protocol)

Control group received Proprioceptive Neuromuscular Facilitation Contract-relax Technique and Physical Therapy protocol.

Group Type: EXPERIMENTAL

PNF C-R Technique and PT Protocol

Intervention Type: OTHER

Treatment provided 3 days every week in 6 weeks with 1 meeting per day, 5 clusters of 3 times repeat and resting period of one minute among clusters. Regime of training involved PNF (proprioceptive neuromuscular facilitation) contract-relax method along with the standard physical therapy protocol which includes passive stretching (3 sets of 10 repetitions) and isometric strengthening exercises (2 sets of 10 repetitions).

Proprioceptive neuro-muscular facilitation contract relax technique performed with 3 repetitions in each cervical movement (flexion, extension, lateral flexion and rotation) (27).

Interventions

SMWAM's and PNF C-R Technique

Treatment provided 3 days every week in 6 total weeks with 1 meeting per day, 3 bunches of 10 times repeat and resting period of one minute among bunches. This group received Mulligan's spinal mobilization with arm movement and proprioceptive neuromuscular facilitatin contract-relax technique. Previous to mobilization, all patients got hot pack (10 minutes) and active range of motion warm up exercises (2 sets of 10 repetitions) and did isometric neck exercise as a home plan of care.

Mobilisation (22) was done depending on the side of involvement, the corresponding spinous process would be mobilised combined with different movements of shoulder (flexion/ abduction/ horizontal abduction/ horizontal adduction).

Proprioceptive neuro-muscular facilitation contract relax technique performed with 3 repetitions in each cervical movement (flexion, extension, lateral flexion and rotation) (27).

Intervention Type: OTHER

PNF C-R Technique and PT Protocol

Treatment provided 3 days every week in 6 weeks with 1 meeting per day, 5 clusters of 3 times repeat and resting period of one minute among clusters. Regime of training involved PNF (proprioceptive neuromuscular facilitation) contract-relax method along with the standard physical therapy protocol which includes passive stretching (3 sets of 10 repetitions) and isometric strengthening exercises (2 sets of 10 repetitions).

Proprioceptive neuro-muscular facilitation contract relax technique performed with 3 repetitions in each cervical movement (flexion, extension, lateral flexion and rotation) (27).

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Both males, females of 21 years to 50 years old
• Patients already diagnosed by orthopedicians
• Patients with positive screening (upper limb tension, spurling & distraction) tests

Exclusion Criteria

• History of trauma, fracture and previous surgery
• Any pathological condition, spinal instability and tumor
• VBI (Vertebral-Basillar Insufficiency) and cervical instability/spondylolisthesis

• Minimum Eligible Age: 21 Years
• Maximum Eligible Age: 50 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Muhammad Azeem

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

Riphah International University

Lahore, Punjab Province, Pakistan

Countries

Pakistan

References

Kamal AS, Zakaria HM, Elsamra MK, Gaballah MA, Elrewainy RM. EFFICACY OF PROPRIOCEPTIVE TRAINING PARADIGM ON CERVICAL RADICULOPATHY. Assessment. 2023;1000(2):12.

Reference Type: BACKGROUND

Gashi AI, Kovačič T, Gashi F, Azemi A. The effect of proprioceptive neuromuscular facilitation technique on treating cervical radiculopathy. Journal of Physical Education and Sport. 2023;23(3):722-9.

Reference Type: BACKGROUND

Taneja D, Saharan A, Ranjeeta W, Sharma M, Saharan M, Dubey S, et al. Effect of Mulligan's Smwam among Subjects with UnilateralCervical Radiculopathy. Eduzone: International Peer Reviewed/Refereed Multidisciplinary Journal. 2023;12(1):11-22.

Reference Type: BACKGROUND

Other Identifiers

Muhammad Azeem

Identifier Type: -

Identifier Source: org_study_id