Impact of Adding Integrated Neuromuscular Inhibition Technique to Mulligan Therapy in Symptomatic Forward Head Posture

NCT ID: NCT07086872

Last Updated: 2025-07-25

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 120 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-07-30
• Study Completion Date: 2026-02-20

Brief Summary

this study will be conducted to investigate the impact of adding integrated neuromuscular inhibition technique to mulligan therapy in symptomatic forward head posture.

Detailed Description

Forward head posture is anterior positioning of the cervical spine, which is regarded as a "bad" head posture and is commonly found in patients who experience problems with the head and neck. Particularly, forward head posture is frequently found in people sitting in front of a computer for prolonged periods. Load increases in the muscles and joints of the cervical spine as a result of forward head posture are considered a major cause of musculoskeletal disorders. INIT is effective as it causes sustained or intermittent compression which causes ischemia reduces local circulation until pressure is released, after which a flushing of fresh oxygenated blood occurs. Mechanoreceptors impulses interface with slower pain messages reducing amount of pain messges reaching the brain, releasing pain relieving hormones, decreasing myofascial pain. Stretches the taut bands of muscles fibers. INIT along with strengthening excercises proved to be beneficial in decreasing disability improving Range of motion. The concept of SNAG is to increase the treatment effects by having patients perform active movements while removing pain in the lesions by means of manipulative therapy. This is a new concept in the manipulative therapy field, and differs from traditional manipulative therapy by combining the active movements of the patients with additional passive movements performed with the aid of therapists

Conditions

Forward Head Posture

Study Design

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

Study Groups

Integrated Neuromuscular Inhibition Technique and mulligan therapy

thirty patients will receive Integrated Neuromuscular Inhibition Technique and mulligan therapy three times a weeks for six weeks+postural correction exercises

Group Type: EXPERIMENTAL

Integrated Neuromuscular Inhibition Technique and mulligan therapy

Intervention Type: OTHER

patients will receive Integrated Neuromuscular Inhibition Technique in the form of intermittent ischemic compression, strain counter strain and muscle energy technique and mulligan therapy for limited cervical range of motion

postural correction exercises

Intervention Type: OTHER

the patients will receive two strengthening exercises (deep cervical flexors and scapular retractors) and two stretching: cervical extensors (sub-occipital muscles) and pectoral muscles). The program was based on a program by Harman and Kendall

Integrated Neuromuscular Inhibition Technique

thirty patients will receive Integrated Neuromuscular Inhibition Technique+postural correction exercises three times a weeks for six weeks

Group Type: EXPERIMENTAL

Integrated Neuromuscular Inhibition Technique

Intervention Type: OTHER

patients will receive Integrated Neuromuscular Inhibition Technique in the form of intermittent ischemic compression, strain counter strain and muscle energy technique

postural correction exercises

Intervention Type: OTHER

the patients will receive two strengthening exercises (deep cervical flexors and scapular retractors) and two stretching: cervical extensors (sub-occipital muscles) and pectoral muscles). The program was based on a program by Harman and Kendall

mulligan therapy

thirty patients will receive mulligan Technique+postural correction exercises three times a weeks for six weeks

Group Type: EXPERIMENTAL

mulligan therapy

Intervention Type: OTHER

patients will receive mulligan therapy for limited cervical range of motion

postural correction exercises

Intervention Type: OTHER

the patients will receive two strengthening exercises (deep cervical flexors and scapular retractors) and two stretching: cervical extensors (sub-occipital muscles) and pectoral muscles). The program was based on a program by Harman and Kendall

postural correction exercises

thirty patients will receive postural correction exercises three times a weeks for six weeks

Group Type: ACTIVE_COMPARATOR

postural correction exercises

Intervention Type: OTHER

the patients will receive two strengthening exercises (deep cervical flexors and scapular retractors) and two stretching: cervical extensors (sub-occipital muscles) and pectoral muscles). The program was based on a program by Harman and Kendall

Interventions

Integrated Neuromuscular Inhibition Technique and mulligan therapy

patients will receive Integrated Neuromuscular Inhibition Technique in the form of intermittent ischemic compression, strain counter strain and muscle energy technique and mulligan therapy for limited cervical range of motion

Intervention Type: OTHER

Integrated Neuromuscular Inhibition Technique

patients will receive Integrated Neuromuscular Inhibition Technique in the form of intermittent ischemic compression, strain counter strain and muscle energy technique

Intervention Type: OTHER

mulligan therapy

patients will receive mulligan therapy for limited cervical range of motion

Intervention Type: OTHER

postural correction exercises

the patients will receive two strengthening exercises (deep cervical flexors and scapular retractors) and two stretching: cervical extensors (sub-occipital muscles) and pectoral muscles). The program was based on a program by Harman and Kendall

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• CVA equal or less than 50
• Had cervical pain for more than three months and had visited an orthopedist clinic

Exclusion Criteria

• cervical spine spondylosis
• fractures or cervical spinal surgery
• Cervical or shoulder neurological movement disorder.
• Temporo-mandibular surgery, (5) Pathologic trauma

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 35 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Al Shaymaa Shaaban Abd El Azeim

principle investigator : alshaymaa shaaban abd el azeim

Responsibility Role: PRINCIPAL_INVESTIGATOR

Central Contacts

alshaymaa abd elazeim, phd

Role: CONTACT

alshaymaa.shaaban@pt.cu.edu.eg

01033771553

Other Identifiers

P.T.REC/012/005806

Identifier Type: -

Identifier Source: org_study_id