Upper Cervical Mobilization vs. Sub-Occipital MET for Neck Pain and FHP

NCT ID: NCT07164963

Last Updated: 2026-01-05

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 45 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-09-12
• Study Completion Date: 2025-12-01

Brief Summary

forty-five patients with MNP and FHP age from 25-40 years will be randomly assigned into three groups: Group A (study): 15patients will receive (upper cervical translatoric mobilization) and traditional physical therapy, Group B (study): 15patients received sub occipital muscle energy technique and traditional physical therapy, and Group C (control): 15 patients will receive the traditional physical therapy treatment only . Interventions will be conducted three times a week for four weeks. Craniovertebral angle (CVA) using Photographic Posture Analysis Method (surgimap software), pain intensity using viual analogue scale (VAS), Cervical ROM using CROM device, and neck functional ability using Neck Disability Index (NDI) will be assessed for all participants before and after the treatment program.

Detailed Description

This randomized controlled trial aims to compare the efficacy of Upper Cervical Translatoric Mobilization (UC-TSM) and Sub-Occipital Muscle Energy Technique (MET) in patients with Mechanical Neck Pain (MNP) and Forward Head Posture (FHP). Forty-five participants will be randomly assigned to one of three groups: Group A (UC-TSM + conventional physical therapy), Group B (Sub-Occipital MET + conventional physical therapy), and Group C (conventional physical therapy only). Interventions will be administered three times per week for four weeks. Outcomes include pain intensity (VAS), neck disability (NDI), cervical range of motion (CROM), and craniovertebral angle (CVA) assessed via photographic analysis (Surgimap). The study will be conducted at Benha University.

Conditions

Mechanical Neck Pain; Forward Head Posture

Study Design

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

Study Groups

Upper Cervical Translatoric Mobilization

Participants will receive Upper Cervical Translatoric Mobilization (UC-TSM) applied to the upper cervical spine (C0-C2), in addition to conventional physical therapy (hot pack and Kendall exercises), three times per week for 4 weeks.

Group Type: EXPERIMENTAL

upper cervical translatoric mobilisation

Intervention Type: OTHER

(UC-TSM) is defined as a system of manual techniques using straight-line forces delivered in a parallel or perpendicular direction to an individual vertebral joint or motion segment there is also increasing in body of evidence supporting the its clinical effectiveness and safety in the management of patients with cervical impairments.

Sub-Occipital Muscle Energy Technique

Participants will receive Sub-Occipital Muscle Energy Technique (MET) targeting the sub-occipital muscles, in addition to conventional physical therapy (hot pack and Kendall exercises), three times per week for 4 weeks.

Group Type: EXPERIMENTAL

sub occipital muscle energy technique

Intervention Type: OTHER

Muscle Energy Technique (MET) is another form of a gentle manual therapy intervention that primarily targets the soft tissues, though it also contributes significantly to joint mobilization. It has been reported that, adding MET to exercise program resulted in better improvement in CVA and FHP than exercise group only

traditional physical therapy

Participants will receive conventional physical therapy only, including application of a hot pack for 15 minutes followed by Kendall exercises for postural correction, three times per week for 4 weeks.

Group Type: ACTIVE_COMPARATOR

traditional physical therapy

Intervention Type: OTHER

hot pack and kendel exercise

Interventions

upper cervical translatoric mobilisation

(UC-TSM) is defined as a system of manual techniques using straight-line forces delivered in a parallel or perpendicular direction to an individual vertebral joint or motion segment there is also increasing in body of evidence supporting the its clinical effectiveness and safety in the management of patients with cervical impairments.

Intervention Type: OTHER

sub occipital muscle energy technique

Muscle Energy Technique (MET) is another form of a gentle manual therapy intervention that primarily targets the soft tissues, though it also contributes significantly to joint mobilization. It has been reported that, adding MET to exercise program resulted in better improvement in CVA and FHP than exercise group only

Intervention Type: OTHER

traditional physical therapy

hot pack and kendel exercise

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• patients aged from 20-60 Years
• suffering from M echanical neck pain with Craniovertebral angle ; < 53
• their NDI ranging from 30-48% [9]. Patients were excluded from the study if they have injury or trauma to cervical region, spinal surgery, cervical canal stenosis, radicular pain and malignancy.

Exclusion Criteria

• Patients were excluded from the study if they have injury or trauma to cervical region, spinal surgery, cervical canal stenosis, radicular pain and malignancy.

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

MTI University

OTHER

Sponsor Role: lead

Responsible Party

reda abd elrazik

Associate Professor, Department of Physical Therapy, Faculty of Physical Therapy, Benha University

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

reda K. Abdelrazik, associate professor

Role: PRINCIPAL_INVESTIGATOR

Benha University

Locations

Faculty of Physical Therapy, Benha University

Cairo, Benha, Egypt

Countries

Egypt

Other Identifiers

PT.BU.EC.22

Identifier Type: -

Identifier Source: org_study_id