Chronic Neck Pain
Conditions
Keywords
Chronic neck pain, Mulligan concept, Mobilization with Movement, Cervical range of motion, Randomized controlled trial
Brief summary
This randomized controlled trial was conducted to evaluate the effectiveness of adding Mulligan Mobilization with Movement (MWM) to conventional physiotherapy in patients with chronic mechanical neck pain. Seventy-six participants aged 18-65 years were randomly assigned to receive either conventional physiotherapy alone or conventional physiotherapy combined with MWM for four weeks. Pain intensity, cervical range of motion, and functional disability were assessed before and after the intervention. The study aimed to compare changes in pain intensity, cervical range of motion, and functional disability between the two treatment groups.
Detailed description
Chronic mechanical neck pain is a common musculoskeletal condition associated with neck pain, reduced cervical mobility, and functional limitations. Conventional physiotherapy is commonly used in the management of chronic mechanical neck pain. Mulligan Mobilization with Movement (MWM) is a manual therapy technique that combines sustained joint mobilization with active movement and may be used as an adjunct to conventional physiotherapy. This randomized controlled trial was conducted to investigate the effect of adding Mulligan Mobilization with Movement (MWM) to conventional physiotherapy in individuals with chronic mechanical neck pain. A total of 76 participants aged 18 to 65 years were initially enrolled in the study. Six participants were excluded before randomization according to the study eligibility criteria. The remaining 70 participants were randomly allocated to one of two treatment groups: a control group receiving conventional physiotherapy alone (n = 32) and an experimental group receiving conventional physiotherapy combined with Mulligan Mobilization with Movement (n = 38). Both groups received treatment three times per week for four consecutive weeks. The control group received the conventional physiotherapy program specified in the study protocol. The experimental group received the same conventional physiotherapy program with the addition of Mulligan Mobilization with Movement. The primary outcome measures included pain intensity, cervical range of motion, and functional disability. Pain intensity was assessed using the Visual Analog Scale (VAS). Cervical range of motion was measured using goniometry. Functional disability related to neck pain was assessed using the Neck Disability Index (NDI). Outcome measures were assessed at baseline and following completion of the four-week intervention period. The outcome measures were used to compare changes between the two treatment groups. Statistical analysis was performed using analysis of covariance (ANCOVA), with adjustment for baseline measurements. Effect sizes were calculated using Cohen's d and partial eta squared (η²) to quantify the magnitude of between-group differences. The study was designed as a randomized controlled trial to compare conventional physiotherapy alone with conventional physiotherapy combined with Mulligan Mobilization with Movement in individuals with chronic mechanical neck pain.
Interventions
OTHERConventional Physical Therapy Program
Included of Cervical mobility and strengthening exercises, Transcutaneous Electrical Nerve Stimulation (TENS) and Soft tissue massage
OTHERMulligan technique
The Mulligan Concept is a manual therapy approach developed by New Zealand physiotherapist Brian Mulligan in the 1980s. It includes techniques such as Mobilization with Movement (MWM) and the Sustained Natural Apophyseal Glide (SNAG), which have attracted significant attention for their effectiveness in treating neck pain.
Sponsors
Prof. Mosab Saleem Hamed Amoudi
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age 18-65 years * Chronic mechanical neck pain lasting ≥ 3 months * NDI score ≥ 10 * Ability to attend 3 sessions per week
Exclusion criteria
* Previous cervical spine surgery * Cervical radiculopathy or myelopathy * Vertebral artery insufficiency * Rheumatologic or neurological disorders * Ongoing physiotherapy elsewhere
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in pain intensity measured by Visual Analog Scale (VAS) | Before treatment (baseline) and 4 weeks (end of treatment) | Pain intensity will be measured using the Visual Analog Scale (VAS), a 0-10 cm scale, where 0 indicates no pain and 10 indicates the worst pain. Higher scores indicate greater pain intensity and therefore worse outcomes. Pain intensity will be assessed at baseline and at the end of the 4-week intervention. The change in pain score from baseline to post-intervention will be reported. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in cervical range of motion (ROM) measured by goniometer (degrees) | Before treatment (baseline) and 4 weeks (end of treatment) | Cervical range of motion (ROM) will be measured in degrees (°) using a goniometer at baseline and at the end of the 4-week intervention. Cervical flexion, extension, rotation, and lateral flexion will be assessed. The change in cervical ROM from baseline to post-intervention will be reported. Greater cervical ROM within the expected physiological range indicates better cervical mobility. |
| Change from baseline in neck-related disability measured by the Neck Disability Index (NDI) | Before treatment (baseline) and 4 weeks (end of treatment) | Neck-related disability will be assessed using the Neck Disability Index (NDI), a 10-item self-reported questionnaire. Each item is scored from 0 to 5, with a total score ranging from 0 to 50. Higher scores indicate greater neck-related disability and therefore worse outcomes. The NDI will be administered at baseline and at the end of the 4-week intervention. The change in total NDI score from baseline to post-intervention will be reported. |
Countries
Palestinian Territories
Contacts
PRINCIPAL_INVESTIGATORMosab S Amoudi
Arab American University (Palestine)
Outcome results
None listed