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Clinical Trial Summary

The purpose of the study is to compare the muscle energy technique, facet joint mobilization and conventional physical therapy in individuals with chronic neck pain on cervical lordosis,cervical range of motions, numeric pain rating scale and NDI. A randomized control trial was conducted at physiotherapy department of HIT hospital, Taxila Cantt. The sample size was 105 calculated through open-epi tool. The participants were divided into three interventional groups, experimental group (1), experimental group (2), and control group (3) each having 35 participants. The study duration was six months. Sampling technique applied was Purposive sampling for recruitment and group randomization using sealed envelope method. Only 35 to 50 years participants with 4-8 pain intensity on NPRS in cervical region were included in the study. Goniometer, Posterior tangent method on lateral radiographs for cervical curve and Self structured Questionnaire. Data was collected at baseline then 2 and 4 weeks after the application of interventions. Data analyzed through SPSS version 21.

Clinical Trial Description

Neck pain is a common musculoskeletal disorder that leads to significant disability in the general population. In a 6-month period, 54% of adults suffer from neck pain, and 4.6% experience limitations of important activities because of neck problems(1). Neck pain is a major problem around the world and all age ranges population affected from neck pain dysfunction(2). The prevalence of neck pain is 13% and lifetime prevalence of 50 % Neck pain is a common problem in our society and, at any given time, affects about 10% of the general population. Estimates of the prevalence of chronic neck pain vary(3). chronic(3).Musculoskeletal disorders are common among general population, the one-year prevalence of neck pain is 30% to 50%(4). Mechanical neck pain can originate from lesions on the zygapophyseal joint or the condition of muscle spasm in the cervical region(5).It causes the limitation of range of motion in all directions of cervical region. Pain followed by a minor positional fault in muscle guarding of the levator scapulae, cervical paravertebral, and upper trapezius is closely related to the limitation of the range of motion of the cervical joint in mechanical neck pain(5). Muscular activity also contributes to the shape and magnitude of the cervical lordosis. discovered a significant relationship between the weakness of the cervical extensor muscles and the loss of cervical lordosis(6).The natural biomechanics of the spine rely on a lordotic curve to distribute most of the load posteriorly. Thus, deviations from this form might lead to the development of cervical pathology(7) Conventional static stretching (SS) is a technique commonly applied in the management of neck pain and other mechanical disorders.(8)Muscle energy technique is also known as post-isometric relaxation technique as it is a direct active post-facilitating technique. The concepts of MET are formed on the basis of autogenic inhibition and reciprocal inhibition(9).MET has demonstrated to be useful in increasing the range of motion (ROM) along with also facilitating the lymphatic circulation(10).Manual therapy is one of the fundamental treatment methods of the physical therapist in the management of cervical dysfunctions and can be effective in alleviating pain, restoring motion, and helping to alter the biomechanics of a particular joint by equally distributing forces(11). Mulligan is one of the facet joint mobilization techniques that can be applied in case of neck pain. Mulligan mobilization techniques (MMTs) include several methods such as sustained natural epiphyseal glides and natural epiphyseal glides that target the spine(3, 12) SNAG is the best technique as it improves the range of motion (ROM) of the patient by correcting the biomechanics of the joint, unlocking a jammed facet, and releasing the entrapped meniscoid between the joints(13).Maitland's techniques involve the application of passive and accessory oscillatory movements to spinal and vertebral joints to treat pain and stiffness in 5 grades(3). Maitland also prescribes stretching techniques to deal with muscle spasm (3, 14)M. Osama et al in 2020 concluded that the current study demonstrates the use of conservative physical therapy management of neck pain, majorly consisting of muscle energy techniques and cervical facet joint mobilization to be effective in improving the cervical lordosis, pain, disability, ROM and isometric muscle strength(15).Gupta et al & Sharma et al studied the effects of integrated neuromuscular inhibition techniques and post isometric relaxation with isometric exercises, respectively. They concluded that pain and functional status improved more in the group receiving post isometric relaxation(16, 17).A study by Sharmila in 2014 compared the effects of MET with conventional physical therapy, concluded that the MET was an effective regime in alleviating pain and improving disability(18). The study by Mahajan et al, which favored the use of muscle energy techniques versus static stretching for mechanical neck pain and showed that MET had marked reduction in neck pain and improvement in neck functions(19)They concluded that both conventional therapy and MET were beneficial for the treatment of upper cross syndrome. However, METs was found to be superior on conventional physical therapy(20). Pragassame, et al in 2020 concluded the patients who received the SNAG Mulligan technique showed better improvement in pain reduction, cervical ROM, and functional disability than the control group(21) Shehri et al. In 2018 conducted a comparative study of Mulligan SNAG and Maitland mobilization in neck pain.They concluded that both mobilization techniques are significant in reducing the symptoms of the patient, but Maitland mobilization is statistically significant compared to Mulligan SNAG mobilization, which is differs from our present study outcome(22) ;

Study Design

Related Conditions & MeSH terms

NCT number NCT05040477
Study type Interventional
Source Riphah International University
Status Completed
Phase N/A
Start date August 30, 2020
Completion date July 31, 2021

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