Muscle Energy Technique and Facet Joint Mobilization in Chronic Neck Pain.

Chronic Neck Pain Clinical Trial

Official title:

Comparison of Muscle Energy Technique and Facet Joint Mobilization in the Patient With Chronic Neck Pain.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05040477
• Other study ID #: REC/00868 Huma Tabassum
• Status: Completed
• Phase: N/A
• Start date: August 30, 2020
• Est. completion date: July 31, 2021

Study information

• Verified date: July 2023
• Source: Riphah International University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 105
• Est. completion date: July 31, 2021
• Est. primary completion date: May 15, 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 35 Years to 50 Years

Eligibility

Inclusion Criteria:

• Chronic patients (more than 12 weeks)
• Male and female patients
• Patients having recurrence of neck pain at least once in the last month.
• Patients from the age group of 35-50 years.
• Patients having mechanical neck pain ranging from 4-8 on Numeric Pain Rating Scale (NPRS).
• Cervical straightening on X-rays.
• Limited &painful cervical Rang of motion (ROMs)

Exclusion Criteria:

• Any recent history of trauma, active inflammation, Tumor, vertebra-basilar insufficiency and cervical myelopathy & radiculopathy.
• No history of serious underlying pathology, nerve root compromise, structural changes and deformities, genetic spinal disorders or previous spinal surgery

Related Conditions & MeSH terms

• Chronic Neck Pain
• Neck Pain

Intervention

Other:
• Muscle energy Technique
Muscle Energy technique was used to increase the strength of weak muscles,relaxation of tightened muscles in result mobilizes the restricted joint segments.MET's group received 3-5 repetition of post isometric relaxation (PIR). Treatment through Facet Joint Mobilization based on 3 sets of 15 repetitions of unilateral poster-anterior glide (UPA) using initially grade I & II mobilizations followed by grade III of mitland glides on selected tender segments and 5 repetitions of extension sustained natural apophyseal glides (SNAGs) on hypo mobile segments. Conventional therapy comprising of stretching and isometric strengthening exercises in combination with TENS and heat therapy.

Locations

Country	Name	City	State
Pakistan	HIT Taxila Cantt Hospital	Rawalpindi	Punjab

Sponsors (1)

Lead Sponsor	Collaborator
Riphah International University

Country where clinical trial is conducted

Pakistan, 

References & Publications (22)

10. Kage V, Bootwala F, Kudchadkar G. Effect of Bowen Technique versus Muscle Energy Technique on Asymptomatic Subjects with Hamstring Tightness: A Randomized Clinical Trial. International Journal of Medical Research & Health Sciences. 2017;6(4):102-8.

13. Hing W, Hall T, Rivett DA, Vicenzino B, Mulligan B. The Mulligan Concept of Manual Therapy-eBook: Textbook of Techniques: Elsevier Health Sciences; 2015.

14. Maitland G, Bank K. Vertebral manipulation 2002. Butterworth Heinemann, Oxford

16. Gupta S, Jaiswal P, Chhabra D. A comparative study between postisometric relaxation and isometric exercises in non-specific neck pain. Journal of exercise science and physiotherapy. 2008;4(2):88-94.

17. Sharma A, Angusamy R, Kalra S, Singh S. Efficacy of post-isometric relaxation versus integrated neuromuscular ischaemic technique in the treatment of upper trapezius trigger points. Indian Journal of Physiotherapy and Occupational Therapy. 2010;4(3):1-5.

18. Sharmila B. Isometric muscle energy technique and non-specific neck pain in secondary school teachers-results of an experimental study. Indian Journal of Physiotherapy and Occupational Therapy. 2014;8(2):58.

19. Mahajan R, Kataria C, Bansal K. Comparative effectiveness of muscle energy technique and static stretching for treatment of subacute mechanical neck pain. Int J Health Rehabil Sci. 2012;1(1):16-21.

20. Rana AA, Ahmad A, Gillani SA, Idrees MQ, Awan I. Effects of conventional physical therapy with and without muscle energy techniques for treatment of Upper Cross Syndrome. Rawal Medical Journal. 2020;45(1):127-32

21. Pragassame SA, Kurup VM, Kour J. Efficacy of sustained natural apophyseal glides mulligan technique on mobility and function in patients with cervical spondylosis: An experimental study. Journal of Natural Science, Biology and Medicine. 2020;11(2):128

22. Al Shehri A, Khan S, Shamsi S, Almureef SS. COMPARATIVE STUDY OF MULLIGAN (SNAGS) AND MAITLAND MOBILIZATION IN NECK PAIN. European Journal of Physical Education and Sport Science. 2018

3. Gautam R, Dhamija JK, Puri A, Trivedi P, Sathiyavani D, Nambi G. Comparison of Maitland and Mulligan mobilization in improving neck pain, ROM and disability. Int J Physiother Res. 2014;2(3):561-6.

5. Sutjana IDP, Erg M, PFK S, Erg A, Sutjana IDP, Irfan M, et al. Pemberian Teknik Mulligan Dan Soft Tissue Mobilization Lebih Baik Daripada Hanya Soft Tissue Mobilization Dalam Meningkatkan Lingkup Gerak Sendi Ekstensi, Rotasi, Lateral Fleksi Cervical Pada Mechanical Neck Pain. Sport and Fitness Journal. 2013;1(2).

9. Chaitow L, Crenshaw K. Muscle energy techniques: Elsevier Health Sciences; 2006

Akhter S, Khan M, Ali SS, Soomro RR. Role of manual therapy with exercise regime versus exercise regime alone in the management of non-specific chronic neck pain. Pak J Pharm Sci. 2014 Nov;27(6 Suppl):2125-8. — View Citation

Andersen LL, Saervoll CA, Mortensen OS, Poulsen OM, Hannerz H, Zebis MK. Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: randomised controlled trial. Pain. 2011 Feb;152(2):440-446. doi: 10.1016/j.pain.2010.11.016. Epub 2010 Dec 21. — View Citation

Borisut S, Vongsirinavarat M, Vachalathiti R, Sakulsriprasert P. Effects of strength and endurance training of superficial and deep neck muscles on muscle activities and pain levels of females with chronic neck pain. J Phys Ther Sci. 2013 Sep;25(9):1157-62. doi: 10.1589/jpts.25.1157. Epub 2013 Oct 20. — View Citation

Buyukturan O, Buyukturan B, Sas S, Kararti C, Ceylan I. The Effect of Mulligan Mobilization Technique in Older Adults with Neck Pain: A Randomized Controlled, Double-Blind Study. Pain Res Manag. 2018 May 15;2018:2856375. doi: 10.1155/2018/2856375. eCollection 2018. — View Citation

Osama M, Tassadaq N, Malik RJ. Effect of muscle energy techniques and facet joint mobilization on spinal curvature in patients with mechanical neck pain: A pilot study. J Pak Med Assoc. 2020 Feb;70(2):344-347. doi: 10.5455/JPMA.14189. — View Citation

Page P. Current concepts in muscle stretching for exercise and rehabilitation. Int J Sports Phys Ther. 2012 Feb;7(1):109-19. — View Citation

Peng B, Pang X, Li D, Yang H. Cervical spondylosis and hypertension: a clinical study of 2 cases. Medicine (Baltimore). 2015 Mar;94(10):e618. doi: 10.1097/MD.0000000000000618. — View Citation

Scheer JK, Tang JA, Smith JS, Acosta FL Jr, Protopsaltis TS, Blondel B, Bess S, Shaffrey CI, Deviren V, Lafage V, Schwab F, Ames CP; International Spine Study Group. Cervical spine alignment, sagittal deformity, and clinical implications: a review. J Neurosurg Spine. 2013 Aug;19(2):141-59. doi: 10.3171/2013.4.SPINE12838. Epub 2013 Jun 14. — View Citation

Yoon SY, Moon HI, Lee SC, Eun NL, Kim YW. Association between cervical lordotic curvature and cervical muscle cross-sectional area in patients with loss of cervical lordosis. Clin Anat. 2018 Jul;31(5):710-715. doi: 10.1002/ca.23074. Epub 2018 Apr 14. — View Citation

* Note: There are 22 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Cervical Lordosis Measurement (posterior tangent method)	measure cervical lordosis by drawing tangent line along posterior border of C2 to C7 vertebra and measuring posterior tangent angle on lateral radio graph of cervical spine.At baseline and 4 weeks after baseline	4 week
Primary	Numeric pain rating scale	Will utilize for measurement of neck pain intensity.Minimum pain score is labeled as "zero" and maximum pain score is labeled as "10".At baseline, 2 and 4 weeks after baseline.	4 week
Secondary	Neck disability index:	Will utilize for measurement of functional disability level among patients with chronic neck pain.At baseline, 2 and 4 weeks after baseline	4 week
Secondary	Cervical goniometry:	Will utilize to measure range of motions for all movement at cervical spine with the help of valid & reliable tool, goniometer.At baseline, 2 and 4 weeks after baseline	4 week