Mobilization With Movement Technique on the Stiffness of Cervical Muscles in Individuals With Mechanical Neck Pain

NCT06396104 | Completed

• 1 other identifier: IUC001
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Mobilisation with movement (Mulligan Sustained Natural Apophyseal Glides (SNAG)). method has been shown to have significant effects on pain, joint range of motion, and functionality in patients with neck pain. However, there is a lack of studies examining the effects of this technique on muscle stiffness associated with neck pain. Considering the immediate effects of a single session of lumbar SNAG application on lumbar muscle stiffness in patients with low back pain, it raises curiosity about the effects it would have on cervical spinal segments and surrounding muscles. The aim of this study is to investigate the immediate effects of Mulligan SNAG application on muscle stiffness, pain, and joint range of motion in patients with mechanical neck pain.

Conditions

Neck Pain

Keywords

Neck Pain; Manual Therapy; Sham Treatment

Outcome Measures

Primary Outcomes (1)

• Muscle stiffness

  Muscle stiffness will be measured with MyotonPRO (Myoton SA, Tallinn, Estonia). A brief mechanical pulse is applied to the skin over the muscle and then quickly released. Stiffness (N/m) is a parameter related to the capacity to withstand an external force. The reliability of the device has been proven in healthy individuals.The measurement site will be marked on the skin with a pen. In all applications, MyotonPRO's probe will be placed perpendicular to the skin and 3 measurements will be recorded using the multi-scanning mode with 10 pulses 1 second apart, and the average of the 3 measurements will be used for analysis. Upper trapezius: Evaluation will be performed in prone position. Measurements are from the midpoint between the lateral edge of the acromion and the spinous process of C7. Sternocleidomastoid: Measurements will be made at the midpoint between the sternum and the mastoid protrusion, with individuals lying in a supine position with a soft pillow under the neck.

  Baseline and immediately after application.

Secondary Outcomes (3)

• Joint Range of Motion

  Baseline and immediately after application.

• Numeric Pain Rating Scale

  Baseline and immediately after application.

• Neck Disability Index

  Baseline

Study Arms (2)

Mobilization with movement group

EXPERIMENTAL

Other: Mobilisation with movement

Sham group

SHAM COMPARATOR

Other: Sham mobilisation

Interventions

Mobilisation with movement OTHER

The physiotherapist places the medial edge of the thumb of one hand on the upper facet joint of the relevant segment, then applies superior-anterior slide to the facet joint by providing support with the thumb of the other hand. The 'gliding' movement is maintained while the patient actively performs the unilateral neck rotation movement and maintains it for a few seconds at the end of the movement. If joint movement is painful, attempts are made on the other facet joint of the same segment or on the spinous process. If this attempt does not immediately improve the patient's active joint motion, Mulligan Sustained Natural Apophyseal Glides (SNAG) will be applied to the upper part of the left zygapophysial joint, and in case of failure again, application will be made through the superior spinous process of the relevant segment. Painless joint movement will be applied in 6 repetitions and 3 sets.

Mobilization with movement group

Sham mobilisation OTHER

While the patients are sitting in a chair with a supported back, the spinal segment where pain is felt in neck joint movements will be determined. Without applying a sliding movement to this segment over the facet joint, only sensory input will be given and the patient will be asked to continue the active rotation movement and wait a few seconds at the end of the movement. The application will be completed as 6 repetitions and 3 sets.

Sham group

Eligibility Criteria

• Age: 20 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Having widespread neck pain lasting more than 3 months
• Pain symptoms that increase with neck movements or palpation
• Volunteering to participate in the study

You may not qualify if:

• History of neck trauma
• Previous cervical surgery
• Cervical radiculopathy or myelopathy
• Fibromyalgia syndrome diagnosis
• Any physiotherapy intervention in the previous 12 months
• Sign of vertebrobasilar insufficiency
• Upper cervical spine ligament instability
• Those using steroids or muscle relaxants

Sponsors & Collaborators

• Istanbul Gelisim University: lead
• Istanbul Kent University: collaborator
• Istanbul University - Cerrahpasa: collaborator
• Istanbul Demiroglu Bilim University: collaborator

Study Sites (1)

Istanbul Kent University

Istanbul, 34320, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Neck Pain

Interventions

Movement

Condition Hierarchy (Ancestors)

Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Physiological Phenomena; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: The physiotherapist who will apply the evaluation methods to be used in our study will be blind to the group distribution of the patients. Additionally, patients will be blind to the procedure.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: A Parallel, double blind, randomised controlled trial

Study Record Dates

• First Submitted: April 24, 2024
• First Posted: May 2, 2024
• Study Start: January 10, 2024
• Primary Completion: June 15, 2024
• Study Completion: June 30, 2024
• Last Updated: July 8, 2024

Record last verified: 2024-04

Locations

TU (1)