Mulligan Mobilization & Stretching Effects of Cervical

NCT07045974 | Recruiting DMC

• 1 other identifier: REC-01012 Mahnoor Ali
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

1. 1.To evaluate the effectiveness of mulligan mobilization and stretching exercises in reducing pain in individuals with cervical radiculopathy.
2. 2.To evaluate the effectiveness of mulligan mobilization and stretching exercises in reducing disability in individuals with cervical radiculopathy.
3. 3.To evaluate the effectiveness of mulligan mobilization and stretching exercises at improving ranges in individuals with cervical radiculopathy.

Conditions

Cervical Radiculopathy

Keywords

Pain; Disability Level; Range of Motion

Outcome Measures

Primary Outcomes (3)

• Change in Cervical Pain Intensity Measured by Numeric Pain Rating Scale (NPRS)

  The NPRS is a segmented numeric version of the visual analog scale (VAS) in which a respondent selects a whole number (0-10 integers) that best reflects the intensity of his/her pain The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable") High test-retest reliability has been observed in both literate and illiterate patients with rheumatoid arthritis (r = 0.96 and 0.95, respectively) before and after medical consultation.

  4 Weeks

• Cervical Range of Motion by Inclinometer

  An inclinometer is a device used to measure angles. It is commonly used in physiotherapy to measure the range of motion (ROM) of joints and very similar to a goniometer. The digital inclinometer demonstrated excellent reliability (ICC=0.75-0.86), except for the right lateral flexion (ICC=0.74) and left rotation (ICC=0.72).

  4 Weeks

• Cervical Disability by Neck Disability Index (NDI)

  This questionnaire has been designed to give us information as to how your neck pain has affected your ability to manage in everyday life. Score: /50 Transform to percentage score x 100 = %points. It has 7 items for daily living, 2 for pain and 1 for concentration. Each item is rated from 0 to 5. Total score is presented in percentage. Higher score tells greater disability while 0 means no disability(16).Total score is 50. In cervical radiculopathy patients it has moderate test retest reliability ICC= 0.68 (22).The NDI has a fair to moderate test-retest reliability in patients with mechanical neck pain but also for patients with cervical radiculopathy. The NDI has a good construct validity.

  4 Weeks

Study Arms (2)

Group A-Mulligan Mobilization

EXPERIMENTAL

Mulligan SNAGs mobilization technique was applied at level C4/5.

Other: Group A-Mulligan Mobilization

Group B-Stretching Exercises

EXPERIMENTAL

Cervical stretching exercises will be performed.

Other: Group B-Stretching Exercises

Interventions

Group A-Mulligan Mobilization OTHER

Group A will receive Mulligan mobilizations (SNAGs). Mulligan SNAGs mobilization technique was applied at level C4/5. Subjects were placed in sitting position and therapist stood behind the patient with therapist's thumbs on spinous process of particular vertebra. Mobilization was given by active movement followed by passive overpressure based on the movement restricted. The duration of treatment was three sets of ten repetitions each. Conventional treatment include the following: Subjects in both the groups were treated with hot pack (20 min), TENS (2 to 10 Hz), and manual traction along with deep neck flexor, and isometric neck strengthening.

Group A-Mulligan Mobilization

Group B-Stretching Exercises OTHER

Group B will receive stretching exercises. Subject was asked to lie supine on the plinth and the head was held at the edge of the plinth by the therapist. Then with one hand the therapist held the neck in cervical lateral flexion to the opposite side so as to achieve the stretching of the trapezius muscle. Myofascial release by applying sustained finger pressure for 5-10 s on the involved trapezius was given. A gentle myofascial stretching force was applied to take up slack and sustained until a release occurred. This protocol comprised four sets of 15 stretches with 3 min rest. Conventional treatment include the following: Subjects in both the groups were treated with hot pack (20 min), TENS (2 to 10 Hz), manual traction along with deep neck flexor, and isometric neck strengthening.

Group B-Stretching Exercises

Eligibility Criteria

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

You may qualify if:

• Participants falling in this category would be recruited into the study.
• Both genders
• Age between 20-50 years
• Subjects with neck pain radiating down to the arm
• Patients with positive findings for spurling test, Upper Limb Tension Test (ULTT), cervical distraction test and cervical rotation test towards the symptomatic side
• Subjects who were willing to participate in the study and willing to take treatment for cervical radiculopathy.

You may not qualify if:

• Participant failing to fall in this category would be excluded of the study.
• Systemic disease potentially affecting the musculoskeletal system Patients experiencing primary shoulder or upper extremity problem of local origin
• Patients with any cardiovascular disorders and respiratory disorders
• Patients with any other pathological conditions involving cervical spine like vertebro basilar insufficiency and canal stenosis
• Patients having osteophytes in cervical vertebrae
• Patients who were undergoing treatment for neck pain with other means of physiotherapy at the time of the study
• Hypermobile joints of cervical vertebrae, Cervical fractures, spinal surgery or other spinal pathologies (i.e. ankylosing spondylitis, spondylolysthesis)
• Peripheral nerve lesions like neurotemesis and axonotemesis

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Leady Reading Hospital (LRH), Hayatabad Medical Complex (HMC)

Peshawar, KPK, 25100, Pakistan

RECRUITING

MeSH Terms

Conditions

Radiculopathy; Pain

Condition Hierarchy (Ancestors)

Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Ayesha Sadiq, MSPT (OMPT)

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Ayesha Sadiq, MSPT (OMPT)

CONTACT

03346257484; ayesha.sadiq@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 23, 2025
• First Posted: July 1, 2025
• Study Start: July 15, 2025
• Primary Completion (Estimated): July 30, 2026
• Study Completion (Estimated): December 30, 2026
• Last Updated: February 25, 2026

Record last verified: 2026-02

Locations

PA (1)