Comparative Effects of Gong's Mobilization and Maitland Mobilization in Patients With Cervical Spondylosis

NCT07808372 | Completed

• 1 other identifier: 2024-MS-PT-029
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Cervical spondylosis is a degenerative condition of the cervical spine that may cause neck pain, reduced cervical range of motion, muscle weakness, and functional disability. Manual therapy is commonly used as part of conservative physiotherapy management. This randomised controlled trial compares Gong's mobilisation with Maitland cervical mobilisation in patients with cervical spondylosis. This randomised controlled trial aims to compare the effects of Gong's mobilisation and Maitland's mobilisation on pain intensity, cervical range of motion, cervical muscle strength, and functional disability in individuals with cervical spondylosis. A total of 50 participants diagnosed with cervical spondylosis were randomly allocated into two equal groups using a computer-generated randomisation method. Group A received Gong's mobilisation combined with conventional physiotherapy, while Group B received Maitland mobilisation combined with the same conventional physiotherapy programme. Conventional treatment included transcutaneous electrical nerve stimulation (TENS) and cervical isometrics. Outcome measures included the Numeric Pain Rating Scale (NPRS) for pain intensity, a universal goniometer for cervical range of motion, Manual Muscle Testing (MMT) for cervical muscle strength, and the Neck Disability Index (NDI) for functional disability. Assessments were performed at baseline and after completion of the treatment period. The findings of this study were intended to determine the comparative effectiveness of Gong's mobilisation and Maitland mobilisation and to provide evidence-based recommendations for the physiotherapy management of patients with cervical spondylosis.

Conditions

Cervical Spondylosis; Neck Pain; Manipulation

Outcome Measures

Primary Outcomes (3)

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

  Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS), an 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain). A reduction in score indicated improvement in pain following the intervention.

  Baseline and after 4 weeks of treatment

• Change in Cervical Range of Motion as Measured by a Universal Goniometer

  Cervical range of motion (ROM) was measured using a universal goniometer. Movements assessed include cervical flexion, extension, right and left side bending, and right and left rotation. Measurements are recorded in degrees, with higher values indicating greater cervical mobility and improved functional movement following the intervention.

  Baseline and after 4 weeks of treatment

• Change in Cervical Muscle Strength as Measured by Manual Muscle Testing (MMT)

  Cervical muscle strength was assessed using Manual Muscle Testing (MMT) for the cervical flexor, extensor, and lateral flexor muscles. Muscle strength was graded using the standard MMT scale, with higher grades indicating greater muscle strength and functional improvement following the intervention.

  Baseline (Week 0, before the first treatment session) and post-intervention (Week 4, after completion of the treatment program).

Secondary Outcomes (1)

• Change in Neck Disability as Measured by the Neck Disability Index (NDI)

  Baseline (Week 0, before the first treatment session) and post-intervention (Week 4, after completion of the treatment program).

Study Arms (2)

Gong's Mobilization Group

EXPERIMENTAL

Participants in this group received Gong's Mobilisation in combination with conventional physiotherapy, including Transcutaneous Electrical Nerve Stimulation (TENS) and cervical isometrics. Treatment was administered according to a standardised protocol throughout the intervention period.

Behavioral: Gong's Mobilization

Maitland Mobilization Group

ACTIVE COMPARATOR

Participants in this group received Maitland cervical mobilisation combined with the same conventional physiotherapy programme for four weeks, with three treatment sessions per week.

Behavioral: Maitland Cervical Mobilization

Interventions

Maitland Cervical Mobilization BEHAVIORAL

Maitland cervical mobilisation was performed with the participant positioned prone. The physiotherapist positioned the thumbs over the targeted hypomobile cervical segment and applied unilateral posteroanterior (PA) oscillatory pressure to the affected cervical segment according to standardised Maitland mobilisation procedures. The mobilisation was performed in repeated bouts with appropriate rest intervals between applications. Following the mobilisation, participants performed the prescribed cervical exercises included in the conventional physiotherapy programme. Treatment was provided for 40 minutes per session, three sessions per week for four consecutive weeks, for a total of 12 sessions.

Maitland Mobilization Group

Gong's Mobilization BEHAVIORAL

Gong's Mobilization was performed with the participant in a sitting position with the cervical spine maintained in a neutral position. The physiotherapist stabilised the selected cervical vertebra using the thumb while supporting the participant's cheek to minimise unwanted movement. Gentle pressure was applied along the cervical facet joint to glide the vertebra and facilitate cervical retraction and extension. At the end range, the physiotherapist increased cervical extension using the weight of the head and gravity. The technique was also applied unilaterally for lateral flexion and bilaterally for extension, using controlled three-point pressure to stabilise selected cervical segments while facilitating movement at the targeted segment. Gong's mobilisation was performed according to a standardised treatment protocol and was combined with conventional physiotherapy. Treatment was provided for 40 minutes per session, three sessions per week for four consecutive weeks, for a total of

Gong's Mobilization Group

Eligibility Criteria

• Age: 40 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Both genders, male \& female.
• Participants with a physician/orthopaedic diagnosis of cervical spondylosis, confirmed by cervical spine radiography (X-ray) demonstrating degenerative changes such as intervertebral disc-space narrowing, osteophyte formation, or facet/vertebral joint degeneration.
• Limited range of motion
• Symptoms present for more than one month
• Limited cervical range of motion for over 2 months.

You may not qualify if:

• Participants were excluded if they reported a history of
• Cervical Radiculopathy: Patients who exhibit evidence of constriction of the normal cervical nerve roots, as indicated by positive findings from the Upper Limb Tension Test (ULTT1), Spurling's test, the cervical distraction test, and neurological examination.
• Neck Sprain and Periarthritis of the Shoulder (Adhesive Capsulitis).
• Rheumatic Myofibrositis: People with a medical history or a doctor's diagnosis of rheumatic or inflammatory musculoskeletal diseases.
• Neurological conditions (Neurasthenia): Patients having history of illness and neurological examination indicate that they have neurological problems compromising neck mobility or pain perception
• Fracture of the cervical spine.
• Cervical instability/subluxation/spondylolisthesis.
• Cervical Instability: Those who tested positive for upper cervical instability, either the Sharp-Purser Test or the Transverse Ligament Stress Test, were removed.
• Vestibular basilar insufficiency, Cervicogenic headache, vertigo, dizziness
• Thoracic outlet syndrome

Sponsors & Collaborators

• University of Faisalabad: lead

Study Sites (1)

Department of Rehabilitation Sciences, The University of Faisalabad

Faisalābad, Punjab Province, 38000, Pakistan

Location

MeSH Terms

Conditions

Spondylosis; Neck Pain

Condition Hierarchy (Ancestors)

Spinal Diseases; Bone Diseases; Musculoskeletal Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• DR Adeera Azam, PT

  The university of faisalabad

  PRINCIPAL INVESTIGATOR

Study Design

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

Model Details: Computer-generated randomization sequence; 25 participants were allocated to each group

Study Record Dates

• First Submitted: September 2, 2026
• First Posted: September 8, 2026
• Study Start: April 24, 2026
• Primary Completion: May 22, 2026
• Study Completion: August 16, 2026
• Last Updated: September 8, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)