Effect of Mulligan Snag and Diaphragmatic Release on Thoracic Kyphosis

Not Applicable

Completed

• Conditions: Postural Kyphosis, Cervicothoracic Region
• Interventions: Other: mulligan snag mobilization and diaphragmatic release

• Registration Number: NCT05458206
• Lead Sponsor: Cairo University

Brief Summary

the aim of this study is to investigate the efficacy of mulligan snag mobilisation and diaphragmatic release on upper crossed syndrome

Detailed Description

Acquired postural disorders can be a consequence, to a large extent, of contemporary living and working conditions. Some of the most typical factors include continuous use of mobile phones and computers, working in sedentary jobs. Prolonged incorrect posture and reduced physical activity present a dis-balance in the musculature . It can also lead to vision issues, as well as headaches, musculoskeletal issues, and pain, as well as a multitude of other symptoms.

Upon the available research studies, there is not study conducted to investigate the effect of mulligan SNAG mobilization and diaphragmatic release in upper crossed syndrome patients this trial has four groups; one will receive diaphragmatic release + conventional, the second will receive mulligan SNAG mobilization, and conventional, the third will receive mulligan SNAG mobilization+diaphragmatic release+conventional, the fourth subjects will receive conventional

Study Timeline

• Study First Submitted: 2022-07-11
• Study First Submitted QC: 2022-07-11
• Study First Posted: 2022-07-14
• Study Start: 2022-10-20
• Status Verified: 2022-11
• Primary Completion: 2023-03-20
• Study Completion: 2023-03-20
• Last Update Submitted: 2023-07-23
• Last Update Posted: 2023-07-25

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

• Age ranged from 17 to 22 years .
• Body Mass Index from 20 to 25 kg/m² .
• All participants have an intensity of neck pain on VAS (4-8) (moderate cases) .
• The subjects were chosen from both sexes.
• All participants have kyphosis angle ≥42°
• All participants have mechanical neck pain and FHP (craniovertebral angle CVA < 49) CVA of < 49) .

Exclusion Criteria

• Malignancy
• Fractures of the cervical spine
• Cervical radiculopathy or myelopathy
• Vascular syndromes such as vertebrobasilar insufficiency
• Rheumatoid arthritis
• Neck or upper back surgery
• Taking anticoagulants
• Local infection
• Whiplash injury

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
the conventional therapy	mulligan snag mobilization and diaphragmatic release	the patient will receive chin-in, inter-scapular exercises, and pectoralis stretch (3 sets,10 repetitions)
diaphragmatic release, and conventional	mulligan snag mobilization and diaphragmatic release	Diaphragmatic release: The patients will be positioned in the supine position. The therapist stood at the head of the patient. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ) with hypothenar regions of the hands and the last three fingers. During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally, while elevating the ribs simultaneously. During exhalation, the therapist will deepen hand contact toward the inner coastal margins for 5 to 7 minute conventional therapy: the patient will receive chin-in, interscapular exercises, and pectoralis stretch
mulligan SNAG mobilization, and conventional	mulligan snag mobilization and diaphragmatic release	mulligan snag: Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement and then sustains it at the end range position for a few seconds. (3 sets,10 repetitions) conventional therapy: the patient will receive chin-in, interscapular exercises, and pectoralis stretch
mulligan SNAG mobilization, diaphragmatic release, and conventional	mulligan snag mobilization and diaphragmatic release	Diaphragmatic release: The patients will be positioned in the supine position. The therapist stood at the head of the patient. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ) with hypothenar regions of the hands and the last three fingers. During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally, while elevating the ribs simultaneously. During exhalation, the therapist will deepen hand contact toward the inner coastal margins. (5 to 7 minutes) mulligan snag: Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement and then sustains it at the end range position for a few seconds(3 sets,10 repetitions) conventional therapy: the patient will receive chin-in, interscapular exercises, and pectoralis stretch

Primary Outcome Measures

Name	Time	Method
pain intensity	up to four weeks	The scale that will be used is the Visual analogue scale;each subject will be instructed to put point on a line from no pain to tolerable pain

Secondary Outcome Measures

Name	Time	Method
cervical range of motion	up to four weeks	theCROM device will placed on patient's head while he/she seated and looking forward the difference between the ponter value and the value after movement will be recorded as the motion angle of the cervical vertebrae

Trial Locations

Locations (2)

Faculty of physical therapy; 🇪🇬 Cairo, Giza, Egypt

Faculty of physical therapy Cairo university; 🇪🇬 Cairo, Giza, Egypt