Sustained Natural Apophysial Glide Versus Instrument Assisted Soft Tissue Mobilization in Patients With Chronic Mechanical Neck Pain
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Cairo University
- Enrollment
- 60
- Primary Endpoint
- neck disability
Study Overview
Brief Summary
this study will be conducted to investigate the effect of sustained natural apophysial glide and Instrument assisted soft tissue mobilization on pain intensity, cervical range of motion and neck functional disability level in patients with chronic mechanical neck pain
Detailed Description
Neck pain is a common musculoskeletal disorder in the era of technology. The International Association for the Study of Pain (IASP) has defined neck pain as:"Pain perceived as arising from anywhere with in the region bounded superiorly by superior nuchal line, inferior by an unoriginally transverse line through the tip of first thoracic spinous process, and laterally by saggital plane tangential to the lateral border of neck. Mulligan pioneered specific manual approach called mobilization with movement (MWM).The advance of this approach was aimed for application on the spinal joints. He claimed that his technique could improve the spinal range of motion (ROM) and decrease pain through the correction of a positional fault occurring between the surfaces of the involved facet joints. The most commonly used Mulligan technique is called "sustained natural apophyseal glides" or SNAGs, this technique has introduced in 1999 by Mulligan and is performed by applying an accessory glide along the axis of the facet joint of the affected level while the patient is doing an active movement from weight-bearing position. The pressure applied by the therapist in a cephalad direction over the spinous process (centrally) or the transverse process (unilaterally) or to the articular pillar of the affected vertebra.The IASTM therapy is designed to promote the restart of connective tissues by resorbing extra fibroses, encouraging collagen secondary to fibroblast recruited healing. In turn this leads to scar tissues, adhesions, and fascial limitations being released and broken down. M2t blade is a multifunctional instrument invented by Adam Bro ger that is reasonable in price and has many planes that can be used in treatment. Its efficiency in improving patients symptoms was proven through many studies. sixty patients with mechanical neck pain will be assigned randomly into three equal group; group A will receive mulligan plus traditional, group B will receive IASTM plus traditional and group C will receive traditional only
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Outcomes Assessor)
Masking Description
opaque sealed envelope
Eligibility Criteria
- Ages
- 20 Years to 55 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Sixety patients of chronic mechanical neck pain diagnosed and reffered from physicians will be participants in the study .
- •Patients of both genders will be included.
- •The age of the participants will beranged from 20 and 55 years
- •The BMI ranged between 18.9 and 25 kg/m2
- •All patients who suffered from neck pain more than 3 months.
Exclusion Criteria
- •Malignancy
- •cervical and cranial surgery
- •Recent fractures
- •spinal tumors
- •severe disc herniation
- •uncontrolled hypertension
- •Heart Disease ( arrhythmia, pacemaker).
- •Pregnant and breast feeding women.
Arms & Interventions
sustained natural apophysial glide
patients will receive sustained natural apophysial glide( SNAGS ) in addition to conventional therapy in the form of ( Infrared, TENS , stretching exercices, isometric exercises) for chronic mechanical neck pain ,3 sessions per week for one month
Intervention: sustained natural apophysial glide (Other)
sustained natural apophysial glide
patients will receive sustained natural apophysial glide( SNAGS ) in addition to conventional therapy in the form of ( Infrared, TENS , stretching exercices, isometric exercises) for chronic mechanical neck pain ,3 sessions per week for one month
Intervention: conventional physical therapy (Other)
instrument assisted soft tissue mobilization
patients will receive instrument assisted soft tissue mobilization ( IASTM) technique in addition to conventional therapy in the form of ( Infrared, TENS , stretching exercices, isometric exercises) for chronic mechanical neck pain ,3 sessions per week for one month.
Intervention: instrument assisted soft tissue mobilization (Other)
instrument assisted soft tissue mobilization
patients will receive instrument assisted soft tissue mobilization ( IASTM) technique in addition to conventional therapy in the form of ( Infrared, TENS , stretching exercices, isometric exercises) for chronic mechanical neck pain ,3 sessions per week for one month.
Intervention: conventional physical therapy (Other)
conventional therapy
patients will receive conventional therapy in the form of ( Infrared, TENS , stretching exercices, isometric exercises) for chronic mechanical neck pain ,3 sessions per week for one month.
Intervention: conventional physical therapy (Other)
Outcomes
Primary Outcomes
neck disability
Time Frame: up to four weeks
Assessment of neck disability will be performed by Arabic version of neck disability index .It is valid and reliable tool in the assessment of neck function. The NDI can be calculated as a raw score or as a percentage Each segment is graded on a scale of 0 to 5, with 0 representing "no discomfort" and 5 suggesting "the most excruciating pain imaginable." With a maximum score of 50 as following
Secondary Outcomes
- pain intensity(up to four weeks)
- cervical range of motion(up to four weeks)
Investigators
Menna Allah Hesham Abd elfatah
principle investigator : menna allah hesham abd elfatah
Cairo University