Neck PainNCT06241014
Effects of Mulligan Mobilization With and Without Sling Exercises in Non-specific Neck Pain
A study testing Mulligan Mobilization and Sling Exercises and Mulligan Mobilization in people with Neck Pain, run by Riphah International University at 1 site in Pakistan.
Trial summary
Neck pain is one of the common musculoskeletal problems. People with neck pain can have difficulties with daily activities and be limited in work and social participation. Main symptoms of people with neck pain include pain, decreased range of motion (ROM), muscle weakness and dysfunction. Read more about this study
- Who is it for?
- Ages 25 to 50 years
- Conditions the study is for
- Neck Pain
- What is being tested?
- Mulligan Mobilization and Sling Exercises and Mulligan Mobilization
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 46 participants
- Where
- 1 sitePakistan
- Study dates
- 10 Mar 2024to 10 Oct 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 25 to 50 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age between 25-50 years.
- Having neck pain for at least 2 weeks
- Pain intensity of at least 2 on NPRS
- Greater than or equal to 15 points on the neck disability index (NDI)
- Having primary complaint of non-specific neck pain
Who cannot join
- History of Cervical surgery
- Cervicogenic headache
- Previous cervical spine surgery
- Serious Spinal pathology (like tumor, infection, and dislocation)
- Traumatic injuries (e.g., contusion, fracture, and whiplash injury)
- Vascular diseases and Neurologic disorders (e.g., trigeminal neuralgia)
- Concomitant medical diagnosis of any primary headache (vertigo, VBI or migraine)
- And clinical diagnosis of cervical radiculopathy, Spinal stenosis or myelopathy.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effects of Mulligan Mobilization With and Without Sling Exercises on Pain and Disability in Non-specific Neck Pain
Neck pain is one of the common musculoskeletal problems. People with neck pain can have difficulties with daily activities and be limited in work and social participation. Main symptoms of people with neck pain include pain, decreased range of motion (ROM), muscle weakness and dysfunction. Common neck pain causes include degenerative disc disease, herniated disc disease, cervical radiculopathies, myofascial pain syndrome and viral infections. Muscular strains, postural and ergonomics are also related to neck pain and whiplash injuries. The onset of pain may be insidious or may follow trauma, and it may be recurrent or persistent in nature. Ideally, the pain goes away in 1-3 weeks, but in some cases it persists and become chronic neck pain. The aim of this study is to compare the effects of mulligan mobilization with and without sling exercises on pain, and disability in non-specific neck pain. Non-specific neck pain reduces range of motion which may be linked to mechanical restriction between two or more vertebrae and muscular spasm.
Read the detailed description
Participants who will meet the inclusion criteria will be recruited by convenience sampling technique and will be allocated to groups by simple randomization process by sealed opaque enveloped labeled as 1 for Group A and 2 for Group B.
After taking consent from the participants with non-specific neck pain of both genders will be randomized into two equal groups. Subjects from physical therapy department will be assessed with neck disability index, goniometer and Numeric pain rating scale. At start of study, a formal educational session, lasting about 30 min will be given by physiotherapist.
Group A: In this group, Subjects will be treated with Mulligan mobilizations along with sling exercises. Mulligan mobilizations include SNAGs. Participants will receive 3 sets of mulligan mobilization techniques per session, each set involving 10 times repetition of the exercise. The interval between the sets will be 15 to 20 seconds. The technique will be repeated total of six times having two sessions per week for 3 weeks.
For the sling exercise, the sling exercise program will also be applied for 3 weeks, 2 times a week for 20 minutes per day. To perform the exercise, the subjects will be instructed with a demonstration and explanation. In supine position, the head will be supported by an inelastic sling and the therapist will hold the cervical vertebral portion softly with two hands. Therapist will pull the cervical vertebral portion and back of the head softly. The subjects will maintain this for 6-7 seconds and relax slowly. In the second technique, Subjects will be positioned in supine lying position with the cervical spine in a neutral position on the sling device. One hand of the therapist contacts and fixes the transverse process of C1 (both), while the other hand grabs the occiput and applies mobilization in the dorsal direction. Subjects in this group will be applied with passive mobilization for 3 min to the segment (occiput-C1). In the same posture the subjects will be instructed to perform a flexion motion at (occiput-C1). The therapist will guide the optimal segmental movement through the hand. This intervention will also be performed 3 times for 1 min, with an interval of 1 min. Similarly, In prone position the forehead will be placed on an inelastic sling. The therapist will hold the cervical vertebral portion with two hands softly. The therapist will pull the cervical vertebral portion toward the upper direction at the same time. The patient will maintain this for 6-7 seconds and relax slowly. Each movement will be repeated 10 times
- Conditions
- Neck Pain
- Being tested
- Mulligan Mobilization and Sling Exercises, Mulligan Mobilization
- Keywords
- Mulligan Exercises, Sling Exercises, Neck disability
- Medical subject headings
- Neck Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Mulligan Mobilization and Sling ExercisesOther
Mulligan mobilizations along with sling exercises. Mulligan mobilizations include SNAGs. Participants will receive 3 sets of mulligan mobilization techniques per session, each set involving 10 times repetition of the exercise. The interval between the sets will be 15 to 20 seconds. The technique will be repeated total of six times having two sessions per week for 3 weeks. For the sling exercise, the sling exercise program will also be applied for 3 weeks, 2 times a week for 20 minutes per day. To perform the exercise, the subjects will be instructed with a demonstration and explanation.
Mulligan MobilizationOther
Mulligan Mobilization
| Study group | Role | What they receive |
|---|---|---|
| Group A: Group A will be treated with mulligan mobilizations and Sling exercises. | Experimental | Group A: In this group, Subjects will be treated with Mulligan mobilizations along with sling exercises. Mulligan mobilizations include SNAGs. Participants will receive 3 sets of mulligan mobilization techniques per session, each set involving 10 times repetition of the exercise. The interval between the sets will be 15 to 20 seconds. The technique will be repeated total of six times, having two sessions per week for 3 weeks. The sling exercise program will also be applied for 3 weeks, 2 times a week for 20 minutes per day. Receives: Other: Mulligan Mobilization and Sling Exercises |
| Group B: Group B will be treated with mulligan mobilizations alone. | Active comparator | Group B: In this group, Subjects will be treated with Mulligan mobilizations and sling exercises. Mulligan mobilizations include SNAGs. Participants will receive 3 sets of mulligan mobilization techniques per session, each set involving 10 times repetition of the exercise. The interval between the sets will be 15 to 20 seconds. The technique will be repeated a total of six times, having two sessions per week for 3 weeks. Receives: Other: Mulligan Mobilization |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numerical Pain Rating Scale
Patient level of pain will be assessed using this scale. In a Numerical Rating Scale (NRS), this scale ranges from 0 to 10. 0 indicates "no pain" and 10 indicates "worst pain" patients are asked to circle the number between 0 and 10, that fits best to their pain intensity.
NRS scores ≤ 5 correspond to mild, scores of 6-7 to moderate and scores ≥8 to severe pain in terms of pain-related interference with functioning.
Measured: upto 4 weeks
Neck Disability Index
NDI is a simple ten-item questionnaire used to assess patients with neck pain. The questionnaire was devised and validated in English. It consists of ten questions each with six answers (scoring 0-5 points). The NDI has a fair to moderate test-retest reliability in patients with mechanical neck pain.
Measured: upto 4 weeks
Universal Goniometer
A goniometer will be used in the study to measure shoulder flexion, internal rotation and external rotation.
Goniometer is an instrument that measures the available range of motion at a joint. To .measure the range of motion physical therapists most commonly use a goniometer. Therapist can use a goniometer to assess what the range of motion is at the initial assessment.
Measured: upto 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Feb 2024
- Study start10 Mar 2024
- Primary completion30 Sep 2024
- Study completion10 Oct 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (8)Papers the sponsor has linked to this study.
- Other trials for Neck PainStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 46 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Abu Zar, MS, Principal investigator, Riphah International University,Lahore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06241014
- Sponsor's protocol ID
- REC/RCR & AHS/23/0157
- Status last verified
- Oct 2024
- First submitted
- 28 Jan 2024
- Last updated
- 15 Oct 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Buyukturan O, Buyukturan B, Sas S, Kararti C, Ceylan I. The Effect of Mulligan Mobilization Technique in Older Adults with Neck Pain: A Randomized Controlled, Double-Blind Study. Pain Res Manag. 2018 May 15;2018:2856375. doi: 10.1155/2018/2856375. eCollection 2018.
PubMed 29861800Kim SY, An CM, Cha YS, Kim DH. Effects of sling-based manual therapy on cervicothoracic junction in patients with neck pain and forward head posture: A randomized clinical trial. J Bodyw Mov Ther. 2021 Jul;27:447-454. doi: 10.1016/j.jbmt.2021.03.007. Epub 2021 Mar 19.
PubMed 34391270Lin KY, Tsai YJ, Hsu PY, Tsai CS, Kuo YL. Effects of Sling Exercise for Neck Pain: A Systematic Review and Meta-Analysis. Phys Ther. 2021 Aug 1;101(8):pzab120. doi: 10.1093/ptj/pzab120.
PubMed 33929540Lee J-D, Shin W-S. Immediate effects of neuromuscular control exercise on neck pain, range of motion, and proprioception in persons with neck pain. Physical Therapy Rehabilitation Science. 2020;9(1):1-9.
Manzoor A, Anwar N, Khalid K, Haider R, Saghir M, Javed MA. Comparison of effectiveness of muscle energy technique with Mulligan mobilization in patients with non-specific neck pain. J Pak Med Assoc. 2021 Jun;71(6):1532-1524. doi: 10.47391/JPMA.981.
PubMed 34111066He Y, Sun W, Zhao X, Ma M, Zheng Z, Xu L. Effects of core stability exercise for patients with neck pain: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2019 Nov;98(46):e17240. doi: 10.1097/MD.0000000000017240.
PubMed 31725601Kim YW, Kim NY, Chang WH, Lee SC. Comparison of the Therapeutic Effects of a Sling Exercise and a Traditional Stabilizing Exercise for Clinical Lumbar Spinal Instability. J Sport Rehabil. 2018 Jan 1;27(1):47-54. doi: 10.1123/jsr.2016-0083. Epub 2018 Jan 17.
PubMed 27992296Mun D-J, Oh H-J, Lee S-H. Effects of sling exercise on pain, trunk strength, and balance in patients with chronic low back pain. The Journal of Korean Physical Therapy. 2022;34(3):110-5.
Study at a glance
From the registry record, last updated by the sponsor on 15 Oct 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Mulligan Mobilization With and Without Sling Exercises on Pain and Disability in Non-specific Neck Pain
- ClinicalTrials.gov ID
- NCT06241014
- Acronym / sponsor ID
- REC/RCR & AHS/23/0157
- Conditions
- Neck Pain
- Keywords
- Mulligan Exercises, Sling Exercises, Neck disability
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 46 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 10 Mar 2024 (actual)
- Primary completion
- 30 Sep 2024 (actual)
- Study completion
- 10 Oct 2024 (actual)
- First posted
- 5 Feb 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Neck pain is one of the common musculoskeletal problems. People with neck pain can have difficulties with daily activities and be limited in work and social participation. Main symptoms of people with neck pain include pain, decreased range of motion (ROM), muscle weakness and dysfunction. Common neck pain causes include degenerative disc disease, herniated disc disease, cervical radiculopathies, myofascial pain syndrome and viral infections. Muscular strains, postural and ergonomics are also related to neck pain and whiplash injuries. The onset of pain may be insidious or may follow trauma, and it may be recurrent or persistent in nature. Ideally, the pain goes away in 1-3 weeks, but in some cases it persists and become chronic neck pain. The aim of this study is to compare the effects of mulligan mobilization with and without sling exercises on pain, and disability in non-specific neck pain. Non-specific neck pain reduces range of motion which may be linked to mechanical restriction between two or more vertebrae and muscular spasm.
Detailed description
Participants who will meet the inclusion criteria will be recruited by convenience sampling technique and will be allocated to groups by simple randomization process by sealed opaque enveloped labeled as 1 for Group A and 2 for Group B.
After taking consent from the participants with non-specific neck pain of both genders will be randomized into two equal groups. Subjects from physical therapy department will be assessed with neck disability index, goniometer and Numeric pain rating scale. At start of study, a formal educational session, lasting about 30 min will be given by physiotherapist.
Group A: In this group, Subjects will be treated with Mulligan mobilizations along with sling exercises. Mulligan mobilizations include SNAGs. Participants will receive 3 sets of mulligan mobilization techniques per session, each set involving 10 times repetition of the exercise. The interval between the sets will be 15 to 20 seconds. The technique will be repeated total of six times having two sessions per week for 3 weeks.
For the sling exercise, the sling exercise program will also be applied for 3 weeks, 2 times a week for 20 minutes per day. To perform the exercise, the subjects will be instructed with a demonstration and explanation. In supine position, the head will be supported by an inelastic sling and the therapist will hold the cervical vertebral portion softly with two hands. Therapist will pull the cervical vertebral portion and back of the head softly. The subjects will maintain this for 6-7 seconds and relax slowly. In the second technique, Subjects will be positioned in supine lying position with the cervical spine in a neutral position on the sling device. One hand of the therapist contacts and fixes the transverse process of C1 (both), while the other hand grabs the occiput and applies mobilization in the dorsal direction. Subjects in this group will be applied with passive mobilization for 3 min to the segment (occiput-C1). In the same posture the subjects will be instructed to perform a flexion motion at (occiput-C1). The therapist will guide the optimal segmental movement through the hand. This intervention will also be performed 3 times for 1 min, with an interval of 1 min. Similarly, In prone position the forehead will be placed on an inelastic sling. The therapist will hold the cervical vertebral portion with two hands softly. The therapist will pull the cervical vertebral portion toward the upper direction at the same time. The patient will maintain this for 6-7 seconds and relax slowly. Each movement will be repeated 10 times
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group A: Group A will be treated with mulligan mobilizations and Sling exercises. | Experimental | Other: Mulligan Mobilization and Sling ExercisesGroup A: In this group, Subjects will be treated with Mulligan mobilizations along with sling exercises. Mulligan mobilizations include SNAGs. Participants will receive 3 sets of mulligan mobilization techniques per session, each set involving 10 times repetition of the exercise. The interval between the sets will be 15 to 20 seconds. The technique will be repeated total of six times, having two sessions per week for 3 weeks. The sling exercise program will also be applied for 3 weeks, 2 times a week for 20 minutes per day. |
| Group B: Group B will be treated with mulligan mobilizations alone. | Active comparator | Other: Mulligan MobilizationGroup B: In this group, Subjects will be treated with Mulligan mobilizations and sling exercises. Mulligan mobilizations include SNAGs. Participants will receive 3 sets of mulligan mobilization techniques per session, each set involving 10 times repetition of the exercise. The interval between the sets will be 15 to 20 seconds. The technique will be repeated a total of six times, having two sessions per week for 3 weeks. |
Who may qualify
- Ages
- 25 to 50 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Age between 25-50 years.
- Having neck pain for at least 2 weeks
- Pain intensity of at least 2 on NPRS
- Greater than or equal to 15 points on the neck disability index (NDI)
- Having primary complaint of non-specific neck pain
Key exclusion criteria (8 listed)
- History of Cervical surgery
- Cervicogenic headache
- Previous cervical spine surgery
- Serious Spinal pathology (like tumor, infection, and dislocation)
- Traumatic injuries (e.g., contusion, fracture, and whiplash injury)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Mulligan Mobilization and Sling ExercisesMulligan mobilizations along with sling exercises. Mulligan mobilizations include SNAGs. Participants will receive 3 sets of mulligan mobilization techniques per session, each set involving 10 times repetition of the exercise. The interval between the sets will be 15 to 20 seconds. The technique will be repeated total of six times having two sessions per week for 3 weeks. For the sling exercise, the sling exercise program will also be applied for 3 weeks, 2 times a week for 20 minutes per day. To perform the exercise, the subjects will be instructed with a demonstration and explanation. | Other | Group A: Group A will be treated with mulligan mobilizations and Sling exercises. |
| Mulligan MobilizationMulligan Mobilization | Other | Group B: Group B will be treated with mulligan mobilizations alone. |
Primary outcome
Numerical Pain Rating Scale
Time frame: upto 4 weeks
Patient level of pain will be assessed using this scale. In a Numerical Rating Scale (NRS), this scale ranges from 0 to 10. 0 indicates "no pain" and 10 indicates "worst pain" patients are asked to circle the number between 0 and 10, that fits best to their pain intensity. NRS scores ≤ 5 correspond to mild, scores of 6-7 to moderate and scores ≥8 to severe pain in terms of pain-related interference with functioning.
Neck Disability Index
Time frame: upto 4 weeks
NDI is a simple ten-item questionnaire used to assess patients with neck pain. The questionnaire was devised and validated in English. It consists of ten questions each with six answers (scoring 0-5 points). The NDI has a fair to moderate test-retest reliability in patients with mechanical neck pain.
Universal Goniometer
Time frame: upto 4 weeks
A goniometer will be used in the study to measure shoulder flexion, internal rotation and external rotation. Goniometer is an instrument that measures the available range of motion at a joint. To .measure the range of motion physical therapists most commonly use a goniometer. Therapist can use a goniometer to assess what the range of motion is at the initial assessment.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Oct 2024.
- Background: PubMed 29861800Buyukturan O, Buyukturan B, Sas S, Kararti C, Ceylan I. The Effect of Mulligan Mobilization Technique in Older Adults with Neck Pain: A Randomized Controlled, Double-Blind Study. Pain Res Manag. 2018 May 15;2018:2856375. doi: 10.1155/2018/2856375. eCollection 2018.
- Background: PubMed 34391270Kim SY, An CM, Cha YS, Kim DH. Effects of sling-based manual therapy on cervicothoracic junction in patients with neck pain and forward head posture: A randomized clinical trial. J Bodyw Mov Ther. 2021 Jul;27:447-454. doi: 10.1016/j.jbmt.2021.03.007. Epub 2021 Mar 19.
- Background: PubMed 33929540Lin KY, Tsai YJ, Hsu PY, Tsai CS, Kuo YL. Effects of Sling Exercise for Neck Pain: A Systematic Review and Meta-Analysis. Phys Ther. 2021 Aug 1;101(8):pzab120. doi: 10.1093/ptj/pzab120.
- BackgroundLee J-D, Shin W-S. Immediate effects of neuromuscular control exercise on neck pain, range of motion, and proprioception in persons with neck pain. Physical Therapy Rehabilitation Science. 2020;9(1):1-9.
- Background: PubMed 34111066Manzoor A, Anwar N, Khalid K, Haider R, Saghir M, Javed MA. Comparison of effectiveness of muscle energy technique with Mulligan mobilization in patients with non-specific neck pain. J Pak Med Assoc. 2021 Jun;71(6):1532-1524. doi: 10.47391/JPMA.981.
- Background: PubMed 31725601He Y, Sun W, Zhao X, Ma M, Zheng Z, Xu L. Effects of core stability exercise for patients with neck pain: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2019 Nov;98(46):e17240. doi: 10.1097/MD.0000000000017240.
- Background: PubMed 27992296Kim YW, Kim NY, Chang WH, Lee SC. Comparison of the Therapeutic Effects of a Sling Exercise and a Traditional Stabilizing Exercise for Clinical Lumbar Spinal Instability. J Sport Rehabil. 2018 Jan 1;27(1):47-54. doi: 10.1123/jsr.2016-0083. Epub 2018 Jan 17.
- BackgroundMun D-J, Oh H-J, Lee S-H. Effects of sling exercise on pain, trunk strength, and balance in patients with chronic low back pain. The Journal of Korean Physical Therapy. 2022;34(3):110-5.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Abu Zar, MS principal investigator
Riphah International University,Lahore
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Mulligan Mobilization and Sling Exercises and Mulligan Mobilization in people with Neck Pain, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numerical Pain Rating Scale (time frame: upto 4 weeks). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06241014, which also lists 8 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Oct 2024.