Chronic Neck PainNCT07912099
Multimodal Manual Therapy vs. Maitland Mobilization for Chronic Non-Specific Neck Pain
A study testing Maitland Mobilization Treatment Approach and Manual therapy protocol in people with Chronic Neck Pain, run by University of Management and Technology Lahore at 1 site in Pakistan.
Trial summary
Chronic non-specific neck pain (CNNP) is a common musculoskeletal disorder associated with persistent pain, functional disability, and reduced quality of life. Manual therapy techniques such as Maitland mobilization and multimodal manual therapy are frequently used in physiotherapy; however, evidence directly… Read more about this study
- Who is it for?
- Ages 18 to 35 years
- Conditions the study is for
- Chronic Neck Pain
- What is being tested?
- Maitland Mobilization Treatment Approach and Manual therapy protocol
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 64 participants
- Where
- 1 sitePakistan
- Study dates
- 27 Oct 2026to 31 Dec 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 18 to 35 years
- All sexes
- No healthy volunteers
- Adult
Inclusion Criteria Age ≥ 18 to 35 years old Both genders. Pain from at least past three months (12 weeks). NPRS score greater than 4 NDI score greater than or equal to 15 points Presence of neck pain without mild referred pain to shoulder/scapular region. Exclusion criteria Irradiated neck pain Neck pain associated with vertigo Osteoporosis (Rx Control) Diagnosed psychological disorders Vertebral fractures (Rx Control) Tumors (Rx Control) Diagnosed metabolic diseases Previous neck surgery
Trial locations and contacts
1 site in 1 country.
Pakistan1 site
University of Management & Technology
Lahore, Punjab Province, 54000
About this study
Official title: Comparative Effects of Multimodal Manual Therapy and Maitland Mobilization on Pain, Functional Disability and Quality of Life in Patients With Chronic Non-Specific Neck Pain.
Chronic non-specific neck pain (CNNP) is a common musculoskeletal disorder associated with persistent pain, functional disability, and reduced quality of life. Manual therapy techniques such as Maitland mobilization and multimodal manual therapy are frequently used in physiotherapy; however, evidence directly comparing their effectiveness remains limited. This study aims to compare the effects of Multimodal Manual Therapy and Maitland Mobilization on pain intensity, functional disability, and quality of life in patients with chronic non-specific neck pain. A randomized clinical trial will be conducted at Life Care Hospital, Bahawalnagar, involving 54 participants aged 18-35 years who meet the inclusion criteria. Participants will be randomly allocated into two equal groups. Group A will receive Maitland mobilization, while Group B will receive Multimodal Manual Therapy, including high thoracic manipulation (T4), cervical mobilization, and suboccipital muscle inhibition. Both groups will receive treatment three times per week for four weeks. Outcome measures will include the Numeric Pain Rating Scale (NPRS) for pain, the Neck Disability Index (NDI) for functional disability, and the Short Form-12 (SF-12) questionnaire for quality of life. Assessments will be performed at baseline, the second week, and the fourth week. Data will be analyzed using SPSS version 24, with appropriate parametric or non-parametric statistical tests based on data distribution. The findings of this study are expected to identify the more effective intervention for improving pain, disability, and quality of life in individuals with chronic non-specific neck pain. The results may assist physiotherapists in selecting evidence-based treatment strategies and contribute to improving clinical management of this condition
- Conditions
- Chronic Neck Pain
- Being tested
- Maitland Mobilization Treatment Approach, Manual therapy protocol
- Keywords
- Chronic, maitland, multimodel, manual therapy, neck pain
- Medical subject headings
- Bronchiolitis Obliterans Syndrome, Neck Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Maitland Mobilization Treatment ApproachOther
Maitland Mobilization will be applied to the cervical and upper thoracic spine using Grade III and Grade IV oscillatory techniques. Before treatment, a detailed assessment including Active Movement Testing, Passive Physiological Intervertebral Movement (PPIVM), and Passive Accessory Intervertebral Movement (PAIVM) will be performed to identify hypomobile and symptomatic spinal segments. Grade III mobilization will be used to increase joint mobility and reduce stiffness, while Grade IV mobilization will be applied at the end range of motion to improve segmental movement and restore normal arthrokinematics. Mobilization will be directed to the restricted cervical and upper thoracic segments according to individual patient findings. Each treatment session will last approximately 60 minutes, three times per week, for a period of two weeks under the supervision of a qualified physiotherapist
Manual therapy protocolOther
- High thoracic manipulation on T4; Patients are positioned supine with their arms crossed in a "V" shape over the chest. The therapist contacts the fist at the level of the spinous process of T4 and blocks the patient's elbows with his chest. Following this, he introduces flexion of the cervical spine until a slight tension is felt in the tissues at the point of contact. Downward and cranial manipulation is applied. If cavitation is not achieved on the first attempt, the therapist repositions the patient and performs a second manipulation. A maximum of two attempts will be allowed in each patient(22).
- Cervical articular mobilization (2 Hz, 2 min × 3 series); The patient is placed on the stretcher in a prone position, placing both hands under his forehead. The therapist makes contact with his two thumbs on the spinous process of the patient vertebra and performs grade III posteroanterior impulses at a speed of 2Hz and for 2 min. There are 3 mobilization intervals with a minute of
| Study group | Role | What they receive |
|---|---|---|
| Maitland Mobilization Treatment Approach | Experimental | Maitland Mobilization will be applied to the cervical and upper thoracic spine using Grade III and Grade IV oscillatory techniques. Before treatment, a detailed assessment including Active Movement Testing, Passive Physiological Intervertebral Movement (PPIVM), and Passive Accessory Intervertebral Movement (PAIVM) will be performed to identify hypomobile and symptomatic spinal segments. Grade III mobilization will be used to increase joint mobility and reduce stiffness, while Grade IV mobilization will be applied at the end range of motion to improve segmental movement and restore normal arthrokinematics. Mobilization will be directed to the restricted cervical and upper thoracic segments according to individual patient findings. Each treatment session will last approximately 60 minutes, three times per week, for a period of two weeks under the supervision of a qualified physiotherapist. Receives: Other: Maitland Mobilization Treatment Approach |
| Manual therapy protocol | Active comparator | 1. High thoracic manipulation on T4; Patients are positioned supine with their arms crossed in a "V" shape over the chest. The therapist contacts the fist at the level of the spinous process of T4 and blocks the patient's elbows with his chest. Following this, he introduces flexion of the cervical spine until a slight tension is felt in the tissues at the point of contact. Downward and cranial manipulation is applied. If cavitation is not achieved on the first attempt, the therapist repositions the patient and performs a second manipulation. A maximum of two attempts will be allowed in each patient(22).
2. Cervical articular mobilization (2 Hz, 2 min × 3 series); The patient is placed on the stretcher in a prone position, placing both hands under his forehead. The therapist makes contact with his two thumbs on the spinous process of the patient vertebra and performs grade III posteroanterior impulses at a speed of 2Hz and for 2 min. There are 3 mobilization intervals with a minute of Receives: Other: Manual therapy protocol |
What is being measured
The primary outcome is the main question the study is designed to answer.
PAIN BY NUMERIC PAIN RATING SCALE
Pain intensity was measured using the NPRS, an 11-point scale ranging from 0 (\no pain") to 10 (\worst imaginable pain"). NPRS is widely validated and used for assessing pain severity in clinical populations. The Minimal Clinically Important Change (MCIC) for the NPRS in individuals with chronic musculoskeletal pain is 2.0 points or a 33.0% change score
Measured: At baseline and after 6 weeks
Disability by NECK DISABILITY INDEX (NDI)
The NDI is a self-assessment instrument of the specific functional status of sub jects with neck pain with 10 elements that include pain, personal care, weight gain, reading, headache, concentration, work, driving, sleeping, and leisure. Each section is rated on a scale of 0 to 5, where 0 means "painless" and 5 means "the worst pain imaginable." The points obtained are added to a total score. The questionnaire was interpreted as a per centage. The disability categories for NDI are 0-8%, without disability; 10-28%, mild; 30-48%, moderate; 50-64%, serious; and 70-100%, complete.
Measured: At baseline and after 6 weeks
Physical and mental health SHORT FORM 12-ITEM SURVEY (SF-12)
This study used short-form 12-item survey (SF-12) which was derived from short-form 36-item survey (SF-36). It assesses overall physical and mental health status and generates two summary scores: Physical Component Summary (PCS) and Mental Component Summary (MCS). The SF-12 has demonstrated good reliability and validity in both general and specific patient populations.
Measured: At baseline and after 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Nov 2026
- Study start27 Oct 2026
- Primary completion31 Dec 2026 (estimated)
- Study completion31 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Chronic Neck PainStudies of the same condition, open and under way.
- 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
- 64 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Management and Technology Lahore
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Nosheen Manzoor, University of Management and Technology Lahore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07912099
- Sponsor's protocol ID
- RE-209-2026
- Status last verified
- Oct 2026
- First submitted
- 27 Oct 2026
- Last updated
- 3 Nov 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: The results data collected , de-identified individual participant data will be shared.
Study at a glance
From the registry record, last updated by the sponsor on 3 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effects of Multimodal Manual Therapy and Maitland Mobilization on Pain, Functional Disability and Quality of Life in Patients With Chronic Non-Specific Neck Pain.
- ClinicalTrials.gov ID
- NCT07912099
- Acronym / sponsor ID
- RE-209-2026
- Conditions
- Chronic Neck Pain
- Keywords
- Chronic, maitland, multimodel, manual therapy, neck pain
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 64 participants (actual)
- Lead sponsor
- University of Management and Technology LahoreUniversity, hospital or other
- Study start
- 27 Oct 2026 (actual)
- Primary completion
- 31 Dec 2026 (estimated)
- Study completion
- 31 Dec 2026 (estimated)
- First posted
- 3 Nov 2026 (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.
Chronic non-specific neck pain (CNNP) is a common musculoskeletal disorder associated with persistent pain, functional disability, and reduced quality of life. Manual therapy techniques such as Maitland mobilization and multimodal manual therapy are frequently used in physiotherapy; however, evidence directly comparing their effectiveness remains limited. This study aims to compare the effects of Multimodal Manual Therapy and Maitland Mobilization on pain intensity, functional disability, and quality of life in patients with chronic non-specific neck pain. A randomized clinical trial will be conducted at Life Care Hospital, Bahawalnagar, involving 54 participants aged 18-35 years who meet the inclusion criteria. Participants will be randomly allocated into two equal groups. Group A will receive Maitland mobilization, while Group B will receive Multimodal Manual Therapy, including high thoracic manipulation (T4), cervical mobilization, and suboccipital muscle inhibition. Both groups will receive treatment three times per week for four weeks. Outcome measures will include the Numeric Pain Rating Scale (NPRS) for pain, the Neck Disability Index (NDI) for functional disability, and the Short Form-12 (SF-12) questionnaire for quality of life. Assessments will be performed at baseline, the second week, and the fourth week. Data will be analyzed using SPSS version 24, with appropriate parametric or non-parametric statistical tests based on data distribution. The findings of this study are expected to identify the more effective intervention for improving pain, disability, and quality of life in individuals with chronic non-specific neck pain. The results may assist physiotherapists in selecting evidence-based treatment strategies and contribute to improving clinical management of this condition
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Maitland Mobilization Treatment Approach | Experimental | Other: Maitland Mobilization Treatment ApproachMaitland Mobilization will be applied to the cervical and upper thoracic spine using Grade III and Grade IV oscillatory techniques. Before treatment, a detailed assessment including Active Movement Testing, Passive Physiological Intervertebral Movement (PPIVM), and Passive Accessory Intervertebral Movement (PAIVM) will be performed to identify hypomobile and symptomatic spinal segments. Grade III mobilization will be used to increase joint mobility and reduce stiffness, while Grade IV mobilization will be applied at the end range of motion to improve segmental movement and restore normal arthrokinematics. Mobilization will be directed to the restricted cervical and upper thoracic segments according to individual patient findings. Each treatment session will last approximately 60 minutes, three times per week, for a period of two weeks under the supervision of a qualified physiotherapist. |
| Manual therapy protocol | Active comparator | Other: Manual therapy protocol1. High thoracic manipulation on T4; Patients are positioned supine with their arms crossed in a "V" shape over the chest. The therapist contacts the fist at the level of the spinous process of T4 and blocks the patient's elbows with his chest. Following this, he introduces flexion of the cervical spine until a slight tension is felt in the tissues at the point of contact. Downward and cranial manipulation is applied. If cavitation is not achieved on the first attempt, the therapist repositions the patient and performs a second manipulation. A maximum of two attempts will be allowed in each patient(22). 2. Cervical articular mobilization (2 Hz, 2 min × 3 series); The patient is placed on the stretcher in a prone position, placing both hands under his forehead. The therapist makes contact with his two thumbs on the spinous process of the patient vertebra and performs grade III posteroanterior impulses at a speed of 2Hz and for 2 min. There are 3 mobilization intervals with a minute of |
Who may qualify
- Ages
- 18 to 35 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
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 |
|---|---|---|
| Maitland Mobilization Treatment ApproachMaitland Mobilization will be applied to the cervical and upper thoracic spine using Grade III and Grade IV oscillatory techniques. Before treatment, a detailed assessment including Active Movement Testing, Passive Physiological Intervertebral Movement (PPIVM), and Passive Accessory Intervertebral Movement (PAIVM) will be performed to identify hypomobile and symptomatic spinal segments. Grade III mobilization will be used to increase joint mobility and reduce stiffness, while Grade IV mobilization will be applied at the end range of motion to improve segmental movement and restore normal arthrokinematics. Mobilization will be directed to the restricted cervical and upper thoracic segments according to individual patient findings. Each treatment session will last approximately 60 minutes, three times per week, for a period of two weeks under the supervision of a qualified physiotherapist | Other | Maitland Mobilization Treatment Approach |
| Manual therapy protocol1. High thoracic manipulation on T4; Patients are positioned supine with their arms crossed in a "V" shape over the chest. The therapist contacts the fist at the level of the spinous process of T4 and blocks the patient's elbows with his chest. Following this, he introduces flexion of the cervical spine until a slight tension is felt in the tissues at the point of contact. Downward and cranial manipulation is applied. If cavitation is not achieved on the first attempt, the therapist repositions the patient and performs a second manipulation. A maximum of two attempts will be allowed in each patient(22). 2. Cervical articular mobilization (2 Hz, 2 min × 3 series); The patient is placed on the stretcher in a prone position, placing both hands under his forehead. The therapist makes contact with his two thumbs on the spinous process of the patient vertebra and performs grade III posteroanterior impulses at a speed of 2Hz and for 2 min. There are 3 mobilization intervals with a minute of | Other | Manual therapy protocol |
Primary outcome
PAIN BY NUMERIC PAIN RATING SCALE
Time frame: At baseline and after 6 weeks
Pain intensity was measured using the NPRS, an 11-point scale ranging from 0 (\no pain") to 10 (\worst imaginable pain"). NPRS is widely validated and used for assessing pain severity in clinical populations. The Minimal Clinically Important Change (MCIC) for the NPRS in individuals with chronic musculoskeletal pain is 2.0 points or a 33.0% change score
Disability by NECK DISABILITY INDEX (NDI)
Time frame: At baseline and after 6 weeks
The NDI is a self-assessment instrument of the specific functional status of sub jects with neck pain with 10 elements that include pain, personal care, weight gain, reading, headache, concentration, work, driving, sleeping, and leisure. Each section is rated on a scale of 0 to 5, where 0 means "painless" and 5 means "the worst pain imaginable." The points obtained are added to a total score. The questionnaire was interpreted as a per centage. The disability categories for NDI are 0-8%, without disability; 10-28%, mild; 30-48%, moderate; 50-64%, serious; and 70-100%, complete.
Physical and mental health SHORT FORM 12-ITEM SURVEY (SF-12)
Time frame: At baseline and after 6 weeks
This study used short-form 12-item survey (SF-12) which was derived from short-form 36-item survey (SF-36). It assesses overall physical and mental health status and generates two summary scores: Physical Component Summary (PCS) and Mental Component Summary (MCS). The SF-12 has demonstrated good reliability and validity in both general and specific patient populations.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Nov 2026.
- Related InfoLink provided by the sponsor.
- Related InfoLink provided by the sponsor.
- Related InfoLink provided by the sponsor.
- Related InfoLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. The results data collected , de-identified individual participant data will be shared.
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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.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Maitland Mobilization Treatment Approach and Manual therapy protocol in people with Chronic Neck Pain, run by University of Management and Technology Lahore 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?
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: under way, not looking for participants, as of the sponsor's last update on 3 Nov 2026. 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?
This study is still under way. Results are not available in the source record yet.
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?
PAIN BY NUMERIC PAIN RATING SCALE (time frame: At baseline and after 6 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?
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 3 Nov 2026.