Upper Cervical Mobilization vs. Sub-Occipital MET for Neck Pain and FHP

January 1, 2026 updated by: reda abd elrazik, MTI University

Upper Cervical Translatoric Mobilization Versus Sub Occipital Muscle Energy Technique in Patients With Mechanical Neck Pain and Forward Head Posture

forty-five patients with MNP and FHP age from 25-40 years will be randomly assigned into three groups: Group A (study): 15patients will receive (upper cervical translatoric mobilization) and traditional physical therapy, Group B (study): 15patients received sub occipital muscle energy technique and traditional physical therapy, and Group C (control): 15 patients will receive the traditional physical therapy treatment only . Interventions will be conducted three times a week for four weeks. Craniovertebral angle (CVA) using Photographic Posture Analysis Method (surgimap software), pain intensity using viual analogue scale (VAS), Cervical ROM using CROM device, and neck functional ability using Neck Disability Index (NDI) will be assessed for all participants before and after the treatment program.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This randomized controlled trial aims to compare the efficacy of Upper Cervical Translatoric Mobilization (UC-TSM) and Sub-Occipital Muscle Energy Technique (MET) in patients with Mechanical Neck Pain (MNP) and Forward Head Posture (FHP). Forty-five participants will be randomly assigned to one of three groups: Group A (UC-TSM + conventional physical therapy), Group B (Sub-Occipital MET + conventional physical therapy), and Group C (conventional physical therapy only). Interventions will be administered three times per week for four weeks. Outcomes include pain intensity (VAS), neck disability (NDI), cervical range of motion (CROM), and craniovertebral angle (CVA) assessed via photographic analysis (Surgimap). The study will be conducted at Benha University.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
45

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Egypt
    • Benha
      • Cairo, Benha, Egypt
        • Faculty of Physical Therapy, Benha University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • patients aged from 20-60 Years
  • suffering from M echanical neck pain with Craniovertebral angle ; < 53
  • their NDI ranging from 30-48% [9]. Patients were excluded from the study if they have injury or trauma to cervical region, spinal surgery, cervical canal stenosis, radicular pain and malignancy.

Exclusion Criteria:

  • Patients were excluded from the study if they have injury or trauma to cervical region, spinal surgery, cervical canal stenosis, radicular pain and malignancy.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Upper Cervical Translatoric Mobilization
Participants will receive Upper Cervical Translatoric Mobilization (UC-TSM) applied to the upper cervical spine (C0-C2), in addition to conventional physical therapy (hot pack and Kendall exercises), three times per week for 4 weeks.
Other: upper cervical translatoric mobilisation
(UC-TSM) is defined as a system of manual techniques using straight-line forces delivered in a parallel or perpendicular direction to an individual vertebral joint or motion segment there is also increasing in body of evidence supporting the its clinical effectiveness and safety in the management of patients with cervical impairments.
Experimental: Sub-Occipital Muscle Energy Technique
Participants will receive Sub-Occipital Muscle Energy Technique (MET) targeting the sub-occipital muscles, in addition to conventional physical therapy (hot pack and Kendall exercises), three times per week for 4 weeks.
Other: sub occipital muscle energy technique
Muscle Energy Technique (MET) is another form of a gentle manual therapy intervention that primarily targets the soft tissues, though it also contributes significantly to joint mobilization. It has been reported that, adding MET to exercise program resulted in better improvement in CVA and FHP than exercise group only
Active Comparator: traditional physical therapy
Participants will receive conventional physical therapy only, including application of a hot pack for 15 minutes followed by Kendall exercises for postural correction, three times per week for 4 weeks.
Other: traditional physical therapy
hot pack and kendel exercise

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Visual Analog Scale (VAS) for Pain Intensity
Time Frame: Baseline and after 4 weeks of treatment
Pain intensity will be assessed using the Visual Analog Scale (VAS), a 10-cm line where 0 = "no pain" and 10 = "worst pain imaginable". A lower score indicates improvement.
Baseline and after 4 weeks of treatment

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Visual Analog Scale (VAS) for Pain Intensity
Time Frame: Baseline and after 4 weeks of treatment
Functional disability will be assessed using the Neck Disability Index (NDI), a 10-item questionnaire scored from 0 to 50, where higher scores indicate greater disability.
Baseline and after 4 weeks of treatment
Craniovertebral Angle (CVA) via Photographic Posture Analysis
Time Frame: baseline and after 4 weeks
The craniovertebral angle (CVA) will be measured using lateral-view photography and analyzed using Surgimap software. A higher CVA indicates improvement in forward head posture.
baseline and after 4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
MTI University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: reda K. Abdelrazik, associate professor, Benha University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 12, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
October 15, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 31, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 9, 2025

First Posted (Estimated)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
September 10, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
January 5, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 1, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
January 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • PT.BU.EC.22

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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