Maitland Mobilization Versus Mulligan Mobilization in Sub-Acute and Chronic Non-Specific Neck Pain

This study investigate the short term effect of Maitland in comparison to Mulligan mobilization with sub-acute and chronic non specific neck pain to improve neck pain, pain pressure threshold, rang of motion, joint position sense, disability, and to evaluate the interaction with psychological factors.

Study design: experimental study

Study Overview

• Status: Unknown
• Conditions: Nonspecific Neck Pain
• Intervention / Treatment: Other: mulligan mobilization; Other: maitland mobilization

Detailed Description

44 patients with sub-acute or chronic neck pain will be randomized into Maitland group: 22 patients receive central postro anterior or unilateral postero anterior. Mulligan group: 22 patients receive sustain natural apophyseal glides. The treatment will be 2 times /week for three weeks. Measurement will be taken pre intervention and after three weeks for neck pain, pain pressure threshold, range of motion, joint position sense, and disability using a numeric pain rating scale, pain pressure threshold test, cervical range of motion device, and neck disability index, depression, anxiety, fear avoidance believe and pain catestrophizing respectively.

• Study Type: Interventional
• Enrollment (Anticipated): 22
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Saudi Arabia
  • Jeddah, Saudi Arabia
    • King AbdulAziz Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 48 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• • Patients aged between 20 to 50 years.

  • Neck pain more than one week without radicular symptoms.
  • Pain on posterior neck from superior nuchal line to first thoracic vertebra.

Exclusion Criteria:

• • Patient contraindicate to mobilization (pregnancy, whiplash injury, tumor, fracture, metabolic diseases, rheumatoid arthritis, osteoporosis and resting blood pressure higher than 140/90 mmHg).

  • Cervical radiculopathy.
  • Fibromyalgia pain syndrome.
  • Previous neck surgery.
  • Neck pain associate with vertigo caused by vertebrobasilar insufficiency or chronic headache.
  • Patient received physical therapy treatment in the previous three months.
  • Psychiatric disorders.
  • Vestibular system deficits.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: mulligan mobilization; mobilization for spinous process or facet with neck movement 10 repetetions for 3 times.	Other: mulligan mobilization; mobilization with movement for spinous process or facet joint.
Experimental: maitland mobilization; maitland mobilization for spinous process or facet joint for 2 min and repeated 3 times.	Other: maitland mobilization; posterioanterior of spinous process or facet joint.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
pain pressure threshold	It will be measured with an electronic algometer (Somedic AB, Farsta, Sweden) with a circular probe of 1 cm2. The PPT will be measured over the following site: (1) area of maximum tenderness over the cervical spine as identify by palpation, (2) tibialis anterior muscle (upper one-third of the muscle belly) bilateral. Tibialis anterior sites will be as remote lower limb sites to investigate any widespread changes in sensitivity. The pressure will be applied perpendicular over the identified sites at a rate of 40 KPa/s until the individual verbally states that the pressure is starting to change to a pain sensation. Then, the pressure will be stopped. The test will be repeated three times for each site within 30 second between measurements. An average of three measurements will be calculated	3 weeks
pain intensity	: numeric pain rating scale (NPRS) will be used to evaluate the intensity of pain perceived by patient. Pain is rated on 11 point scale from (0) no pain to (10) sever pain. The patients will be asked to point out the number that describes their pain level.	3 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
cervical range of motion	it will be measured by cervical range of motion (CROM) device. It consists of three gravitational inclinometers system for flexion, extension and lateral flexion, and magnetic inclinometer for rotation.	3 weeks
joint position sense	it will be measured by using the (CROM) device	3 weeks
neck disability index	This questioner is used to report disability results from neck pain and it is a self-report based outcome. In addition, it contains ten sections with total score of 50 points	3 weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
State trait anxiety inventory questionnaire (STAI-Y):	It has 20 items for assessing trait anxiety and 20 for state anxiety	3 weeks
Beck depression inventory questionnaire (BDI)	it contains 21 items; each item has four self evaluation statements in a time frame of two weeks, and scores from 0 to 3. The total score for 21 items range from 0 to 63	3 weeks
Fear avoidance believe questionnaire (FABQ)	this questionnaire can assess the fear avoidance believe about the pain. It consists of 16 items. First five questions are related to fear avoidance of physical activities (FABQ- PA). Then the eleven questions are related to avoidance of work (FABQ-W). The score for each question is ranged from 0 (strong disagreement) to 6 (strong agreement). The total score is ranged from 0 to 66. Higher score is represented high level of fear avoidance believe	3 weeks
pain catestrophizing scale		3 weeks

Collaborators and Investigators

• Sponsor: Imam Abdulrahman Bin Faisal University
• Investigators: Principal Investigator: samar alansari, master, Imam Abdulrahman Bin Faisal University

Study record dates

Study Major Dates

• Study Start (Actual): December 20, 2016
• Primary Completion (Anticipated): November 1, 2017
• Study Completion (Anticipated): December 28, 2017

Study Registration Dates

• First Submitted: March 20, 2017
• First Submitted That Met QC Criteria: March 23, 2017
• First Posted (Actual): March 24, 2017

Study Record Updates

• Last Update Posted (Actual): September 20, 2017
• Last Update Submitted That Met QC Criteria: September 19, 2017
• Last Verified: September 1, 2017

More Information

Terms related to this study

• Keywords: neck pain,
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Neck Pain
• Other Study ID Numbers: IRB -PGS-2016-03-143

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Undecided
• IPD Plan Description: only coded data (describtive)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No