Effects of Maitland's Antero-Posterior Versus Lateral Mobilizations on Cardiovascular Responses

Effects of Maitland's Antero-posterior Versus Lateral Mobilizations on Cardiovascular Responses in Non-Specific Chronic Neck Pain

This study will be a randomized control trial and will be conducted in Polyclinic Hospital Islamabad & Rawal Dental and General Hospital Rawalpindi. A sample of 62 participants will be taken. Patients will be divided into two equal groups of 31 participants in each group, group Randomization will be done through flip coin method. Patients in group A will receive Maitland's antero-posterior Mobilization, while Patients in group B will receive Maitland's lateral mobilizations. 4 sessions of treatment will be given for 2 weeks with interval of 3 days, 4 days and 7 days between 1st & 2nd session, 2nd & 3rd session and 3rd & 4th session, respectively. The outcome measures will be OMRON Automatic Blood Pressure Monitor, Numeric pain rating scale(NPRS) and Global Rating of Change questionare will be measured at baseline and at the end of 4th session. Data will be analyzed by SPSS 25.

Study Overview

• Status: Recruiting
• Conditions: Neck Pain
• Intervention / Treatment: Other: MAITLAND'S ANTEROPOSTERIOR(AP) MOBILIZATION; Other: MAITLAND'S LATERAL MOBILIZATION

• Study Type: Interventional
• Enrollment (Anticipated): 62
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Waqar Ahmed Awan, PhD; Phone Number: +92-3335348846; Email: waqar.ahmed@riphah.edu.pk

Study Locations

• Pakistan
  • Punjab
    • Rawalpindi, Punjab, Pakistan, 44000
      • Recruiting
      • Rawal General Hospital Rawalpindi
      • Contact: Sajjad Ali, MS-OMPT; Phone Number: +923145757092; Email: Sajjad.ali@riphah.edu.pk
      • Contact: MS-OMPT*
      • Principal Investigator: Ayesha Afsar

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 25 years to 55 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Participants falling in this category would be recruited into the study.
• Age 25 to 55 years
• Pain in neck with no known cause for > 3 months
• Resting systolic blood pressure between 90 to 139 mmHg
• resting diastolic blood pressure between 60 to 88 mmHg
• resting heart rate between 60 to 100 beats/min
• no prior exposure to antero-posterior and lateral mobilizations

Exclusion Criteria:

• Participants falling in this category would be excluded from the study.
• age <25 and >55
• current smokers
• history of fainting spells, diabetes mellitus, spinal surgery and whiplash injury( in last 6 months)
• taking medications for blood thinning, diabetes mellitus
• having neurologic or cardiovascular disease, radiating pain, cervicogenic headaches
• movement coordination impairment
• athletes
• unable to read and write

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: MAITLAND'S ANTEROPOSTERIOR(AP) MOBILIZATION; Patients in this group will receive Maitland's Antero-Posterior Mobilization.	Other: MAITLAND'S ANTEROPOSTERIOR(AP) MOBILIZATION; Group A will receive the 5 sets of 10 seconds Grade 1 mobilizations with a rate of 15 oscillations each set (total 75 oscillations) for AP mobilizations at most symptomatic segment, with 10 seconds rest between sets. Most symptomatic segment is that segment of cervical spine at which patient will feel greatest pain by palpation. For AP mobilizations, patient will lye supine and therapist will stand by his head. Therapist will make broad contact with the thumb, at the costal process of the vertebrae to be mobilized and spread fingers around adjacent neck for stability. Shoulder will be positioned above the joint being treated. Gentle oscillatory Anteroposterior pressure will be performed by the therapist's arm and trunk.
Experimental: MAITLAND'S LATERAL MOBILIZATION; Patients in this group will receive Maitland's Lateral Mobilization.	Other: MAITLAND'S LATERAL MOBILIZATION; Group B will receive the same sets (i.e. 5 sets of 10 seconds Grade 1 mobilizations with a rate of 15 oscillations each set) for lateral mobilizations at most symptomatic segment, with 10 sec rest between each set. For lateral mobilization, patient will lye supine and therapist will stand by his head. Therapist will place the anterolateral aspect 2nd metacarpophalangeal joint over the lateral aspect of transverse process of most symptomatic segment. Gentle lateral oscillations towards the asymptomatic side will be provided by the therapist.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
OMRON Automatic Blood Pressure Monitor	The Omron is an automatic digital device for professional blood pressure measurement at the upper arm level. It measures BP range of 0-299 mmHg	2 Weeks
OMRON Automatic heart rate Monitor	The Omron is an automatic digital device for professional heart rate range of 40 -180 beats/min	2 Weeks
Numeric Pain Rating Scale (NPRS)	It is a tool used for measuring intensity of pain. Patient select numeric from (0-10) that reflects his/her pain intensity. The reliability of tool is ICC = 0.67; [0.27 to 0.84])	2 Weeks
Global Rating of Change (GROC)	It is a scale commonly used in clinical research, particularly in the musculoskseletal area to measure a patient's improvement or deterioration over time, to determine the effect of an intervention .	2 Weeks

Collaborators and Investigators

• Sponsor: Riphah International University

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2021
• Primary Completion (Anticipated): April 1, 2022
• Study Completion (Anticipated): April 1, 2022

Study Registration Dates

• First Submitted: December 29, 2021
• First Submitted That Met QC Criteria: January 10, 2022
• First Posted (Actual): January 11, 2022

Study Record Updates

• Last Update Posted (Actual): April 18, 2022
• Last Update Submitted That Met QC Criteria: April 15, 2022
• Last Verified: April 1, 2022

More Information

Terms related to this study

• Keywords: Maitland mobilization
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Neck Pain
• Other Study ID Numbers: Ayesha Afsar

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