Sustained Natural Apophysial Glides (SNAGs) Technique in Non-Specific Neck Pain Patients

Investigation of the Effectiveness of Mulligan Concept Sustained Natural Apophysial Glides (SNAGs) Technique in Non-Specific Neck Pain Patients: A Randomized Controlled Single Blinded Trial

Mechanical neck pain is defined for the absence of cervical spinal pathologies.With the SNAGs mobile mobilization method, it reveals effective results in cases of limitation and pain in the cervical joints.Although there are studies with the Mulligan concept in the literature, studies examining the effects of the SNAGs technique on non-specific neck pain are limited.

The aim of this study is to investigate the effectiveness of the Mulligan Concept SNAGs mobilization method applied in addition to the conventional physiotherapy program in individuals with nonspecific neck pain.

Study Overview

• Status: Completed
• Conditions: Neck Pain
• Intervention / Treatment: Other: application of SNAGs technique

Detailed Description

This study was conducted to investigate the effectiveness of Mulligan concept cervical sustained natural apophysial glides (SNAGs) mobilization method in addition to the conventional treatment program in patients with nonspecific neck pain. The study included 40 patients (18-50 years of age) with non-specific neck pain, radicular compression and loss of strength for at least 3 months, diagnosed by a specialist physician; patients with central nervous system disease, distal-peripheral nerve injuries Patients with inflammatory joint disease, cervical spine fracture or surgery, patients with upper extremity surgery, cervical spine tumor and infection, cervical spine congenital anomaly and diabetes were not included in the study. 15 sessions were applied for 3 weeks, 5 days a week for 10 weeks, 10 minutes ultrasound, 20 minutes transcutaneous electrical nerve stimulation (TENS) and hotpack application and Mulligan mobilization in addition to physiotherapy programs. The patient was rested for 5 seconds between sets. The physiotherapy program was applied to the control group and the application session was completed. Normal range of motion exercises were performed in both groups and given as home exercise.

• Study Type: Interventional
• Enrollment (Actual): 32
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Istanbul, Turkey
    • Istınye University Medical Park Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 50 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Volunteer patients with non-specific neck pain lasting at least 3 months,
• Volunteer patients without radicular pressure,
• Volunteer patients with loss of strength,
• Volunteer patients diagnosed with non-specific neck pain by a specialist physician.

Exclusion Criteria:

• Volunteer patients with central nervous system disease,
• Volunteer patients with distal-peripheral nerve injuries,
• Volunteer patients with inflammatory joint disease,
• Volunteer patients with cervical spine fracture or surgery, upper extremity surgery,
• Volunteer patients with vertebrobasilar artery stenosis,
• Volunteer patients with osteoporosis,
• Volunteer patients with cervical dislocation,
• Volunteer patients with cervical spine tumor and infection,
• Volunteer patients with congenital anomalies involving the spine,
• Volunteer patients with patients with diabetes.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: experiment group; Number of participant is 16. In addition to the conventional therapy, SNAGs technique was applied.	Other: application of SNAGs technique; in experiment group, the SNAGs technique was applied to 16 participants in addition to conventional therapy.
No Intervention: control group; Number of participant is 16. Only the conventional therapy was applied.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Range of motion assessments	Active and passive range of motion	Two weeks for each participants
Pain assessments	McGill Pain Scale; minimum pain score: 0, maximum pain score: 78, The higher the pain score the greater the pain.	Two weeks for each participants

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sleep quality assessments	Pittsburgh Sleep Quality Index (PSQI)	Two weeks for each participants
Quality of life assessments	The Nottingham Health Profile	Two weeks for each participants

Collaborators and Investigators

• Sponsor: Hacettepe University
• Investigators: Principal Investigator: DUYGU KORKEM YORULMAZ, PhD., Istinye University

Publications and helpful links

General Publications

• Ali A, Shakil-Ur-Rehman S, Sibtain F. The efficacy of Sustained Natural Apophyseal Glides with and without Isometric Exercise Training in Non-specific Neck Pain. Pak J Med Sci. 2014 Jul;30(4):872-4.
• Shin EJ, Lee BH. The effect of sustained natural apophyseal glides on headache, duration and cervical function in women with cervicogenic headache. J Exerc Rehabil. 2014 Apr 30;10(2):131-5. doi: 10.12965/jer.140098. eCollection 2014 Apr.

Study record dates

Study Major Dates

• Study Start (Actual): April 22, 2019
• Primary Completion (Actual): January 6, 2020
• Study Completion (Actual): April 6, 2020

Study Registration Dates

• First Submitted: June 8, 2022
• First Submitted That Met QC Criteria: June 15, 2022
• First Posted (Actual): June 21, 2022

Study Record Updates

• Last Update Posted (Actual): June 21, 2022
• Last Update Submitted That Met QC Criteria: June 15, 2022
• Last Verified: June 1, 2022

More Information

Terms related to this study

• Keywords: quality of life; neck pain; manual therapy; sleep quality; SNAGs
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Neck Pain
• Other Study ID Numbers: 2017-KAEK-120/2019-14

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