Effect of SNAGs and Scapular Mobilizations in Patients With Scapulocostal Syndrome

To determine the impact of SNAGs and Scapular mobilizations on pain, cervical and shoulder Range of motion and functional outcomes in individuals with Scapulocostal Syndrome.

Study Overview

• Status: Recruiting
• Conditions: Scapulocostal Syndrome
• Intervention / Treatment: Other: Cervical and Thoracic SNAGs; Other: traditional physical therapy and scapular mobilizations

Detailed Description

The rationale for employing SNAGS (Sustained Natural Apophyseal Glides) in treating scapulocostal syndrome is multifaceted. By targeting specific joint surfaces and soft tissue structures, SNAGS aim to address joint dysfunction, alleviate pain, and improve mobility in the scapulothoracic region. These sustained gliding movements not only modulate pain signals but also promote relaxation and reduce muscle tension, thereby enhancing the effectiveness of therapeutic exercises aimed at strengthening the surrounding musculature. Additionally, SNAGS facilitate proper muscle activation patterns, optimizing muscle function and coordination. Their adaptability allows for a patient-centered approach, ensuring tailored treatment that considers individual symptoms, mobility deficits, and treatment goals, ultimately promoting better functional outcomes in individuals with scapulocostal syndrome.

• Study Type: Interventional
• Enrollment (Estimated): 36
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Asmar Fatima, MS-OMPT; Phone Number: 03336195644; Email: asmar.fatima@riphah.edu.pk

Study Locations

• Pakistan
  • Punjab
    • Rawalpindi, Punjab, Pakistan, 44000
      • Recruiting
      • DSK physio and Rehab Center
      • Contact: Asmar Fatima, MS-OMPT; Phone Number: 03336195644; Email: asmar.fatima@riphah.edu.pk
      • Contact: Rabia Asif, MS_OMPT*; Phone Number: 03335193218; Email: aasif.rabia@gmail.com
      • Principal Investigator: Rabia asif, MS-OMPT*
      • Sub-Investigator: Asmar Fatima, MS-OMPT

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age- 18 to 40 years.

  • Male and female both
  • Nonspecific neck pain with a duration of greater than 3 months
  • No pain reproduction on isometric muscle testing in shoulder.
  • Patients who could not achieve 60 degrees of upward rotation when elevating the arms above the head i.e. presence of scapular dyskinesia
  • pain with a referral pattern while receiving manual pressure of at least 3 points on the medial scapular muscles (levator scapulae, rhomboid major, rhomboid minor, and serratus posterior superior) evaluated through Travels and Simon criteria.
  • Discomfort, pain, or limitations in neck extension, neck rotation bilaterally, shoulder forward flexion, shoulder abduction attributed to SCS.
  • Willing to provide informed consent to participate in the study.

Exclusion Criteria:

• Musculoskeletal pathologies affecting the cervical spine or lower extremities (e.g., herniated disc, cervical radiculopathy, cervical stenosis, shoulder labral tear).

  • history of degenerative shoulder joint disease
  • rotator cuff dysfunction
  • Thoracic outlet syndrome
  • Brachial neuralgia
  • shoulder impingement syndrome
  • adhesive capsulitis
  • Pregnant individuals due to potential discomfort.
  • Open wounds, infections, or skin conditions at pain site.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Cervical and Thoracic SNAGs; Cervical and Thoracic SNAGs with 6 reps and 1 set along with cervical and shoulder muscle stretching and scapular mobilizations	Other: Cervical and Thoracic SNAGs; cervical SNAGs (C3-C7) and thoracic SNAGs (T1-T12) with 6 repetitions of 1 set three times per week for 4 weeks along with scapular mobilizations of 10 repetitions of 1 set and stretching of trapezius (upper, middle and lower fibers), levator scapulae and rhomboids (major and minor)
Active Comparator: traditional physical therapy and scapular mobilizations; cervical and shoulder muscle stretching and scapular mobilizations	Other: traditional physical therapy and scapular mobilizations; scapular mobilizations of 10 repetitions of 1 set and stretching of trapezius (upper, middle and lower fibers), levator scapulae and rhomboids (major and minor)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Neck disability index	changes from baseline The Neck Disability Index (NDI) serves as a valuable tool for evaluating neck pain issues, drawing on the framework of the Oswestry index for back pain and the Pain Disability Index. Its effectiveness lies in its focus on the impact of neck pain on daily activities, reflecting the specific concerns and experiences of individual patients. Comprising 10 sections, each containing 5 questions related to affected activities, the index allows patients to select the response that best represents their situation, with scores ranging from 0 to 5.	4th week

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
NPRS	changes from baseline Pain through NPRS at the end of every week for 4 weeks	every week
Cervical and Shoulder ROM	changes from baseline at the end of every week till last week	every week

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Asmar Fatima, MS-PT, Riphah International University

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2024
• Primary Completion (Estimated): March 31, 2025
• Study Completion (Estimated): March 31, 2025

Study Registration Dates

• First Submitted: October 23, 2024
• First Submitted That Met QC Criteria: October 23, 2024
• First Posted (Actual): October 24, 2024

Study Record Updates

• Last Update Posted (Actual): October 24, 2024
• Last Update Submitted That Met QC Criteria: October 23, 2024
• Last Verified: October 1, 2024

More Information

Terms related to this study

• Keywords: SNAGs; NDI; non specific neck pain; Scapular mobilizations
• Additional Relevant MeSH Terms: Pathologic Processes; Disease; Syndrome
• Other Study ID Numbers: REC/MS-PT/01941 Rabia Asif

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