Spinal Mobilization and PNF Comparison on Pain, Disability in Patients With Cervical Radiculopathy

March 10, 2025 updated by: Riphah International University

Comparison of Mulligan's Spinal Mobilization With Proprioceptive Neuromuscular Facilitation Technique on Pain, Disability and Range of Motion in Patients With Cervical Radiculopathy

As in this modern era of digitalization; mobile phones, touch pads and computers devices use is increasing, neck pain that radiates into upper limb is also becoming common due to such devices long term use in bad postures or positions for more workload. The resulted findings could significantly contribute to the refinement of rehabilitation interventions, offering a more holistic and tailored approach for addressing cervical radiculopathy sensory and motor symptoms, ultimately improving individuals daily living activities and life quality. It will be helpful for physiotherapists to find evidence about comparison of mulligan's spinal mobilization along with arm movement with proprioceptive neuromuscular facilitation technique on pain, disability and range of motion in patients with cervical radiculopathy. It will be beneficial for patients also to improve pain, activities of daily living and working tasks in a comfortable position.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Cervical radiculopathy is a clinical situation in which reflex, motor, and sensory alterations e.g. radicular pain, paresthesia, or numbness might be present and might be increased by neck bad postures and movements. Due to sustained forward head and neck posture and repetitive movements, cervical pain and numbness is becoming common in office, bank and online workers. The cervical radiculopathy new cases report yearly is almost 107.3 per 1 lac for men and 63.5 per 1 lac for women. It is essential to find new efficient methods of cervical radiculopathy physical therapy management.

Males and females of age 21-50 years old added in this study. Screening tests will include upper limb tension tests (ULTT), spurling (compression) test and distraction test. Subjects randomly assigned into two groups by lottery method. Experimental group (N=19) received Mulligan's spinal mobilization with arm movements (SMWAMs) and proprioceptive neuromuscular facilitation (PNF) contract-relax technique and control group (N=19) received Proprioceptive neuromuscular facilitation (PNF) contract-relax technique and standard physical therapy protocol including passive stretching exercises (3 sets of 10 repetitions) and isometric strengthening exercises (2 sets of 10 repetitions). Outcome measures included numeric pain rating scale (NPRS) for pain, neck disability index (NDI) for functional disability and goniometer for range of motion (ROM). Data analyzed by statistical package for social sciences (SPSS 26) software.

Study Type

Interventional

Enrollment (Actual)

38

Phase

  • 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 Locations

  • Pakistan
    • Punjab
      • Lahore, Punjab, Pakistan, 54000
        • Riphah International 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

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Both males, females of 21 years to 50 years old
  • Patients already diagnosed by orthopedicians
  • Patients with positive screening (upper limb tension, spurling & distraction) tests

Exclusion Criteria:

  • History of trauma, fracture and previous surgery
  • Any pathological condition, spinal instability and tumor
  • VBI (Vertebral-Basillar Insufficiency) and cervical instability/spondylolisthesis

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: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental Group (SMWAM's and PNF C-R Technique)
Experimental group received Mulligan's Spinal Mobilization with Arm Movements and Proprioceptive Neuromuscular Facilitation contract-relax technique.
Other: SMWAM's and PNF C-R Technique

Treatment provided 3 days every week in 6 total weeks with 1 meeting per day, 3 bunches of 10 times repeat and resting period of one minute among bunches. This group received Mulligan's spinal mobilization with arm movement and proprioceptive neuromuscular facilitatin contract-relax technique. Previous to mobilization, all patients got hot pack (10 minutes) and active range of motion warm up exercises (2 sets of 10 repetitions) and did isometric neck exercise as a home plan of care.

Mobilisation (22) was done depending on the side of involvement, the corresponding spinous process would be mobilised combined with different movements of shoulder (flexion/ abduction/ horizontal abduction/ horizontal adduction).

Proprioceptive neuro-muscular facilitation contract relax technique performed with 3 repetitions in each cervical movement (flexion, extension, lateral flexion and rotation) (27).
Experimental: Control Group (PNF C-R Technique and PT Protocol)
Control group received Proprioceptive Neuromuscular Facilitation Contract-relax Technique and Physical Therapy protocol.
Other: PNF C-R Technique and PT Protocol

Treatment provided 3 days every week in 6 weeks with 1 meeting per day, 5 clusters of 3 times repeat and resting period of one minute among clusters. Regime of training involved PNF (proprioceptive neuromuscular facilitation) contract-relax method along with the standard physical therapy protocol which includes passive stretching (3 sets of 10 repetitions) and isometric strengthening exercises (2 sets of 10 repetitions).

Proprioceptive neuro-muscular facilitation contract relax technique performed with 3 repetitions in each cervical movement (flexion, extension, lateral flexion and rotation) (27).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain by Numeric Pain Rating Scale
Time Frame: 6 weeks
This was used for pain intensity assessment. Patient rested on stool or chair and ordered to score resting pain extent in between 0 and 10 range; 0 means without pain and 10 means much high pain as possible in 10cm numbers line.
6 weeks
Neck level of disability by Neck Disability Index
Time Frame: 6 weeks
Neck disability Index was used for functional disability of neck assessment. NDI is a 10-items questionnaire that assesses the effect of neck signs and symptoms on daily living functional activities. Every item is marked from range 0 to 5, along with total score from 0 to 50 range and maximum scores means maximum disability. NDI has reliability acceptable in the self-perceptual disability assessment and an MCID (minimal clinically important difference) of 8.5 points in cervical radiculopathy patients.
6 weeks
Cervical Range of Motion by Goniometer
Time Frame: 6 weeks
Goniometer was used for active cervical spine range of the motion (flexion, extension, rotation, side bending) assessment. Side bending, rotation measured on the symptomatic and asymptomatic both sides.
6 weeks

Collaborators and Investigators

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

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Muhammad Azeem, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • Kamal AS, Zakaria HM, Elsamra MK, Gaballah MA, Elrewainy RM. EFFICACY OF PROPRIOCEPTIVE TRAINING PARADIGM ON CERVICAL RADICULOPATHY. Assessment. 2023;1000(2):12.
  • Gashi AI, Kovačič T, Gashi F, Azemi A. The effect of proprioceptive neuromuscular facilitation technique on treating cervical radiculopathy. Journal of Physical Education and Sport. 2023;23(3):722-9.
  • Taneja D, Saharan A, Ranjeeta W, Sharma M, Saharan M, Dubey S, et al. Effect of Mulligan's Smwam among Subjects with UnilateralCervical Radiculopathy. Eduzone: International Peer Reviewed/Refereed Multidisciplinary Journal. 2023;12(1):11-22.

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)

January 12, 2024

Primary Completion (Actual)

February 21, 2025

Study Completion (Actual)

February 21, 2025

Study Registration Dates

First Submitted

March 4, 2025

First Submitted That Met QC Criteria

March 4, 2025

First Posted (Actual)

March 25, 2025

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

March 10, 2025

Last Verified

March 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Muhammad Azeem

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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