Upper Cervical Mobilization vs. Sub-Occipital MET for Neck Pain and FHP

Upper Cervical Translatoric Mobilization Versus Sub Occipital Muscle Energy Technique in Patients With Mechanical Neck Pain and Forward Head Posture

forty-five patients with MNP and FHP age from 25-40 years will be randomly assigned into three groups: Group A (study): 15patients will receive (upper cervical translatoric mobilization) and traditional physical therapy, Group B (study): 15patients received sub occipital muscle energy technique and traditional physical therapy, and Group C (control): 15 patients will receive the traditional physical therapy treatment only . Interventions will be conducted three times a week for four weeks. Craniovertebral angle (CVA) using Photographic Posture Analysis Method (surgimap software), pain intensity using viual analogue scale (VAS), Cervical ROM using CROM device, and neck functional ability using Neck Disability Index (NDI) will be assessed for all participants before and after the treatment program.

Study Overview

• Status: Completed
• Conditions: Forward Head Posture; Mechanical Neck Pain
• Intervention / Treatment: Other: upper cervical translatoric mobilisation; Other: sub occipital muscle energy technique; Other: traditional physical therapy

Detailed Description

This randomized controlled trial aims to compare the efficacy of Upper Cervical Translatoric Mobilization (UC-TSM) and Sub-Occipital Muscle Energy Technique (MET) in patients with Mechanical Neck Pain (MNP) and Forward Head Posture (FHP). Forty-five participants will be randomly assigned to one of three groups: Group A (UC-TSM + conventional physical therapy), Group B (Sub-Occipital MET + conventional physical therapy), and Group C (conventional physical therapy only). Interventions will be administered three times per week for four weeks. Outcomes include pain intensity (VAS), neck disability (NDI), cervical range of motion (CROM), and craniovertebral angle (CVA) assessed via photographic analysis (Surgimap). The study will be conducted at Benha University.

• Study Type: Interventional
• Enrollment (Actual): 45
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Benha
    • Cairo, Benha, Egypt
      • Faculty of Physical Therapy, Benha University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• patients aged from 20-60 Years
• suffering from M echanical neck pain with Craniovertebral angle ; < 53
• their NDI ranging from 30-48% [9]. Patients were excluded from the study if they have injury or trauma to cervical region, spinal surgery, cervical canal stenosis, radicular pain and malignancy.

Exclusion Criteria:

• Patients were excluded from the study if they have injury or trauma to cervical region, spinal surgery, cervical canal stenosis, radicular pain and malignancy.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Upper Cervical Translatoric Mobilization; Participants will receive Upper Cervical Translatoric Mobilization (UC-TSM) applied to the upper cervical spine (C0-C2), in addition to conventional physical therapy (hot pack and Kendall exercises), three times per week for 4 weeks.	Other: upper cervical translatoric mobilisation; (UC-TSM) is defined as a system of manual techniques using straight-line forces delivered in a parallel or perpendicular direction to an individual vertebral joint or motion segment there is also increasing in body of evidence supporting the its clinical effectiveness and safety in the management of patients with cervical impairments.
Experimental: Sub-Occipital Muscle Energy Technique; Participants will receive Sub-Occipital Muscle Energy Technique (MET) targeting the sub-occipital muscles, in addition to conventional physical therapy (hot pack and Kendall exercises), three times per week for 4 weeks.	Other: sub occipital muscle energy technique; Muscle Energy Technique (MET) is another form of a gentle manual therapy intervention that primarily targets the soft tissues, though it also contributes significantly to joint mobilization. It has been reported that, adding MET to exercise program resulted in better improvement in CVA and FHP than exercise group only
Active Comparator: traditional physical therapy; Participants will receive conventional physical therapy only, including application of a hot pack for 15 minutes followed by Kendall exercises for postural correction, three times per week for 4 weeks.	Other: traditional physical therapy; hot pack and kendel exercise

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Analog Scale (VAS) for Pain Intensity	Pain intensity will be assessed using the Visual Analog Scale (VAS), a 10-cm line where 0 = "no pain" and 10 = "worst pain imaginable". A lower score indicates improvement.	Baseline and after 4 weeks of treatment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Analog Scale (VAS) for Pain Intensity	Functional disability will be assessed using the Neck Disability Index (NDI), a 10-item questionnaire scored from 0 to 50, where higher scores indicate greater disability.	Baseline and after 4 weeks of treatment
Craniovertebral Angle (CVA) via Photographic Posture Analysis	The craniovertebral angle (CVA) will be measured using lateral-view photography and analyzed using Surgimap software. A higher CVA indicates improvement in forward head posture.	baseline and after 4 weeks

Collaborators and Investigators

• Sponsor: MTI University
• Investigators: Principal Investigator: reda K. Abdelrazik, associate professor, Benha University

Study record dates

Study Major Dates

• Study Start (Actual): September 12, 2025
• Primary Completion (Actual): October 15, 2025
• Study Completion (Actual): December 1, 2025

Study Registration Dates

• First Submitted: August 31, 2025
• First Submitted That Met QC Criteria: September 9, 2025
• First Posted (Estimated): September 10, 2025

Study Record Updates

• Last Update Posted (Actual): January 5, 2026
• Last Update Submitted That Met QC Criteria: January 1, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Muscle Energy Technique; Neck Disability Index; Forward Head Posture; Mechanical Neck Pain; Craniovertebral Angle; Upper Cervical Mobilization
• Other Study ID Numbers: PT.BU.EC.22

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