Self-Mobilization With SNAGs Vs. DIE on CMNP in Computer Professionals

Self-Mobilization With Self-Applied Sustained Natural Apophyseal Glides Versus Dynamic Isometric Exercises for Chronic Mechanical Neck Pain in Computer Professionals: A Randomized Controlled Trial

The goal of this clinical trial was to find out whether a self-applied neck mobilization technique (called self-SNAGs) or neck strengthening exercises (dynamic isometric exercises) works better to reduce pain and improve daily function in computer professionals aged 25-45 years who had long-lasting mechanical neck pain.

The main questions it aimed to answer were:

• Does self-SNAG treatment reduce neck pain more than strengthening exercises?
• Does self-SNAG treatment improve neck-related daily activities more than strengthening exercises?

Researchers compared self-SNAG exercises with dynamic isometric neck exercises to see which approach led to greater pain relief and better function over six weeks.

Participants were asked to:

• Perform either self-SNAG neck movements using a towel or neck-strengthening exercises using elastic bands.
• Do the exercises five days per week for six weeks.
• Follow ergonomic advice for proper posture during computer work.
• Complete pain and disability questionnaires before and after the program.

Study Overview

• Status: Completed
• Conditions: Chronic Mechanical Neck Pain
• Intervention / Treatment: Other: Self-applied Sustained Natural Apophyseal Glides; Other: Conventional Adjuncts; Other: Dynamic Isometric Exercise

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• India
  • Utter Pradesh
    • Greater Noida, Utter Pradesh, India, 201315
      • Prakash Institute of Physiotherapy Rehabililation and Allied Medical Sciences

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Participants' ages ranged from 25 to 45 years.
• Having chronic mechanical neck pain persisting for at least 3 months.
• Computer users of at least 4 to 5 hours daily for greater than 3 years.
• Understand and be able to perform the indicated exercises well.
• Cooperation in the study with voluntary participation.

Exclusion Criteria:

• Prior history of musculoskeletal neck disorders, trauma, fracture, inflammation, malignancy, active infection, any neurological disorders or deficits, and any spinal surgeries.
• Acute mechanical neck pain
• Non-cooperation in the study,

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: Self-SNAGs Group; Participants assigned to the self-SNAG arm engaged in structured Mulligan self-mobilization sessions conducted on a five-day weekly schedule for six weeks, with ongoing oversight and instructional feedback to promote correct application and consistent participation.	Other: Self-applied Sustained Natural Apophyseal Glides; Participants in the Self-SNAG Group performed self-administered cervical SNAG mobilizations using a towel following initial physiotherapist instruction to ensure correct technique. Movements included cervical extension, bilateral rotation, and bilateral lateral flexion. The towel edge was placed beneath the targeted vertebral level to apply a sustained glide while participants actively moved through the available range, with brief end-range overpressure before returning to neutral. Each movement was repeated 6-10 times per session.; Other Names: Self-applied SNAGs; Other: Conventional Adjuncts; All participants of both groups received a standard ergonomic education and postural advice program, which included guidance on neutral spine alignment, workstation optimization, and the incorporation of regular movement breaks during computer work to minimize cervical strain.
Active Comparator: DIE Group; Participants assigned to the DIE arm performed structured dynamic isometric cervical exercises using elastic resistance bands. Sessions were conducted on a five-day weekly schedule for six weeks, with ongoing oversight and instructional feedback to promote correct application and consistent participation.	Other: Conventional Adjuncts; All participants of both groups received a standard ergonomic education and postural advice program, which included guidance on neutral spine alignment, workstation optimization, and the incorporation of regular movement breaks during computer work to minimize cervical strain.; Other: Dynamic Isometric Exercise; Participants in the DIE Group performed dynamic isometric exercises using elastic resistance bands, including resisted flexion, extension, and lateral flexion. The band was secured around the head and anchored to a stable surface while participants maintained upright posture and controlled cervical alignment. The head was displaced approximately 10 cm against resistance and slowly returned to the starting position. Each session comprised 2-3 sets of 10-15 repetitions per movement, with instruction to prevent compensatory motions.; Other Names: DIE

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Intensity	Pain intensity was assessed using a reliable and valid Visual Analog Scale, marked with 0 and 10 at either end, indicating no pain and unbearable pain, respectively.	6 weeks
Functional Disability	Participants' functional disability was measured using the reliable and validated Neck Disability Index (NDI), with total scores ranging from 0 (no disability) to 50 (severe disability).	6 weeks

Collaborators and Investigators

• Sponsor: King Saud University
• Collaborators: PIPRAMS, Greater Noida, Uttar Pradseh, India
• Investigators: Study Director: Ahmad H. Alghadir, PhD, King Saud University

Study record dates

Study Major Dates

• Study Start (Actual): March 22, 2021
• Primary Completion (Actual): August 25, 2021
• Study Completion (Actual): December 16, 2021

Study Registration Dates

• First Submitted: January 28, 2026
• First Submitted That Met QC Criteria: January 28, 2026
• First Posted (Actual): February 4, 2026

Study Record Updates

• Last Update Posted (Actual): February 6, 2026
• Last Update Submitted That Met QC Criteria: February 4, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Mulligan; Disability; Chronic Neck Pain; Isometric Exercise; Self Mobilization; SNAG; Occupatrional Health; Computer Users
• Other Study ID Numbers: RRC-2021-03

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No