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Effect of Mulligan Technique on Craniovertebral Angle in Females With Dowager's Hump (DH)

10. července 2026 aktualizováno: Nadia Abdelmoniem Abdelmeged, Cairo University
this study will be conducted to investigate the effect of Mulligan technique on craniovertebral angle, pain intensity, function neck disability, cervical range of motion, thoracic range of motion in females with dowager's hump.

Přehled studie

Postavení

Zatím nenabíráme

Podmínky

Intervence / Léčba

Detailní popis

Dowager's hump is an abnormal outward curvature of the lower cervical and upper thoracic vertebrae in upper back which leads to the compression or wedging of the anterior portion of certain thoracic vertebrae. Hyperkyphosis is commonly reported in post- menopausal women due to associated osteoporosis. The curvature results in the forward bending of the spine (hyperkyphosis) and the formation of a hump at cervicothoracic junction and upper thoracic area . The Mulligan Technique is extensively applied in managing various cervical spine dysfunctions, particularly mechanical neck pain, cervicogenic headaches, and restricted cervical range of motion. Mobilizations with Movement (MWMs) targeting the cervical facet joints can effectively reduce pain and improve mobility in patients with neck stiffness and discomfort.Despite increasing interest in conservative treatment options, there remains a notable gap in the literature regarding the range and effectiveness of therapeutic approaches specifically targeting Dowager's hump. Most existing research has focused on general postural training or corrective exercises, with limited investigation into manual therapy techniques. To date, no studies have exclusively examined the use of the Mulligan concept as a treatment for Dowager's hump, even though it has demonstrated benefits in improving spinal alignment, joint mobility, and neuromuscular control in other musculoskeletal conditions.

Typ studie

Intervenční

Zápis (Odhadovaný)

56

Fáze

  • Nelze použít

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

  • Dospělý

Přijímá zdravé dobrovolníky

Ne

Popis

Inclusion Criteria:

  • The age of patients will be ranged from 39 to 58 years old; mean menopausal age
  • The patients with CVA were less than 50°.
  • Pain intensity level will be examined by VAS which will be more than 3.
  • Limited cervical range of motion .
  • Limited thoracic range of motion (flexion, extension)
  • BMI will be more than 30 kg \m2.

Exclusion Criteria:

  • Patients with any neck surgeries.
  • Neurological infection and spinal cord injury.
  • Patients with congenital musculoskeletal deformities or ankylosing spondylitis.
  • Patients with cervical trauma or car accident.

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Léčba
  • Přidělení: Randomizované
  • Intervenční model: Paralelní přiřazení
  • Maskování: Singl

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Mulligan Technique
28 female patients will receive Mulligan technique for cervical & thoracic region and conventional treatment three times per week for four weeks
Jiný: : Mulligan Technique
the patients will receive Mulligan technique in the form of Natural Apophyseal Glide (NAG) for cervical, Sustained natural apophysial glide ( SNAG ) for cervical,Sustained natural apophysial glide ( SNAG ) for Thoracic
Jiný: conventional treatment.

The exercise program will consist of postural correction exercises to be performed under the supervision of a physical therapist. Each session will last 15-20 minutes per day, either under supervision or practiced individually at home. The exercises will include the following:

  • While seated, participants will lift both hands together above the head
  • While seated or standing with their back against a wall, participants will straighten their back as much as possible
  • While seated on a chair with both hands placed on the neck or crossed over the chest on the shoulders, participants will lift their arms and extend the upper back without compensating with hip or lumbar spine movement
  • While standing in front of a wall, participants will slide both hands upward along the wall as high as possible , Retraction in supine position,Retraction with extension,Pectoral stretch exercise training,Upper back extension exercise from prone training
Aktivní komparátor: conventional treatment.
28 female patients will receive conventional treatment three times per week for four weeks
Jiný: conventional treatment.

The exercise program will consist of postural correction exercises to be performed under the supervision of a physical therapist. Each session will last 15-20 minutes per day, either under supervision or practiced individually at home. The exercises will include the following:

  • While seated, participants will lift both hands together above the head
  • While seated or standing with their back against a wall, participants will straighten their back as much as possible
  • While seated on a chair with both hands placed on the neck or crossed over the chest on the shoulders, participants will lift their arms and extend the upper back without compensating with hip or lumbar spine movement
  • While standing in front of a wall, participants will slide both hands upward along the wall as high as possible , Retraction in supine position,Retraction with extension,Pectoral stretch exercise training,Upper back extension exercise from prone training

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
pain intensity
Časové okno: up to four weeks
The patient will choose a number from the scale which represents value of pain intensity, VAS will be more than 3. Scores are based on self-reported measures of symptoms that are recorded with a single handwritten mark placed at one point along the length of a 10-cm line that represents a continuum between the two ends of the scale- "no pain" on the left end (0 cm) of the scale and the "worst pain" on the right end of the scale (10 cm).
up to four weeks
craniovertebral angle
Časové okno: up to four weeks
The Craniovertebral Angle (CVA) was assessed using a standardized photographic method. Participants were instructed to stand or sit in a relaxed natural posture with the head maintained in a neutral position while facing forward. The spinous process of the seventh cervical vertebra (C7) and the tragus of the ear were identified by palpation and marked with adhesive markers to improve measurement accuracy. A lateral photograph was then captured using a digital camera positioned perpendicular to the participant's sagittal plane, approximately 1 m away at shoulder height. The image was analyzed using Kinovea software by drawing a horizontal line through the C7 marker and a second line connecting the C7 marker to the tragus. The angle formed between these two lines at C7 was recorded as the CVA. A smaller CVA indicates a greater degree of forward head posture, with values below 50° commonly considered indicative of forward head posture
up to four weeks

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
neck disability
Časové okno: up to four weeks
neck disability index will be used to assess neck disability.The patient will set relaxed and asked to complete the neck disability index before treatment and after treatment. which consists of 10 items. Each item is scored from zero (no disability) to five (total disability), with the maximum possible total score being 50. For each item, the subject asked to choose one answer that best defined his/her neck functional disability level. Scores for each item tallied and the total score will recorded. Mean duration of the test: 3 to 7.8 minutes. Vernon and Mior presented the following interpretation.
up to four weeks
thoracic range of motion
Časové okno: up to four weeks
Thoracic Schober test will be used to test thoracic range of motion by tape measurement. The tape measure is placed at the marked points, from the spinous process of T1 to the level of T12, and active flexion of the thoracic spine is requested. After completing the movement, the difference between the initial and final measurements (T1 and T12) is recorded as the Schober test flexion value of the thoracic spine. Normal mobility values are those that show a gain of at least 5 cm on the tape measure
up to four weeks
cervical range of motion
Časové okno: up to four weeks
cervical range of motion will be measured by CROM device
up to four weeks

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Cairo University

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Odhadovaný)

30. července 2026

Primární dokončení (Odhadovaný)

20. února 2027

Dokončení studie (Odhadovaný)

20. února 2027

Termíny zápisu do studia

První předloženo

10. července 2026

První předloženo, které splnilo kritéria kontroly kvality

10. července 2026

První zveřejněno (Aktuální)

15. července 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

15. července 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

10. července 2026

Naposledy ověřeno

1. července 2026

Více informací

Termíny související s touto studií

Klíčová slova

Další identifikační čísla studie

  • P.T.REC/012/006007

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

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Klinické studie na : Mulligan Technique

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Podmínky

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Drogové intervence

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Místa

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