The study was conducted to determine the effects of Sustained Natural Apophysial Glide with and without Integrated Neuromuscular Inhibition Technique on pain, range of motion and function in patients with chronic mechanical neck pain
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
44
SNAGs were applied in three sets, with repetitions progressively increased from 6 to 10 over a period of four weeks, administered three times per week.
The integrated neuromuscular inhibition technique comprised three steps: ischemic compression, strain-counterstrain technique, and muscle energy technique. The technique was applied to the upper trapezius, levator scapulae, sternocleidomastoid, and splenius capitis muscles. Muscle selection was based on palpatory examination performed prior to each treatment session. Each treatment session lasted 10 minutes, during which all three steps were repeated three times within a single session. The intervention was delivered three times per week for four weeks, resulting in a total of 12 treatment sessions.
Lahore General Hospital,Lahore
Lahore, Punjab Province, Pakistan
Numeric Pain Rating Scale
Numeric Pain Rating Scale is utilized to evaluate pain.This is a scale between 0 and 10 where 0 denotes no pain and 10 denotes the worst pain whereas 1-3 denotes mild pain 4-6 denotes moderate pain and 7-10 denotes severe pain.
Time frame: From enrollment to end of treatment at 4th weeks
Neck Disability Index
The Neck Disability Index is a self-reported questionnaire used to assess neck-related functional disability. It consists of 10 items addressing pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, and recreation. Each item is scored on a 6-point scale (0-5), with a total score ranging from 0 to 50, where higher scores indicate greater disability. Scores are categorized as no disability (0-4), mild disability (5-14), moderate disability (15-24), severe disability (25-34), and complete disability (≥35).
Time frame: From enrollment to the end of treatment at 4th weeks
Range of Motion Cervical Spine (Flexion)
Changes in cervical spine flexion range of motion at baseline and 4th week of intervention was measured using goniometer
Time frame: From enrollment to the end of treatment at 4th week.
Range of Motion Cervical Spine (Extension)
Changes in cervical spine extension range of motion at baseline and 4th week of intervention was measured using goniometer.
Time frame: From enrollment to the end of treatment at 4th week
Range of Motion Cervical Spine (Lateral Flexion) Right Side
Changes in cervical spine lateral flexion on right side range of motion at baseline and 4th week of intervention was measured using goniometer.
Time frame: From enrollment to the end of treatment at 4th week
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Standardized physiotherapy included the application of an electrical hot pack at moderate intensity for 10 minutes. Transcutaneous electrical nerve stimulation (TENS) delivered in continuous mode at a frequency of 100 Hz for 15 minutes. Passive stretching was performed for cervical muscles prone to tightness, including the levator scapulae, sternocleidomastoid, upper trapezius, and scalene muscles, with a 30-second hold, three sets of ten repetitions, and a one-minute rest between sets. Scapular stabilization exercises, comprising shoulder shrugging and scapular retraction, were performed for 15 repetitions with a 6-second hold. Neck isometric exercises were repeated ten times with a 6-second hold. Cervical stabilization exercises were performed in two sets of ten repetitions per session, with each repetition held for ten seconds, a forty-second rest between repetitions, and a two-minute rest between sets.
Range of Motion Cervical Spine (Lateral Flexion) Left Side
Changes in cervical spine lateral flexion on left side range of motion at baseline and 4th week of intervention was measured using goniometer.
Time frame: From enrollment to the end of treatment at 4th week
Range of Motion Cervical Spine (Rotation) Right Side
Changes in cervical spine rotation on right side range of motion at baseline and 4th week of intervention was measured using goniometer
Time frame: From enrollment to the end of treatment at 4th week
Range of Motion Cervical Spine (Rotation) Left Side
Changes in cervical spine rotation on left side range of motion at baseline and 4th week of intervention was measured using goniometer
Time frame: From enrollment to the end of treatment at 4th week