The study will include a total of 40 individuals aged 18-65 years with chronic neck pain for at least three months. Participants will be randomly assigned to two groups: the Mulligan mobilization group (n=20) and the AYDM group (n=20). Both groups will receive a total of 12 treatment sessions, 3 days a week for 4 weeks. Assessments will be performed before and after treatment. Pain intensity will be assessed using the Visual Analog Scale (VAS), cervical awareness using the Fremantle Neck Awareness Questionnaire (FNA), and functionality using the Copenhagen Neck Functional Disability Scale (CNFDS). In addition, measurements of cervical joint range of motion, deep neck flexor muscle endurance, quality of life (SF-36), and depression level (Beck Depression Scale) will be taken.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
The treatments will administered 3 days a week for a total of 12 sessions over 4 weeks.
The treatments will administered 3 days a week for a total of 12 sessions over 4 weeks.
Istanbul Rumeli University
Istanbul, Turkey (Türkiye)
Pain Intensity
Visual Pain Scale.Participants' pain intensity will be assessed using the Visual Analog Scale (VAS). The Visual Analog Scale is a validated and reliable scale that quantitatively determines the intensity of pain perceived by an individual. The scale consists of a 10 cm long horizontal or vertical line, with one end of the line defined as "0 = no pain" and the other end as "10 = unbearable pain".
Time frame: Baseline and at the end of treatment (week 4)
Range of motion
To assess the active range of motion of the cervical joint, the tape measure method described by Hsieh et al. (1986) was used. This method is reported to be a practical and reliable measurement tool for assessing cervical range of motion in clinical practice.
Time frame: Baseline and at the end of treatment (week 4)
Cervical awareness
Fremantle Neck Awareness Questionnaire
Time frame: Baseline and at the end of treatment (week 4)
Copenhagen Neck Functional Disability Scale
Neck Functional Disability is a 15-item questionnaire. Total score(0-30) indicate higher disability
Time frame: Baseline and at the end of treatment (week 4)
Neck flexor endurance
The test protocol is performed with the individual in a supine position, with knees bent and soles of feet touching the ground (hook position). Individuals are asked to comfortably position their hands on their abdominal area. During the procedure, the physiotherapist places their index and middle fingers overlapping under the participant's head. Participants are first instructed to pull their chin inward and downward (chin-tuck) and, while maintaining this position, to perform active craniocervical flexion, raising their head approximately 2.5 cm above the physiotherapist's fingers. The maximum time participants canmaintain this position without breaking it was recorded in seconds using a stopwatch.
Time frame: Baseline and at the end of treatment (week 4)
SF-36 Quality of life
The SF-36 does not have a total scoring system; assessment is based on eight sub-dimensions: physical function, physical role difficulty, emotional role difficulty, social function, mental health, energy (vitality), pain, and general health perception.
Time frame: Baseline and at the end of treatment (week 4)
Depression Scale
Beck Depression Scale is a psychological status-based scale consisting of 21 items developed to assess an individual's recent emotional state. Each item on the scale is scored between 0 and 3, and the level of depression is determined based on the total score obtained.
Time frame: Baseline and at the end of treatment (week 4)
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