This study will be conducted to compare between Mulligan mobilization technique and Active release technique in management of non-specific chronic neck pain as regard to neck pain, cervical range of motion and neck function.
Neck pain is the second leading cause of disability worldwide among people with musculoskeletal disorders , and neck pain is responsible for a substantial burden to society . Current guidelines advocate a multimodal approach including different types of exercise and manual therapy for managing non-specific neck pain and there is little evidence of what specific intervention of this multimodal approach is most beneficial. This means that there is a gap in literature regarding this point in general. If effectiveness of each intervention is clear, this will inform selection of individual components of the multimodal approach. 36 Subjects of both genders with a primary complaint of neck pain more than 12 weeks will participate in this study.Group A will receive only the conventional physical therapy program prescribed in the form of ( hot packs , stretching exercises, isometric strengthening exercises and postural correction exercises) .Group B: will receive combination of traditional treatment of neck pain and Mulligan mobilization technique.Group C:will receive combination of traditional treatment of neck pain and ART .
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
36
twelve participants will receive only the conventional physical therapy program prescribed for chronic non-specific neck pain in the form of: 1.Source of superficial heat using hot packs for 15 minutes. 2.Postural correction exercises. 3.Isometric strengthening exercises for neck muscles in all directions (Flexion, extension, side bending and rotation). 4.Stretching for common tight muscles (Trapezius, levator scapulae and sternocleidomastoid muscles). 5.Chin tuck exercises. 6.Scapular stabilization exercises
Participant will sit comfortably supported in a chair with a neutral head and cervical spine position. Practitioner, A gentle, painless posterior-to-anterior (PA) glide will be applied to the facets (bony projections) on the spinous process or the articular pillar/cervical lamina. This glide will be maintained throughout the movement. Participant Action: While the glide will be held, the participant actively will move their neck in the direction that previously caused pain. If pain-free, the participant can gently push further into the movement restriction
Cervical range of motion
Cervical ROM will be assessed using CROM device.
Time frame: 4 weeks
Neck function
Arabic version of neck disability index will be used to assess neck function
Time frame: 4 weeks
Pain intensity
Numerical Rating Scale will be used to assess pain intensity
Time frame: 4 weeks
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The patient will sit on a stool with hands supported on the thighs, the therapist will apply deep pressure on both sides of levator scapulae and upper trapezius muscles (over the area of tenderness) and the patient will be instructed to actively move the muscle from a shortened to lengthened position and thereby breaking adhesions.1 set of 3-5 repetitions in one session