Publications
Immediate Effects of Mobilization With Movement Technique on Cervical Muscle Stiffness, Pain, and Range of Motion in Individuals With Mechanical Neck Pain: A Double-Blind Randomized Controlled Trial
Authors: Yildiz Analay Akbaba 1, Aysem Ecem Ozdemir 2, 3, Kubra Bali 2, 4, Ecem Yalcin 2, 4
Affiliations:
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
- Department of Physiotherapy and Rehabilitation, Institute of Graduate Studies, Istanbul University-Cerrahpaşa, Istanbul, Turkey
- Department of Physiotherapy and Rehabilitation English, Faculty of Health Sciences, Istanbul Gelisim University, Istanbul, Turkey
- Program of Physiotherapy, Department of Therapy and Rehabilitation, Vocational School of Health Services, Istanbul Kent University, Istanbul, Turkey
Journal: Physiotherapy Theory and Practice - March 2025 (DOI: 10.1080/09593985.2025.2473471)
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Field & Applications:
- Medical
- Treatment evaluation
- Physiotherapy
- Musculoskeletal disorder
Background: Mulligan sustained natural apophyseal glide (SNAG) is a mobilization technique that aims to reduce pain and improve function by correcting positional errors in the facet joint.
Purpose: To investigate the immediate effects of the Mulligan SNAG application on muscle stiffness, pain, pressure pain threshold (PPT) and range of motion (RoM) in patients with chronic mechanical neck pain.
Methods: A randomized, double-blind trial was conducted. Forty individuals with chronic mechanical neck pain (mean age = 39.35 ± 6.68 years) were randomized into two groups: Mobilization with movement group (MWMG), and sham group (SG). Muscle stiffness was measured with MyotonPRO, pain intensity with Numerical Pain Rating Scale, cervical RoM with a digital inclinometer, and PPT with an algometer. Measurements were performed pre-and 5 minutes post-intervention in a single session.
Results: Muscle stiffness significantly changed in the MWMG for the left trapezius and right cervical extensors (p = .003, effect size (ES) = 0.42; p = .031, ES = 0.49, respectively), whereas no significant changes were observed in the SG (p = .097, ES = 0.12; p = .270, ES = 0.22, respectively). The MWMG showed improvements in pain (p = .001, ES = 0.70) and RoM (right: p = .0001, ES = 0.89; left: p = .0001, ES = 0.99). The SG also showed improvements in pain (p = .0001, ES = 0.76) and RoM (right: p = .0001, ES = 0.49; left: p = .0001, ES = 0.35). PPT improvements were observed in the MWMG for right and left trapezius (p = .0001, ES = 1.21; p = .040, ES = 0.43, respectively), whereas no significant changes occurred in the SG (p = .713, ES = 0.03; p = .839, ES = 0.01, respectively).
Conclusion: The mobilization with movement technique leads to significant immediate improvements in muscle stiffness and pain-related parameters in individuals with chronic neck pain.
Keywords: neck pain, manual therapy, muscle stiffness, range of motion
The mobilization with movement technique applied to individuals with chronic mechanical neck pain provides a notable immediate improvement in muscle stiffness and pain-related parameters. Additionally, we believe that the sham intervention used in the study produced similar outcomes to the mobilization technique in terms of pain and RoM, likely due to the active joint movement and tactile input involved in its application. However, the inability of the sham intervention to produce the same effects as the actual technique, particularly in muscle stiffness and PPT measurements, underscores the necessity of applying the mobilization with movement technique.