Comparison of the Effects of Mulligan Joint Mobilization and Instrument-Assisted Soft Tissue Mobilization on Pain Intensity, Cervical Awareness, and Functionality in Individuals With Chronic Neck Pain
Phase: NA
Conditions: Neck Pain
Sponsor: Istanbul Rumeli University

1.Cover Page 
OFFICIAL TITLE: The Effects of Mulligan Joint Mobilization Versus Instrument-
Assisted Soft Tissue Mobilization (IASTM) on Pain Intensity, Cervical Awareness, 
and Functional Status in Individuals with Chronic Neck Pain: A Randomized 
Controlled Trial 
NCT NUMBER:  
DOCUMENT TYPE: Study Protocol and Statistical Analysis Plan (SAP) 
DOCUMENT DATE: March 13, 2026 
 
2. Study Protocol 
A. Objective(s) 
The primary objective of this study is to compare the efficacy of Mulligan joint 
mobilization and Instrument-Assisted Soft Tissue Mobilization (IASTM) on pain, 
cervical awareness, and functional status in patients with chronic neck pain. 
B. Study Design 
¥ 
Study Type: Interventional (Clinical Trial) 
¥ 
Allocation: Randomized 
¥ 
Intervention Model: Parallel Assignment 
¥ 
Masking: Single Blind (Assessor) 
¥ 
Primary Purpose: Treatment 
C. Methods & Interventions 
¥ 
Mulligan Group (n=20): Participants will receive Mulligan joint mobilization 
techniques (e.g., SNAGs) targeted at the cervical spine. 
¥ 
IASTM Group (n=20): Participants will receive soft tissue mobilization using 
specialized instruments (e.g., Graston technique tools). 
¥ 
Dosage: Both groups will receive 12 sessions (3 sessions per week for 4 
weeks). 
D. Eligibility Criteria 
¥ 
Inclusion: Ages 18-65, chronic neck pain (≥3 months). 
¥ 
Exclusion: Recent surgery, cervical fractures, malignancy, or neurological 
deficits. 
3. Outcome Measures 

Outcome 
Measure 
Tool/Scale 
Time Frame 
Pain Intensity 
Visual Analog Scale (VAS) 
Baseline, Week 
4 
Cervical 
Awareness 
Fremantle Neck Awareness Questionnaire 
(FNAQ) 
Baseline, Week 
4 
Functional Status Copenhagen Neck Functional Disability Scale 
(CNFDS) 
Baseline, Week 
4 
ROM 
Universal Inclinometer / Goniometer 
Baseline, Week 
4 
Muscle 
Endurance 
Deep Cervical Flexor Endurance Test 
Baseline, Week 
4 
Quality of Life 
SF-36 Health Survey 
Baseline, Week 
4 
Depression Level Beck Depression Inventory (BDI) 
Baseline, Week 
4 
 
4. Statistical Analysis Plan (SAP) 
A. Sample Size Calculation 
A total of 40 participants (20 per group) were determined to provide adequate power 
based on previous literature regarding cervical mobilization effects. 
B. Statistical Methods 
¥ 
Descriptive Statistics: Mean, standard deviation, and percentages for 
demographic data. 
¥ 
Normality Test: Shapiro-Wilk test will be used to assess the distribution of 
data. 
¥ 
Within-Group Analysis: Paired Samples t-test (parametric) or Wilcoxon 
Signed-Rank test (non-parametric) to compare pre- and post-treatment 
results. 
¥ 
Between-Group Analysis: Independent Samples t-test or Mann-Whitney U 
test to compare the effectiveness of Mulligan vs. IASTM. 
¥ 
Significance Level: p < 0.05 will be considered statistically significant. 
¥ 
Software: SPSS Version [Versiyon No] will be used for all analyses.