The Comparsion of MCkenzie and Mulligan Exercise in Patients With Non-Specific Neck Pain
Condition: Neck Pain
MeSH terms: Neck Pain
Study type: Interventional

Summary: 
      Non-specific neck pain (NSBA) is defined as pain in the posterior and lateral parts of the
      neck in the absence of neurological and specific pathologies (fracture, infection,
      inflammation, etc.) between the superior nuchael line and the 1st thoracic vertebra. The
      lifetime neck pain rate is approximately 12-70%; Neck pain is the reason for admission in
      approximately 25% of applications to outpatient clinics of the Physical Medicine and
      Rehabilitation Clinic. Neck pain is the most common spinal problem after low back pain, and
      it is defined as nonspecific neck pain due to its multifactorial etiology. Many conservative
      treatment methods are used in the treatment of NSBA. These include medical treatments,
      exercise, massage, acupuncture, neural therapy and physical therapy modalities. The basis of
      Mulligan's theory is based on a positional error that develops secondarily, causing
      misplacement of the joint. With the Mulligan mobilization technique, the joint is displaced
      to normal and positional error is corrected. Restoration of motion is aimed by repositioning
      the bone. The main indication in this technique is increased pain, stiffness and weakness in
      movement. The Mulligan mobilization technique is performed by asking for active movement
      while maintaining a manually applied joint shift. Painless movement is aimed at the joint.
      According to the general principles of Mulligan treatment, all techniques are applied in a
      way that does not cause pain and creates an effect that will eliminate the pain in a short
      time after the application.
    

Detailed description: 
      The McKenzie approach is an evaluative and therapeutic strategy in the practice of
      musculoskeletal physiotherapy to manage pain and restore the function of the cervical spine.
      This approach aims to control cervical disability when used in the early stages such as
      postural correction and increasing flexibility of adjacent musculotendinous structures. It
      aims to classify mechanically induced spinal pain into postural, dysfunctional and
      dysregulation syndromes to centralize and reduce spinal pain. Cervical self-treatment
      techniques used by McKenzie specialists have been shown to be effective for nonspecific neck
      pain. The purpose of evaluating patients with cervical-related disorders is to select
      self-management techniques as directional preference movements that should be repeated to
      reduce pain and symptoms. When we look at the studies in the literature; It has been reported
      that Mulligan concept techniques improve pain and disability symptoms in patients with
      chronic mechanical neck pain at the short- and medium-term effect level. In a study comparing
      Mulligan and McKenzie practices previously, it was concluded that Mulligan exercise was more
      effective in improving cervical range of motion than McKenzie exercise in adults with reduced
      cervical lordosis. In another comparative article, according to the results of the study
      comparing the two exercise techniques, it was seen that cervical ROM increased in both
      exercise groups.

      However, it was concluded that the Mulligan exercise group showed better results than the
      Mckenzie group in the early period. Different types of mobilization are used to treat neck
      pain, but limited studies have been conducted to compare the effectiveness of two different
      mobilization techniques in the treatment of neck pain.

      The aim of the study was that two different exercise programs (mckenzi-mulligan) were used in
      individuals with non-specific neck pain; to compare their effects on pain, range of motion
      (ROM) and functional outcomes. It is aimed to compare the effect of Mulligan exercises and
      Mckenzie exercises on pain reduction, joint range of motion, recovery speed, muscle
      activation and functional treatment in individuals with non-specific neck pain due to
      non-specific neck pain due to multifactorial etiology. Considering that there should be a
      larger number of studies on this subject with the literature review, it is aimed to
      contribute this study to the literature.
    

Intervention name(s): Mckenzie Exercises; Mulligan Exercise
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Cervical Retraction Exercise in Sitting Position The participant sits on the chair, puts the second and third fingers on his chin and pushes his head posteriorly and inferiorly.
Cervical Rotation Exercise in Sitting Position
Cervical Retraction Exercise in Supine Position
Cervical Rotation Exercise in Supine Position The participant turns his head to the right and left, respectively, while taking his head back in the supine position with his head out of the bed.
Cervical Lateral Flexion Exercise
Cervical Flexion Exercise in Sitting Position; The exercises to be applied are listed below.
1- C1-C2 Self Mobilization Slip is applied for natural apophyseal cervical right rotation. The belt is put on level C1. At the same time, the participant actively pulls the belt and turns his head to the right. To facilitate the rotation of the belt in C1, pressure is applied to the belt in the same direction as C2 and rotation of the head towards the restricted side is requested. It waits like this for 3 seconds. These movements are done in the painless range.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: 2 group, intervention
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: neck pain; exercise; manuel therapy; physiotherapy