Comparison of Weight Bearing Thrust Manipulation With Non Weightbearing Thrust Manipulation in Patients With Forward Head Posture
Condition: Cervical Pain
MeSH terms: Neck Pain
Study type: Interventional

Summary: 
      This randomized controlled trial was performed in MMRC (Majestic medicine rehabilitation
      Sciences) Islamabad in February 2023 and consisted of patients having neck pain and forward
      head posture. 30 Patients were divided into two groups of 15 each by sealed envelope method .
      Treatment group was given weight bearing thrust manipulation in sitting and control was given
      non weight bearing thrust manipulation in supine lying. Pain was calculated through NPRS and
      Cervical ranges were calculated by Inclinometer before and immediately after treatment.
    

Detailed description: 
      Cervical Spine is most integral part of human spine as it sits between highly stable thoracic
      and highly movable occipital bodies. It help the head movement of flexion , rotation which
      are constantly required for performing basic activities of daily life. It is a link between
      head and rest of the body and due to its need in mobility it is often put under greater
      stress , muscular imbalance, reduced disc spaces and common site for many spinous syndromes.
      One of the most common disability that occurs on cervical spine is forward headv posture
      usually associated with upper crossed syndrome and is known as text neck also due to strain
      put on spine due to high usage of screen devices. Sedentary lifestyle and postural imbalances
      and effect of gravity are usually the major causes of muscular and bony imbalances that
      result in forward head posture. Prolonged state of stress on muscles usually result in pain
      in neck specially during movement.

      High Velocity Low Amplitude Thrust (HVLAT) is a common technique to unlock cervical joints
      and muscular pain associated with it and immediately reduce pain. Cavitation sound or pop is
      often associated with this thrust technique that is result decrease in pressure causes
      dissolved gasses in the synovial fluid to be released into the joint cavity of due to which ,
      the force-displacement curve shifts and the range of motion of the joint increases.It has
      been stated that spinal manipulation activates presynaptic inhibition of segmental pain
      pathways, reflex muscle relaxation, and reflex pain Inhibition. It has been repeatedly proved
      by literature that thrust manupulation is an effective was of increasing ROM and pain in
      patients in non weight bearing positions but it can also be given in weight bearing position
      effects of which are yet not very clear specially in patient population such as forward head
      posture .The current study was planned to compare the effectiveness of thrust manipulation in
      weight bearing and non weight bearing postions on pain and range in forward head posture .
      The hypothesis was that there will be significant difference in the effect of thrust
      manipulation in different positions.
    

Intervention name(s): Thrust Manipulation (in weight bearing and non weight bearing)
Intervention type(s): Other
Intervention description(s): Pain and Range of cervical motion was assessed before and after manipulation in both groups.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: forward head posture, cervical thrust manipulation