SNAGs in Mechanical Neck Pain

Study Overview
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Brief Summary
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Neck pain is second largest cause of disability worldwide. Chronic neck pain prevalence is 14% which is somewhat higher in females as compared to males. In India reported prevalence is 6%. Therapeutically, neck pain is managed by physiotherapists using rest, stretching and strengthening exercises, educating patient, and intense proprioception and positional exercises.

Detailed Description
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To determine the evidences for the efficacy of SNAGs in the Management of Mechanical Neck Pain. 100 patients [Age group 25-45 yrs] who were diagnosed with neck pain, with onset ˃1-3 months (chronic) were randomly assigned to group A receiving conventional Physiotherapy plus SNAGs and group B receiving conventional Physiotherapy plus ultrasound. Subjects in-group A that received conventional Physiotherapy plus SNAGs showed greater Improvement in pain and range of motion compared with the conventional Physiotherapy plus ultrasound group on 2nd week compared with pretreatment. The result of study suggests that both SNAGs and Ultrasound groups improves the symptoms of neck pain. Ultrasound group improved the pain symptoms but was too small to reach satisfactory outcome for patients. Based on these results conventional Physiotherapy plus SNAGs should be the treatment of choice for neck pain rather than conventional Physiotherapy plus Ultrasound .

Official Title
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Efficacy of SNAGs in the Management of Mechanical Neck Pain

Conditions
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Neck Pain

Intervention / Treatment
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* Other: Ultrasound Therapy, SNAGs


Participation Criteria
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Eligibility Criteria
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Inclusion criteria Age group between 20- 45 years. Both Gender male and female. Individuals having localized pain or stiffness in spine or both combined b/w C3 to C7 without upper limbs radiculopathy. Pain reported on VAS score ˃3 in neck region. Patients agree to sign written consent form. Exclusion Criteria Patients were excluded if they were diagnosed with following conditions for ˃6 months: T.B, carcinoma, heart disease, osteoporosis. Neural disorders due to PIVD. Any trauma or localized infection in neck region. Upper MND, cervical stenosis, metabolic diseases in bone and joint. Hyper flexibility Open sores, Ongoing radiotherapy, chemotherapy, steroid therapy or anticoagulants. Psychiatric diseases such as phobia/obsession, depression. Allergy to hot pack Patients with history of surgery in cervical spine region with in a year.

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants randomly assigned to group A receiving conventional Physiotherapy plus SNAGs and group B receiving conventional Physiotherapy plus ultrasound.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mean and standard deviations of age and height between group A and B<br>100 subjects with a mean age of 30.82±6.75 (group A, 31.42±6.67; group B, 30.82±6.82) ranging from 20 to 45 years, with a mean height of 165.52±7.85 (group A, 164.92±7.79; group B, 166.12±7.87) centimeters | Other: Ultrasound Therapy, SNAGs<br> <br> * Other names: Hot Pack, Exercise;|
| Experimental: Between group comparison of VAS, NDI and ROM<br>VAS, NDI and Neck ROM between two groups were compared at pretest (0 day) and posttest (end of two weeks) | Other: Ultrasound Therapy, SNAGs<br> <br> * Other names: Hot Pack, Exercise;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual analog scale | Visual analog scale is a subjective outcome measurement where patients judge the intensity of their pain on a scale of 0-10, which is in the form of a 10cm straight line. On this 0-10 scale, zero denotes no pain and ten denotes severe pain intensity. | 2 weeks | 
| Neck Range of motion | Range of motion of the cervical spine measured by bubble inclinometer. It consists of a 360-degree scale with a fluid filled circular tube containing a small air bubble. It is a gravity dependent Goniometer, which uses the gravity's effect on fluid level to measure joint position and motion. | 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neck disability Index | Neck disability Index contains 10 items, seven related to activities of daily living, two related to pain, and one item related to concentration. Each item is scored ranging from 0 (no pain or disability) to 5 (severe pain and disability); and the total score is expressed as a percentage, with higher scores corresponding to greater disability. | 2 weeks |