Effectiveness of Mulligan Mobilization Technique And Cervical Stabilization Training in Patients With Chronic Neck Pain

Study Overview
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Brief Summary
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The aim of our study is to compare the efficiency of Mulligan mobilization technique and cervical stabilization training in patients with chronic neck pain. The results obtained from the study will contribute to the planning of the treatment of patients with chronic neck pain more effectively.

Detailed Description
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The aim of our study is to compare the efficiency of Mulligan mobilization technique and cervical stabilization training in patients with chronic neck pain. The results obtained from the study will contribute to the planning of the treatment of patients with chronic neck pain more effectively. The hypotheses we will test for this purpose; H1. Home exercise program will improve positively after treatment in patients with chronic neck pain compared to before treatment. H2. Mulligan mobilization will improve positively after treatment in patients with chronic neck pain compared to before treatment. H3. Cervical stabilization training will improve positively after treatment in patients with chronic neck pain compared to before treatment. H4. Mulligan mobilization will provide more effective results in patients with chronic neck pain compared to other applications.

Official Title
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Comparison of Effectiveness of Mulligan Mobilization Technique and Cervical Stabilization Training in Patients With Chronic Neck Pain: A Single-Blinded Randomized Controlled Trial

Conditions
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Chronic Neck Pain

Intervention / Treatment
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* Other: Home exercise
* Other: Mulligan mobilization
* Other: Cervical stabilization


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Having neck pain lasting more than 3 months Expressing neck pain at least 3,5/10 points and above on a Visual Analog Scale Being 18-65 years old Agree to participate in the study Having obtained 5/50 points and above in Neck Disability Index Exclusion Criteria: Having had spinal surgery Other musculoskeletal problems that may affect the cervical region such as impingement, thoracic outlet and scoliosis. Having a diagnosed psychiatric illness Having benefited from physiotherapy and / or another treatment method due to spinal pain problem in the last 1 year. The presence of specific pathological conditions such as malignant condition, fracture, systemic rheumatoid disease. Any health problem that may prevent the application of evaluations and / or treatment other than those mentioned above. Difficulty in communication at a level that prevents the application of evaluations and / or treatment.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

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
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Home exercise<br>The exercise program will include active normal joint movements in the cervical region, postural exercises, strengthening exercises for the scapular retractor muscles, and stretching exercises for the pectoral muscles, levator scapula and upper part of the trapezius and breathing/relaxation exercises. | Other: Home exercise<br>* Exercise program will include active normal joint movements in the cervical region, postural exercises, strengthening exercises for the scapular retractor muscles, and stretching exercises for the pectoral muscles, levator scapula and upper part of the trapezius and breathing/relaxation exercises.<br>|
| Other: Mulligan mobilization<br>Mulligan mobilization will be applied to this group in addition to the exercises in the home exercise group. In painless directions, each session will be applied in 3 sets, a set of 10 repetitions. Sixty seconds of rest will be given between sets. | Other: Mulligan mobilization<br>* Mulligan mobilization: Mulligan mobilization will be applied to this group in addition to the exercises in the home exercise group. In painless directions, each session will be applied in 3 sets, a set of 10 repetitions.Sixty seconds of rest will be given between sets.<br>|
| Other: Cervical stabilization<br>In addition to the exercises in the home exercise group, this group will be given cervical stabilization training that focuses on the deep neck muscles. | Other: Cervical stabilization<br>* Cervical stabilization group: In addition to the exercises in the home exercise group, this group will be given cervical stabilization training that focuses on the deep neck muscles.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain Intensity | Pain intensity will be evaluated with the Visual Analogue Scale. The Visual Analogue Scale is a horizontal scale in the range of 0-10 cm, where 0 is the lowest pain and 10 the highest pain. The patient will be asked to mark the pain felt in the neck area on this line and the point marked will be measured with a ruler and recorded in cm. | 5 minutes | 
| Neck Disability | Neck Disability will be measured by Neck Disability Index. The Neck Disability Index is a frequently used scale to evaluate the level of disability due to neck pain. It consists of 10 items and 6 options under each item. Options are scored between 0-5 points. An increasing score indicates a higher level of disability. | 5 minutes | 
| Cervical Range of Motion | Cervical Range of Motion will be assessed by Baseline Bubble Inclinometer as degree of flexion-extension, rotation and lateral flexion and will be recorded. | 5 minutes | 
| Head Posture | Head posture will be evaluated using the craniovertebral angle. The decrease in the craniovertebral angle indicates an increased anterior head posture. | 5 minutes | 
| Proprioception | The joint position sense error test defined by Revel et al. Will be used to evaluate cervical proprioception. | 5 minutes | 
| Muscle Endurance | Cervical Deep Flexor Muscle Endurance Test will be used. | 3 minutes | 
| Neck Awareness | The Fremantle Neck Awareness Questionnaire, which consists of few and short questions, does not take time, is easy to access, evaluates neck perception, attention and proprioceptive awareness, will be used. An increase in the score obtained from the questionnaire indicates a decrease in neck awareness. | 5 minutes |