Clinical trial NCT06858124: Mulligan vs Maitland With Home-Based Exercise for Non-Specific Neck Pain
Official title: Comparison of Mulligan and Maitland Mobilization Techniques Combined With Home-Based Exercise for Non-Specific Neck Pain: A Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Neck Pain
Keywords: Non-Specific Neck Pain
Mulligan
Maitland
Lead sponsor: International Hellenic University
Sponsor class: OTHER
First posted: 2025-03-05
Enrollment: 43
Sex: ALL
Minimum age (years): 18
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: PARALLEL
Intervention model description: 43 participants with non-specific neck pain pain will be randomly assigned to three groups of 14, 14 and 15 participants each. The allocation of the sample to the groups will be performed using the randomization app Randomiser (Rob Sammons, Apple Store) by an independent researcher. In the first group, a mulligan mobilization protocol will be applied and the practitioners will follow a daily therapeutic exercise program at home, in the second group, a maitland mobilization protocol will be applied and the practitioners will follow a daily therapeutic exercise program at home, while the third group will follow only a daily therapeutic exercise program at home. Participants of the two intervention groups will follow a total of four treatments over a period of two weeks. The therapeutic home-based exercise program will be performed daily over the same period of two weeks.
Primary purpose: TREATMENT

Brief summary: Non-specific neck pain (NSNP) is a prevalent musculoskeletal condition with multiple contributing factors. The aim of this clinical study is to investigate the short-term effects of Mulligan in comparison to Maitland mobilization techniques in conjunction with a home-based therapeutic exercise program. 43 adults with non-specific neck pain will be randomly divided into three groups of 14,14 and 15 participants each. In the participants of the first group, a therapeutic protocol of Mulligan mobilizations in the cervical region will be applied and a protocol of exercises will be performed. To the participants of the second group, a therapeutic protocol od Maitland mobilizations in the cervical region will be applied and the same exercise program with the first group will be performed. The third group participants will perform only the same exercise protocol as the other groups. The first two groups will receive four mobilization treatments over two weeks. All three groups will perform the home-based exercise protocol daily for two weeks. Pain in the last 24 hours with the Numeric Pain Rating Scale (NPRS), Pressure Pain Threshold (PPT) in the cervical region with an algometer, functional ability with the Neck Disability Index (NDI), Range of Motion (ROM) with a digital goniometer, pain catastrophizing with the Pain Catastrophizing Scale (PCS) and kinesiophobia with the Tampa Scale of Kinesiophobia (TSK) will be evaluated before and after the intervention. For the statistical analysis of the results, a two-way repeated measures analysis of variance (ANOVA) will be applied using SPSS program, while the statistical significance index will be set at p \< .05.

Detailed description: Background: Non-specific neck pain (NSNP) is a prevalent musculoskeletal condition with multiple contributing factors. Various manual therapy approaches, such as Mulligan and Maitland mobilizations, are commonly applied to alleviate pain and enhance function.

Aim: The purpose of this clinical study is to investigate the short-term effects of Mulligan in comparison to Maitland mobilization techniques in conjunction with a home-based therapeutic exercise (TE) program.

Method: 43 participants with non-specific neck pain will be randomly assigned to three groups of 14, 14 and 15 participants each. In the participants of the first group, a therapeutic protocol of mulligan mobilizations will be applied to the cervical region. In addition, the participants will perform a home-based therapeutic exercise program. To the participants of the second group, a therapeutic protocol of maitland mobilizations will be applied to the cervical region and they will perform the same home-based exercise protocol with the first group. The third group participants will perform only the same home-based exercise protocol with the other groups. The first two groups will receive four mobilization treatments over two weeks. All three groups will perform the home-based exercise protocol daily for two weeks. Pain in the last 24 hours with the Numeric Pain Rating Scale (NPRS), Pressure Pain Threshold (PPT) in the cervical region with an algometer, functional ability with the Neck Disability Index (NDI), Range of Motion (ROM) with a digital goniometer, pain catastrophizing with the Pain Catastrophizing Scale (PCS) and kinesiophobia with the Tampa Scale of Kinesiophobia (TSK) will be evaluated before and after the intervention. For the statistical analysis of the results, a two-way repeated measures analysis of variance (ANOVA) will be applied using SPSS program, while the statistical significance index will be set at p \< .05. Expected results: The protocol proposed in this clinical study combines the benefits of applying manual therapy mobilizations with the beneficial effects of therapeutic exercise. Previous research shows Mulligan mobilizations may be slightly more beneficial in improving patients' symptoms with non-specific neck pain. For this reason, we expect that the combination of Mulligan mobilizations and home-based therapeutic exercise will be more effective than the combination of Maitland mobilizations and home-based therapeutic exercise only in improving the clinical symptoms of young adults with non-specific neck pain.

Eligibility criteria: Inclusion Criteria:

* Acute-subacute-chronic neck pain
* Women - Men
* Age range between 18 and 30 years
* NPRS score \>2
* Written consent to participate in the study

Exclusion Criteria:

* • Previous cervical/thoracic surgery

  * Recent whiplash (≤6 months)
  * Upper cervical pathology
  * Osteoporosis
  * Pregnancy
  * Cancer
  * Systemic diseases or spinal disorders
  * Neurological symptoms
  * Severe medical conditions, positive red flags (Spurling test, Hoffmann's sign, Babinski reflex, clonus)

Primary outcomes:
measure: Changes in neck pain intensity with Numeric Pain Rating Scale (NPRS)
timeFrame: pre-treatment, week: 2
measure: Changes in Pressure Pain Threshold (PPT) with pressure algometry
timeFrame: pre-treatment, week: 2
measure: Changes in cervical range of motion with digital goniometry
timeFrame: pre-treatment, week: 2
measure: Changes in functional ability with Neck Disability Index (NDI)
timeFrame: pre-treatment, week: 2]
measure: Changes in pain catastrophizing with Pain Catastrophizing Scale (PCS
timeFrame: pre-treatment, week: 2]
measure: Changes in kinesiophobia with Tampa Scale of Kinesiophobia (TSK)
timeFrame: pre-treatment, week: 2
Secondary outcomes:
Other outcomes:
Locations:
city: Thessaloniki
country: Greece
facility: International Hellenic University
Study officials:
References: