Mobilization With Movement Versus Thoracic Manipulation On Neck Proprioception In Mechanical Neck Pain: A Randomized Controlled Study

Abstract

Objective: Compare the impact of thoracic manipulation (TM) and Mulligan (SNAGs) when applied in combination with conventional physical therapy (CPT) on pain, neck proprioception, and scapular retraction in subjects with mechanical neck pain (MNP).  Methods: Sixty patients with MNP, ages ranging from 18 to 45 years, were randomized into three groups of equal number: Mulligan SNAGs as well as CPT (group Ⅰ), thoracic manipulation as well as CPT (group Ⅱ), and CPT only (group Ⅲ). All Patients received three sessions a week for 4 weeks. The visual analogue scale, cervical range of motion device, and tape measurements were utilized to assess pain, proprioception, and scapular retraction at baseline and 4 weeks post-treatment. Results: following four weeks of intervention, there were no statistically substantial differences among group Ⅰ and group Ⅱ in neck proprioception (p>0.05). However, both group Ⅰ and Ⅱ showed superiority to group Ⅲ in all measured variables (p<0.05). Following four weeks of intervention, the mean ± SD of The VAS and scapular retraction were 13 ± 4.41mm, 27.32 ± 2.65 cm respectively in Mulligan SNAG group, 18 ± 6.15 mm, 29.89 ± 2.93 cm respectively in Thoracic Manipulation group, and 23.75 ± 7.41 mm, 32.97 ± 2.69 cm respectively in conventional physical therapy program. Conclusion: when Mulligan SNAGs or TM were added to CPT, more significant improvements in pain intensity, proprioception, as well as scapular retraction was observed in favor of Mulligan SNAGs rather than CPT only in patients with mechanical neck pain.