Compare the Effectiveness of Mulligan (Nags & Snags) and McKenzie (Self-Stretching) On Improving the Pain and Functional Ability in Patient with Chronic Neck Pain

Effectiveness of Mulligan and McKenzie in Patient with Chronic Neck Pain

Authors

  • Sania Naz Department of Physiotherapy, Government College University Faisalabad, Layyah, Pakistan
  • Nargis Jamali Department of Physiotherapy, University of Lahore, Lahore, Pakistan
  • Arooj Iftikhar Department of Physiotherapy, University of Lahore, Lahore, Pakistan
  • Hira Nawaz Department of Physiotherapy, Afro-Asian Institute, Lahore, Pakistan
  • Touseef Iqbal Punjab University, Lahore, Pakistan
  • Faisal Ghafoor Department of Physiotherapy, Superior University, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i08.501

Keywords:

Mulligan, NAGs, SNAGs, McKenzie, Functional Ability, Chronic Neck Pain

Abstract

Neck pain is Consider the major problems and the prevalence of this musculoskeletal disorders are very common in people. Objective: To compare the effectiveness of mulligan and McKenzie on improving pain and functional ability in chronic neck patient. Methods: This trial was registered with Iranian trail registry with reference no: IRCT20220414054537N4. It’s a Double-Blind Randomized Clinical Trial that was conducted in DHQ Hospital Shadrah a affiliated teaching hospital attached with Afro-Asia University Lahore from 1 May 2022 to 30 June 2022.The sample size was calculated and total 26 patients were divided into two groups. The ages of the patients were around 20-55 years old. The entire patient having the mechanical neck pain was included in this study. Patients were selected from DHQ hospital in May to June 2022 duration. In group A we applied the mulligan technique of manual therapy treatment that included the Natural apophyseal glides, sustained natural apophyseal glides and Self SNAGs in sitting position of the patient. The second group of 13 patients had applied the Mackenzie exercises in seven motions like 4 movement of neck extension,2 movements in lateral flexion and rotation and one movement in flexion direction. Results: Overall the post Numeric pain rating scale and Neck Disability index was significantly improved in group A which received the NAGs & SNAGs Mobilization technique. Conclusion: Mulligan (NAGs SNAGS) is effective than Mackenzie (self-stretching) treatment technique to improve the functional ability and reducing pain in chronic neck patient.

References

Binder AI. Cervical Spondylosis and Neck Pain. Bmj. 2007 Mar; 334(7592): 527-31. doi: 10.1136/bmj.39127.608299.80 DOI: https://doi.org/10.1136/bmj.39127.608299.80

Misailidou V, Malliou P, Beneka A, Karagiannidis A, Godolias G. Assessment of Patients with Neck Pain: A Review of Definitions, Selection Criteria, and Measurement Tools. Journal of Chiropractic Medicine. 2010 Jun; 9(2): 49-59. doi: 10.1016/j.jcm.2010.03.002 DOI: https://doi.org/10.1016/j.jcm.2010.03.002

Zhou C, Luo ZD. Electrophysiological Characterization of Spinal Neuron Sensitization by Elevated Calcium Channel Alpha‐2‐Delta‐1 Subunit Protein. European Journal of Pain. 2014 May; 18(5): 649-58. doi: 10.1002/j.1532-2149.2013.00416.x DOI: https://doi.org/10.1002/j.1532-2149.2013.00416.x

Cohen SP. Epidemiology, Diagnosis, and Treatment of Neck Pain. InMayo Clinic Proceedings 2015 Feb; 90(2): 284-299. Elsevier. doi: 10.1016/j.mayocp.2014.09.008 DOI: https://doi.org/10.1016/j.mayocp.2014.09.008

Zhu L, Wei X, Wang S. Does Cervical Spine Manipulation Reduce Pain in People with Degenerative Cervical Radiculopathy? A Systematic Review of the Evidence, and a Meta-Analysis. Clinical Rehabilitation. 2016 Feb; 30(2): 145-55. doi: 10.1177/0269215515570382 DOI: https://doi.org/10.1177/0269215515570382

McDowell JM, Johnson GM, Hetherington BH. Mulligan Concept Manual Therapy: Standardizing Annotation. Manual Therapy. 2014 Oct; 19(5): 499-503. doi: 10.1016/j.math.2013.12.006 DOI: https://doi.org/10.1016/j.math.2013.12.006

Said SM, Ali OI, Abo Elazm SN, Abdelraoof NA. Mulligan Self Mobilization Versus Mulligan Snags on Cervical Position Sense. 2017. doi: 10.15621/ijphy/2017/v4i2/141947 DOI: https://doi.org/10.15621/ijphy/2017/v4i2/141947

Ojoawo A, Nihinlola B. Effects of Sustained Natural Apophyseal Glides in the Management of Cervical Radiculopathy. International Journal of Medical Reviews and Case Reports. 2019; 1(0): 1. doi: 10.5455/IJMRCR.Management-Cervical-Radiculopathy DOI: https://doi.org/10.5455/IJMRCR.Management-Cervical-Radiculopathy

Wickstrom BM, Oakley PA, Harrison DE. Non-Surgical Relief of Cervical Radiculopathy Through Reduction of Forward Head Posture and Restoration of Cervical Lordosis: A Case Report. Journal of Physical Therapy Science. 2017; 29(8): 1472-4. doi: 10.1589/jpts.29.1472 DOI: https://doi.org/10.1589/jpts.29.1472

Warude T, Shanmugam S. The effect of Mckenzie Approach and Mulligan’s Mobilisation (SNAGS) in Lumbar Disc Prolapse with Unilateral Radiculopathy. International Journal of Science and Research. 2014; 39(4.89): 38-93.

Kang JI, Jeong DK, Park SK, Yang DJ, Kim JH, Moon YJ, Baek SY. Effect of Self-Stretching Exercises on Postural Improvement in Patients with Chronic Neck Pain Caused by Forward Head Posture. Journal of the Korean Society of Physical Medicine. 2020; 15(3): 51-9. doi: 10.13066/kspm.2020.15.3.51 DOI: https://doi.org/10.13066/kspm.2020.15.3.51

Zemadanis K. The Short and Mid-term Effects of Mulligan Concept in Patients with Chronic Mechanical Neck Pain. Journal of Novel Physiotherapy and Rehabilitation. 2018; 2: 022-35. doi: 10.29328/journal.jnpr.1001018 DOI: https://doi.org/10.29328/journal.jnpr.1001018

Hurwitz EL, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Côté P, Hogg-Johnson S, Cassidy JD. Treatment of neck pain: noninvasive interventions: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Journal of manipulative and physiological therapeutics. 2009 Feb; 32(2): S141-75. doi: 10.1016/j.jmpt.2008.11.017 DOI: https://doi.org/10.1016/j.jmpt.2008.11.017

Nobari M, Arslan SA, Hadian MR, Ganji B. Effect of Corrective Exercises on Cervicogenic Headache in Office Workers with Forward Head Posture. Journal of Modern Rehabilitation. 2017; 11(4): 201-8.

Exelby L. The Locked Lumbar Facet Joint: Intervention Using mobilizations with Movement. Manual therapy. 2001 May; 6(2): 116-21.doi: 10.1054/math.2001.0394 DOI: https://doi.org/10.1054/math.2001.0394

Boonstra MC, Malefijt MD, Verdonschot N. How to Quantify Knee Function After Total Knee Arthroplasty?. The Knee. 2008 Oct; 15(5): 390-5. doi: 10.1016/j.knee.2008.05.006 DOI: https://doi.org/10.1016/j.knee.2008.05.006

Viir R, Laiho K, Kramarenko J, Mikkelsson M. Repeatability of Trapezius Muscle Tone Assessment by a Myometric Method. Journal of Mechanics in Medicine and Biology. 2006 Jun; 6(02): 215-28.doi: 10.1142/S0219519406001856 DOI: https://doi.org/10.1142/S0219519406001856

Ali A, Shakil-ur-Rehman S, Sibtain F. The Efficacy of Sustained Natural Apophyseal Glides With and Without Isometric Exercise Training in Non-Specific Neck Pain. Pakistan Journal of Medical Sciences. 2014 Jul; 30(4): 872.doi: 10.12669/pjms.304.5148 DOI: https://doi.org/10.12669/pjms.304.5148

Lopez-Lopez A, Alonso Pérez JL, Gonzalez Gutierez JL, La Touche R, Lerma Lara S, Izquierdo H, Fernández-Carnero J. Mobilization Versus Manipulations Versus Sustain Apophyseal Natural Glide Techniques and Interaction with Psychological Factors for Patients with Chronic Neck Pain: Randomized Controlled Trial. Eur J Phys Rehabil Med. 2015 Apr; 51(2): 121-32.

Put M, Huber J, Pieniążek M, Gądek-Michalska A, Szczygieł A. A Randomized Clinical Trial of Multimodal Therapy and Mulligan’s Concept of Manual Therapy for Patients with Chronic Pain Syndrome Caused by Upper Cervical Spine Disorders. Int J Orthop Rehabil. 2016; 3: 40-6. doi: 10.12974/2313-0954.2016.03.01.6 DOI: https://doi.org/10.12974/2313-0954.2016.03.01.6

Gautam R, Dhamija JK, Puri A, Trivedi P, Sathiyavani D, Nambi G. Comparison of Maitland and Mulligan Mobilization in Improving Neck Pain, ROM and Disability. Int J Physiother Res. 2014 June; 2(3): 561-6.

Ahmad R, Asim H, Nasir R. Comparison of Mulligan Manual Therapy Techniques with Kaltenborn Manual Therapy Techniques in Patients with Nonspecific Neck Pain in Improvement on Neck Disability Index. Int J Sci Res. 2015; 4: 1-4.

Ganesh GS, Mohanty P, Pattnaik M, Mishra C. Effectiveness of Mobilization Therapy and Exercises in Mechanical Neck Pain. Physiotherapy Theory and Practice. 2015 Feb; 31(2): 99-106. doi: 10.3109/09593985.2014.963904 DOI: https://doi.org/10.3109/09593985.2014.963904

El-Sodany AM, Alayat MS, Zafer AM. Sustained Natural Apophyseal Glides Mobilization Versus Manipulation in the Treatment of Cervical Spine Disorders: A Randomized Controlled Trial. Int J Adv Res. 2014; 2(6): 274-80.

Downloads

Published

2023-08-31
CITATION
DOI: 10.54393/pjhs.v4i08.501
Published: 2023-08-31

How to Cite

Naz, S., Jamali, N. ., Iftikhar, A. ., Nawaz, H. ., Iqbal, T. ., & Ghafoor, F. . (2023). Compare the Effectiveness of Mulligan (Nags & Snags) and McKenzie (Self-Stretching) On Improving the Pain and Functional Ability in Patient with Chronic Neck Pain: Effectiveness of Mulligan and McKenzie in Patient with Chronic Neck Pain. Pakistan Journal of Health Sciences, 4(08), 47–52. https://doi.org/10.54393/pjhs.v4i08.501

Issue

Section

Original Article

Plaudit