Clinical Outcomes of Maitland's Mobilization in Patients With Myofacial Chronic Neck Pain

Riphah International University

Status: Completed

Conditions: Myofascial Pain Syndrome of Neck

Treatments: Other: Traditional Physical therapy; Other: Maitland's mobilization

Study type: Interventional

Funder types: Other

Identifiers

NCT04660292

PT-Associate-MARYAM SHABBIR

Details and patient eligibility

About

Myofacial neck pain is a common musculoskeletal problem caused by presence of trigger points and local and referred pain patterns. Chronic neck pain is responsible for the involvement of joints, ligaments, fascia and connective tissue as well. The objective of this study was to assess the impacts of Maitland's mobilization in patients with myofacial chronic neck pain. Maitland's mobilization is one of the most common manual therapy approaches used by physiotherapists. Maitland's techniques involve the application of passive and accessory oscillatory movements to spinal and vertebral joints to treat pain and stiffness.

In this randomized, placebo treatment controlled trial, 30 patients consecutively aged 25-45 years meeting inclusion criteria were isolated into two groups. The study group was treated with Maitland's mobilization consistently for 8 weeks while the control group got placebo treatment for a similar time frame. Visual analog Scale (VAS), Neck disability index (NDI) and cervical range of motion (ROM) questionnaire was filled by patients before, intermediate and after the intervention to evaluate the severity of pain, functional ability and range of motion.

Enrollment: 30 patients

Sex: All

Ages: 25 to 45 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients age between 25-45 years old,
• Bilateral pain involving the upper trapezius and elevator muscle of the scapula;
• Duration of pain of at least 3 months;
• A pain intensity corresponding to at least 2 cm on a 10 cm visual analogue scale (VAS); -Neck pain with symptoms provoked by either neck postures or neck movement;
• Pain localized at least in the cervical and occipital regions but not in the orofacial region; --Neck disability index (NDI) greater than or equal to 15 points;
• Restricted cervical range of movements (flexion, extension, rotation, and side-bending); ---Presence of bilateral MTrPs in upper trapezius and levator scapulae muscles were included in this study.

Exclusion criteria

• A history of traumatic injuries (e.g., contusion, fracture, and whiplash injury);
• Systemic diseases such as fibromyalgia, systemic erythematous lupus and arthritis;
• Neurologic disorders (e.g., trigeminal neuralgia or occipital neuralgia);
• Concomitant medical diagnosis of any primary headache (tension type or migraine);
• Cervical spine surgery; and clinical diagnosis of cervical radiculopathy or myelopathy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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30 participants in 2 patient groups

Study Group

Experimental group

Description:

The study group was treated with Maitland mobilization and manipulation techniques including postero-anterior Maitland mobilization for C1-C2, Maitland lateral PA glide for C3-C6 and Maitland thrust manipulation for cervico-thoracic junction. Frequency of mobilization was 2 days a week for 4 weeks. While intensity of mobilization was grade 3 and 4 based on the Maitland concept.13 Time of oscillations was 2 or 3 oscillations in a second for 1 to 2 minutes.

Treatment:

Other: Maitland's mobilization

Control Group

Active Comparator group

Description:

While placebo treatment with conventional physiotherapy (active exercises-10 repetitions in all direction in pain free range, isometrics 5-10 seconds brief but maximum contraction each held for 5-16 seconds for flexors, extensors, side flexors and rotators)14 without gliding, oscillations and thrust were recommended for the control group.The placebo group was treated with baseline treatment including TENS 10 minutes and moist hot packs in sitting position for 15 minutes on cervical region in with head resting on table with a pillow.

Treatment:

Other: Traditional Physical therapy