Effects of Diaphragm Manual Therapy Verses Sustained Natural Apophyseal Glide in Mechanical Neck Pain

Riphah International University

Status: Completed

Conditions: Neck Pain

Treatments: Other: Baseline treatment

Study type: Interventional

Funder types: Other

Identifiers

NCT06460532

REC/RCR & AHS/23/0196 Anam

Details and patient eligibility

About

Mechanical neck pain is defined as pain and discomfort localized between the superior nuchal line, cervical spine, and the spinous process of the first thoracic vertebra. Some of the most typical factors include continuous use of mobile phones and computers, working in sedentary jobs, etc. Study aimed to compare diaphragm manual therapy and Sustained Natural Apophyseal Glide on pain, range of motion and functional disability in patients with mechanical neck pain.

Full description

This project will be a Randomized Clinical Trial conducted to check the effects of Diaphragm manual therapy versus sustained natural apophyseal glide on pain, range of motion and functional disability in patients with mechanical neck pain at Sehat Medical Complex Lahore through non-probability convenient sampling technique on 34 patients will be allocated using simple random sampling through Computer generated Randomization into Group A and Group B. Group A will be treated with Diaphragm Manual Therapy and baseline treatment was given and Group B with Sustained Natural Apophyseal Glide and baseline treatment was given. All Exercise were performed 3 times a week for total 4 weeks. Outcome measures will be conducted through NPRS for pain, ROM measured by Goniometer, and Neck Disability Index (NDI) for Disability after 4 weeks. Data was analyzed during SPSS software version 25. After assessing the normality of data by the Shapiro-Wilk test, it decided whether either parametric or non-parametric tests were used within a group or between two groups.

Enrollment: 34 patients

Sex: All

Ages: 18 to 40 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age group between 18 and 40 years
• Both gender male and female
• Individuals having localized pain or stiffness in the cervical spine or both combined between C3 and C7 without upper-limb radiculopathy
• Pain reported on NPRS score ˃3 to <7/10 in neck region for more than 3 months.
• Limited Neck ROM
• Negative Spurling's test, traction test, upper limb tension test, and shoulder abduction test

Exclusion criteria

Patients were excluded if they were diagnosed with the following conditions for ˃6 months

• Tuberculosis, carcinoma, heart disease, and osteoporosis
• Neural disorders due to prolapsed intervertebral disc
• Any trauma or localized infection in neck region
• Upper motor neuron disease, cervical stenosis, and metabolic diseases in bone and joint
• Hyper flexibility
• Open sores
• Ongoing radiotherapy, chemotherapy, steroid therapy, or anticoagulants
• Psychiatric diseases such as phobia/obsession and depression
• Allergy to hot pack
• Patients with history of surgery in cervical spine region with in a year.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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34 participants in 2 patient groups

Group A: Diaphragm Manual Therapy

Experimental group

Description:

Group A were receiving diaphragm Manual therapy by Leon Chaitow. Subsequently, in order to indirectly stretch and mobilize the fibres of the diaphragm, diaphragmatic manual therapy was used, which should result in improved muscle contraction and reduced tension. The doming diaphragmatic technique and the manual diaphragmatic release technique, both as described by Leon Chaitow, will be among the experimental methods employed. For 10 min, both manoeuvres were performed in 2 sets of 10 repetitions each, separated by 1 min.

Treatment:

Other: Baseline treatment

Group B: Sustained Natural Apophyseal Glide (SNAGs)

Active Comparator group

Description:

Group B has received the Sustained natural apophyseal glide (SNAGS). Treatment procedure for SNAGs was sustained natural apophyseal glides whereby the patient attempts to actively move a painful or stiff joint through its ROM while the therapist overlays an accessory glide parallel with the treatment plane. SNAG mobilization was given to a patient (as defined by Mulligan) sitting on a chair. At the same time, the treating physiotherapist stood behind by placing the medial border of the distal phalanx of the thumb on the spine of one vertebra above the affected region. The glides were given with the tip of the thumb placed at an angle of 45° along the eyeball direction reinforced by another thumb. In the session, glides were repeated six times, and three sets were given at C3-C7 cervical levels.

Treatment:

Other: Baseline treatment