Impact of Adding Integrated Neuromuscular Inhibition Technique to Mulligan Therapy in Symptomatic Forward Head Posture

Overview

this study will be conducted to investigate the impact of adding integrated neuromuscular inhibition technique to mulligan therapy in symptomatic forward head posture.

Detailed description

Forward head posture is anterior positioning of the cervical spine, which is regarded as a "bad" head posture and is commonly found in patients who experience problems with the head and neck. Particularly, forward head posture is frequently found in people sitting in front of a computer for prolonged periods. Load increases in the muscles and joints of the cervical spine as a result of forward head posture are considered a major cause of musculoskeletal disorders. INIT is effective as it causes sustained or intermittent compression which causes ischemia reduces local circulation until pressure is released, after which a flushing of fresh oxygenated blood occurs. Mechanoreceptors impulses interface with slower pain messages reducing amount of pain messges reaching the brain, releasing pain relieving hormones, decreasing myofascial pain. Stretches the taut bands of muscles fibers. INIT along with strengthening excercises proved to be beneficial in decreasing disability improving Range of motion. The concept of SNAG is to increase the treatment effects by having patients perform active movements while removing pain in the lesions by means of manipulative therapy. This is a new concept in the manipulative therapy field, and differs from traditional manipulative therapy by combining the active movements of the patients with additional passive movements performed with the aid of therapists

Interventions

• Other Integrated Neuromuscular Inhibition Technique and mulligan therapy
  patients will receive Integrated Neuromuscular Inhibition Technique in the form of intermittent ischemic compression, strain counter strain and muscle energy technique and mulligan therapy for limited cervical range of motion
• Other Integrated Neuromuscular Inhibition Technique
  patients will receive Integrated Neuromuscular Inhibition Technique in the form of intermittent ischemic compression, strain counter strain and muscle energy technique
• Other mulligan therapy
  patients will receive mulligan therapy for limited cervical range of motion
• Other postural correction exercises
  the patients will receive two strengthening exercises (deep cervical flexors and scapular retractors) and two stretching: cervical extensors (sub-occipital muscles) and pectoral muscles). The program was based on a program by Harman and Kendall

Primary outcome measures

• pain intensity [Time frame: up to six weeks]

Secondary outcome measures (4)

• neck disability [Time frame: up to 6 weeks]
• pressure pain threshold [Time frame: up to six weeks]
• cervical range of motion [Time frame: up to six weeks]
• craniovertebral angle [Time frame: up to six weeks]

Eligibility criteria

Inclusion criteria

• CVA equal or less than 50
• Had cervical pain for more than three months and had visited an orthopedist clinic

Exclusion criteria

• cervical spine spondylosis
• fractures or cervical spinal surgery
• Cervical or shoulder neurological movement disorder.
• Temporo-mandibular surgery, (5) Pathologic trauma

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Center list to be confirmed — check the primary protocol.

Identifiers

NCT: NCT07086872 · P.T.REC/012/005806

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗