About
Scope & Aims
Editorial office
Editorial board
Reviewers
Ethical standards and procedures
Abstracting and indexing
Contact
Articles & Issues
Current issue
Articles in press
Archive
For Authors
General rules
Guide for authors
Templates
Publication charge
For Reviewers
Guide for reviewers
Our reviewers
ORIGINAL PAPER
Efficacy of Mulligan on electromyography activation of cervical muscles in mechanical neck pain: randomised experimental trial
1
Faculty of Physical Therapy, Cairo University, Giza, Egypt
Submission date: 2022-01-04
Acceptance date: 2022-03-02
Publication date: 2023-02-14
Physiother Quart. 2023;31(4):7-14
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The aim of this trial is to determine the efficacy of the Mulligan mobilisation technique on electromyography activation of cervical muscles, pain, and function in chronic mechanical neck pain.
Methods:
Ninety subjects of both sexes (44 females and 46 males) who were diagnosed with chronic mechanical neck pain by a physician and referred to the clinic of physiotherapy participated in this randomised controlled trial. The subjects were randomly allocated to two groups: group A, which is the experimental group, received the Mulligan technique combined with conventional therapy, and group B, which is the control group, received conventional therapy only. The two groups were given the treatment three times a week for four weeks. In this trial, muscle activity, pain and function were measured using electromyography, the visual analogue scale and the Arabic neck disability index, respectively, and measured before and after the 12 sessions of the treatment.
Results:
MANOVA was used to detect the effect of treatment and time on all measured variables, which revealed a statistically significant effect (p < 0.05) in treatment and time in both groups.
Conclusions:
Mulligan has a positive effect on muscle activity, pain and function in subjects with mechanical neck pain in excess of conventional therapy alone.
The aim of this trial is to determine the efficacy of the Mulligan mobilisation technique on electromyography activation of cervical muscles, pain, and function in chronic mechanical neck pain.
Methods:
Ninety subjects of both sexes (44 females and 46 males) who were diagnosed with chronic mechanical neck pain by a physician and referred to the clinic of physiotherapy participated in this randomised controlled trial. The subjects were randomly allocated to two groups: group A, which is the experimental group, received the Mulligan technique combined with conventional therapy, and group B, which is the control group, received conventional therapy only. The two groups were given the treatment three times a week for four weeks. In this trial, muscle activity, pain and function were measured using electromyography, the visual analogue scale and the Arabic neck disability index, respectively, and measured before and after the 12 sessions of the treatment.
Results:
MANOVA was used to detect the effect of treatment and time on all measured variables, which revealed a statistically significant effect (p < 0.05) in treatment and time in both groups.
Conclusions:
Mulligan has a positive effect on muscle activity, pain and function in subjects with mechanical neck pain in excess of conventional therapy alone.
REFERENCES (41)
1.
Parikh P, Santaguida P, Macdermid J, Gross A, Eshtiaghi A. Comparison of CPG’s for the diagnosis, prognosis and management of non-specific neck pain: a systematic review. BMC Musculoskelet Disord. 2019;20(1):81; doi: 10.1186/s12891-019-2441-3.
2.
Fejer R, Kyvik KO, Hartvigsen J. The prevalence of neck pain in the world population: asystematic critical review of the literature. Eur Spine J. 2006;15:834–848; doi: 10.1007/s00586-004-0864-4.
3.
Ghaderi F, Jafarabadi MA, Javanshir K. The clinical and EMG assessment of the effects of stabilization exercise on nonspecific chronic neck pain: a randomizes controlled trial. J Back Musculoskelet Rehabil. 2017;30(2):211–219; doi: 10.3233/BMR-160735.
4.
Hidalgo B, Hall T, Bossert J, Dugeny A, Cagnie B, Pitance L. The efficacy of manual therapy and exercise for treating non-specific neck pain: a systematic review. J Back Musculoskelet Rehabil. 2017;30(6):1149–1169; doi: 10.3233/BMR-169615.
5.
Vernon H, Humphreys K, Hagino C. Chronic mechanical neck pain in adults treated by manual therapy: a systematic review of change scores in randomized clinical trials. J Manipulative Physiol Ther. 2007;30(3):215–227; doi: 10.1016/j.jmpt.2007.01.014.
6.
Kumar S, Prasad N. Cervical EMG profile differences between patients of neck pain and control. Disabil Rehabil 2010;32(35): 2078–2087; doi: 10.3109/09638288.2010.481029.
7.
Zakharova-Luneva E, Jull G, Johnston V, O’Leary S. Altered trapezius muscle behavior in individuals with neck pain and clinical signs of scapular dysfunction. J Manipulative Physiol Ther. 2012;35(5):346–353; doi: 10.1016/j.jmpt.2012.04.011.
8.
Kristjansson E, Leivseth G, Brinckmann P, Frobin W. Increased sagittal plane segmental motion in the lower cervical spine in women with chronic whiplash-associated disorders, grades I–II: a case-control study using a new measurement protocol. Spine. 2003;28(19):2215–2221; doi: 10.1097/01.BRS.0000089525.59684.49.
9.
Hodges PW, Tucker K. Moving differently in pain: a new theory to explain the adaptation to pain. Pain. 2011;152(3 Suppl):90–98; doi: 10.1016/j.pain.2010.10.020.
10.
Tsang SMH, Szeto GPY, Lee RYW. Altered spinal kinematics and muscle recruitment pattern of the cervical and thoracic spine in people with chronic neck pain during functional task. J Electromyogr Kinesiol. 2014;24(1):104–113; doi: 10.1016/j.jelekin.2013.10.011.
11.
Grase MO, Ali OI, RezkAllah SS, Abdelsattar MH, Elhafez HM. Inter-relationships between cervical angles, muscle activity levels and mechanical neck pain. J Med Sci. 2018;18(1):11–19; doi: 10.3923/jms.2018.11.19.
12.
Childs JD, Cleland JA, Elliott JM, Teyhen DS, Wainner RS, Whitman JM, Sopky BJ, Godges JJ, Flynn TW.Neck pain: clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopedic section of the American physical therapy association. J Orthop Sports Phys Ther. 2008;38(9):1–34; doi: 10.2519/jospt.2008.0303.
13.
Damgaard P, Bartels EM, Inge R, Christensen R, Juul-Kristensen B. Evidence of physiotherapy interventions for patients with chronic neck pain: a systematic review of randomized controlled trial. ISRN Pain. 2013;2013:567175; doi: 10.1155/2013/567175.
14.
Tank KD, Choksi P, Makwana P. To study the effect of muscle energy technique versus Mulligan snags on pain, range of motion and functional disability for individuals with mechanical neck pain: a comparative study. Int J Physiother Res. 2018;6(1):2582–2587; doi: 10.16965/IJPR.2017.253.
15.
Vicenzino B, Paungmali A, Teys P. Mulligan’s mobilisation-with-movement, positional faults and pain relief: current concepts from a critical review of the literature. Man Ther. 2007;12(2):98–108; doi: 10.1016/j.math.2006.07.012.
16.
Duymaz T, Yagci N. Effectiveness of the Mulligan mobilization technique in mechanical neck pain. J Clin Anal Med. 2018;9(4):304–309; doi: 10.4328/jcam.5715.
17.
Zemadanis K. The short and mid-term effects of Mulligan concept in patients with chronic mechanical neck pain. J Nov Physiother Rehabil. 2018;2(2):022–021; doi: 10.29328/journal.jnpr.1001018.
18.
Aggarwal S, Verma M. Efficacy of Mulligan’s self‑sustained natural apophyseal glides in decreasing pain, disability, and improving neck mobility among the nursing professional suffering from work-related neck pain. Arch Med Health Sci. 2018;6(1):48–53; doi: 10.4103/amhs.amhs_8_18.
19.
Ali MN, Sethi K, Noohu MM. Comparison of two mobilization techniques in management of chronic non-specific low back pain randomized controlled trial. J Bodyw Mov Ther. 2019;23(4):918–923; doi: 10.1016/j.jbmt.2019.02.020; doi: 10.1016/j.jbmt.2019.02.020.
20.
Schulz KF, Altman DG, Moher D, CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. BMJ. 2010;340:c332; doi: 10.1136/bmj.c332.
21.
Cazotti LA, Jones A, Roger-Silva D, Ribeiro LHC, Natour J. Effectiveness of the Pilates method in the treatment of chronic mechanical neck pain: a randomized controlled trial. Arch Phys Med Rehabil. 2018;15(1):220–227; doi: 10.1016/j.apmr.2018.04.018.
22.
Boonstra AM, Preuper HRS, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008;31(2):165–169; doi: 10.1097/MRR.0b013e3282fc0f93.
23.
MacDermid JC, Walton DM, Avery S, Blanchard A, Etruw E, McAlpine C, et al. Measurement properties of the neck disability index: a systematic review. J Orthop Sports Phys Ther. 2009;39(5):400–417; doi: 10.2519/jospt.2009.2930.
24.
Shaheen AAM, Omar MTA, Vernon H. Cross-cultural adaptation, reliability, and validity of the arabic version of neck disability index in patients with neck pain. Pain. 2013;38(10):609–615; doi: 10.1097/BRS.0b013e31828b2d09.
25.
El-Abd AM, Ibrahim AR, El-Hafez HM. Efficacy of kinesio taping versus postural correction exercises on pain intensity and axioscapular muscles activation in mechanical neck dysfunction: a randomized blinded clinical trial. J Sports Med Phys Fitness. 2017;57(10):1311–1317; doi: 10.23736/S0022-4707.16.06522-1.
26.
McLean L. The effect of postural correction on muscle activation amplitudes recorded from the cervicobrachial region. J. Electromyogr Kinesiol. 2005;15(6):527–535; doi: 10.1016/j.jelekin.2005.06.003.
27.
Johnston V, Jull G, Darnell R, Jimmieson NL, Souvlis T. Alterations in cervical muscle activity in functional and stressful tasks in female office workers with neck pain. Eur J Appl Physiol. 2008;103(3):253–264; doi: 10.1007/s00421-008-0696-8.
28.
Falla D, Dall’Alba P, Rainoldi A, Merletti R, Jull G. Location of innervation zones of sternocleidomastoid and scalene muscles – a basis for clinical and research electromyography applications. Clinic Neurophysiol. 2002;113(1):57–63; doi: 10.1016/s1388-2457(01)00708-8.
29.
Larsson B, Karlsson S, Eriksson M, Gerdle B. Test-retest reliability of EMG and peak torque during repetitive maximum concentric knee extensions. J Electromyogr Kinesiol. 2003;13(3):281–287; doi: 10.1016/s1050-6411(03)00022-1.
30.
Akshay Pal, Anand Misra. Effectiveness of snag mobilization on computer professionals with mechanical neck pain and mobility deficit. Int J Physiother Res 2019;7(2):3022-3027; doi: 10.16965/ijpr.2019.104.
31.
Gupta S, Jaiswal P, Chhabra DA. Comparative study between postisometric relaxation and isometric exercises in non-specific neck pain. J Exerc Sci Physiother. 2008;4(2):88–94; doi: 10.18376//2012/v8i2/67588.
32.
Häkkinen A, Salo P, Tarvainen U, Wiren K, Ylinen J. Effect of manual therapy and stretching on neck muscle strength and mobility in chronic neck pain. J Rehabil Med. 2007;39(3):575–579; doi: 10.2340/16501977-0094.
33.
Griffths C, Dziedzic K, Waterfield J, Sim J. Effectiveness of specific neck stabilization exercises or a general neck exercises program for chronic neck disorder: a randomized controlled trial. J Rheumatol. 2009;36(2):390–397. doi: 10.3899/jrheum.080376.
34.
Sterling M, Jull G, Wright A. Cervical mobilization: concurrent effects on pain, sympathetic nervous system activity and motor activity. Man Ther. 2001;6(3):72–81; doi: 10.1054/math.2000.0378.
35.
Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther. 2009;14(5):531–538; doi: 10.1016/j.math.2008.09.001.
36.
Schmid A, Brunner F, Wright A, Bachmann LM. Paradigm shift in manual therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilization. Man Ther. 2008;13(5):387–396; doi: 10.1016/j.math.2007.12.007.
37.
Kumar D, Mulligan BR. Manual of Mulligan Concept. 1st ed. CreateSpace Independent Publihsing Platform; 2014.
38.
Ganesh GS, Mohanty P, Pattnaik M, Mishra C. Effectiveness of mobilization therapy and exercises in mechanical neck pain. Physiother Theory Pract. 2015;31(2),99–106; doi: 10.3109/09593985.2014.963904.
39.
Exelby L. The Mulligan concept: its application in the management of spinal conditions. Man Ther. 2002;7(2):64–70; doi: 10.1054/math.2001.0435.
41.
Morningstar M. Cervical curve restoration and forward head posture reduction for the treatment of mechanical thoracic pain using the pettibon corrective and rehabilitative procedures. J Chiropr Med. 2002;1(3):113–115; doi: 10.1016/S0899-3467(07)60013-5.
Share
RELATED ARTICLE
| eISSN: | 2544-4395 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
