Immediate effects of mobilization with movement technique on cervical muscle stiffness, pain, and range of motion in individuals with mechanical neck pain: A double-blind randomized controlled trial

Abstract

Background: Mulligan sustained natural apophyseal glide (SNAG) is a mobilization technique that aims to reduce pain and improve function by correcting positional errors in the facet joint. Purpose: To investigate the immediate effects of the Mulligan SNAG application on muscle stiffness, pain, pressure pain threshold (PPT) and range of motion (RoM) in patients with chronic mechanical neck pain. Methods: A randomized, double-blind trial was conducted. Forty individuals with chronic mechan ical neck pain (mean age = 39.35 ± 6.68 years) were randomized into two groups: Mobilization with movement group (MWMG), and sham group (SG). Muscle stiffness was measured with MyotonPro, pain intensity with Numerical Pain Rating Scale, cervical RoM with a digital inclinometer, and PPT with an algometer. Measurements were performed pre-and 5 minutes post-intervention in a single session. Results: Muscle stiffness significantly changed in the MWMG for the left trapezius and right cervical extensors (p = .003, effect size (ES) = 0.42; p = .031, ES = 0.49, respectively), whereas no significant changes were observed in the SG (p = .097, ES = 0.12; p = .270, ES = 0.22, respectively). The MWMG showed improvements in pain (p = .001, ES = 0.70) and RoM (right: p = .0001, ES = 0.89; left: p = .0001, ES = 0.99). The SG also showed improvements in pain (p = .0001, ES = 0.76) and RoM (right: p = .0001, ES = 0.49; left: p = .0001, ES = 0.35). PPT improvements were observed in the MWMG for right and left trapezius (p = .0001, ES = 1.21; p = .040, ES = 0.43, respectively), whereas no significant changes occurred in the SG (p = .713, ES = 0.03; p = .839, ES = 0.01, respectively). Conclusion: The mobilization with movement technique leads to significant immediate improve ments in muscle stiffness and pain-related parameters in individuals with chronic neck pain.