Mulligan Mobilizations and McKenzie Exercises Along With Neural Mobilizations in Cervical Spondylosis

Effectiveness of Mulligan Mobilizations With Upper Limb Movement and McKenzie Exercises Along With Neural Mobilizations in Cervical Spondylosis - A Comparative Randomized Controlled Trial

Cervical pain is one of the common problem among general population. However, cervical spondylosis may cause unavoidable neck pain and range limitations due to wear and tear changes in the cervical spine. This condition can further lead to dysfunction and neuro musculoskeletal symptoms. Literature suggests the use of Mulligan therapy, McKenzie exercises and Neural mobilizations in spondylosis. According to author's knowledge there is limited evidence regarding effects of specific treatment approach.

A randomized control trial will be conducted among 80 patients with cervical spondylosis having age group 40 to 60 years. The non-probability purposive sampling technique will be used to recruit on the basis of study criteria. The study settings will be Dow University of health sciences, Karachi Pakistan. After taking informed consent all the patients will be randomized into two groups (A, B). Group A will receive mulligan with upper limb movement of involved side, group B will receive McKenzie exercises and neural mobilizations. Patients will be evaluated at baseline and after four weeks of treatment by using a goniometer, numerical pain rating scale (NPRS), and neck disability index (NDI) for cervical range of motions, pain intensity and neck disability respectively. There will be twelve sessions of treatment with thrice a week.

Duration of each session will be thirty minutes. All the data will be entered and analyzed through statistical package of social sciences version 24. Descriptive analysis will be performed for both continuous and categorical data. Inferential statistics will be performed to compare pain, disability index and range of motion between group and within group. The level of significance will be considered as 0.05.

Inclusion Criteria:

• 40 - 60 years old adults.
• Diagnosed and referred cases of cervical spondylosis and both males and females are included.
• Unilateral radiculopathy pain C5-C8 and T1.
• Individuals whose Spurling's and distraction test is positive.
• Patients with NPRS > 3/10 score.
• Patients with ipsilateral cervical rotation less than 60 degrees.

Exclusion Criteria:

Individuals with history of;

• cervical or shoulder girdle trauma.
• any specific pathology or red flags (diplopia, dizziness, drop attacks, dysarthria, dysphagia)
• cervical myelopathy
• neoplastic lesions
• vertebral artery insufficiency
• upper cervical ligamentous instability,
• spondylolisthesis
• hypermobile cervical spine
• cervical fracture inflammatory
• cardiac or severe psychiatric disease.