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Neck pain is considered one of the very common cause behind musculoskeletal pain and is 4th leading cause of disability . Cervical pain is among 5 most contributing factors in causing years lived with disability.Individuals with unilateral neck pain exhibit significantly less Lower Trapezius strength than Middle and Upper Trapezius fibers .Mulligan is one of the mobilization techniques that can be applied in case of neck pain.In prolong neck pain there is a hyperactivation and shortening of upper trapezius which makes the lower trapezius weak this leads to imbalance between cervical and scapular muscles and result in impaired biomechanics. So mostly treatment focused on upper trapezius and neglecting the lower trapezius and this create increase chances of recurrency of neck pain because the imbalance remains present. So, this study aims at evaluating the effects of SNAGS combined with strengthening exercises of lower fibers of trapezius .
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SNAGS + Conventional PT Group | Experimental | Participants of this group receive conventional physical therapy.Hot pack and tens ( 10 min each)
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| SNAGS+Strengthening of lower fibers trapezius+Conventional PT Group | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Conventional Physical Therapy | Procedure | It will comprise of hot pack for 10 minutes, TENs at 80-100 Hz over trapezius for 10 minutes.Strengthening of deep neck flexors |
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| Measure | Description | Time Frame |
|---|---|---|
| Pain intensity | Pain will be measured on the basis of Numeric Pain Rating Scale score.It is rated on 0-10 scale in which 0 means no pain and 10 means the maximum possible pain | 2 weeks |
| ROM | Cervical ROM will be measured through CROM device | 2 weeks |
| Level of Neck Disability | Neck Disability Index will be used to measure level of neck disability | 2 weeks |
| Muscle strength | MMT for Lower fibers of trapezius | 2 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Foundation University College of Physical Therapy | Rawalpindi | Punjab Province | 46000 | Pakistan |
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This is a randomized controlled trial having two groups. One group will receive conventional physical therapy along with SNAGS and the second will receive SNAGS and strengthening of lower fibers of trapezius with conventional physical therapy. Both groups will be recruited concurrently.
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The outcome assessor will not be aware of which group the participant belongs to.
| Strengthening Exercise | Procedure | Strengthening exercises of lower fibers of trapezius |
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| SNAG'S | Procedure | Sustained natural apophysial glides will consist of frequency: 4 sets of 3-5 repetition per session for 2 weeks |
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| ID | Term |
|---|---|
| D019547 | Neck Pain |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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