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forty-five patients with MNP and FHP age from 25-40 years will be randomly assigned into three groups: Group A (study): 15patients will receive (upper cervical translatoric mobilization) and traditional physical therapy, Group B (study): 15patients received sub occipital muscle energy technique and traditional physical therapy, and Group C (control): 15 patients will receive the traditional physical therapy treatment only . Interventions will be conducted three times a week for four weeks. Craniovertebral angle (CVA) using Photographic Posture Analysis Method (surgimap software), pain intensity using viual analogue scale (VAS), Cervical ROM using CROM device, and neck functional ability using Neck Disability Index (NDI) will be assessed for all participants before and after the treatment program.
This randomized controlled trial aims to compare the efficacy of Upper Cervical Translatoric Mobilization (UC-TSM) and Sub-Occipital Muscle Energy Technique (MET) in patients with Mechanical Neck Pain (MNP) and Forward Head Posture (FHP). Forty-five participants will be randomly assigned to one of three groups: Group A (UC-TSM + conventional physical therapy), Group B (Sub-Occipital MET + conventional physical therapy), and Group C (conventional physical therapy only). Interventions will be administered three times per week for four weeks. Outcomes include pain intensity (VAS), neck disability (NDI), cervical range of motion (CROM), and craniovertebral angle (CVA) assessed via photographic analysis (Surgimap). The study will be conducted at Benha University.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Upper Cervical Translatoric Mobilization | Experimental | Participants will receive Upper Cervical Translatoric Mobilization (UC-TSM) applied to the upper cervical spine (C0-C2), in addition to conventional physical therapy (hot pack and Kendall exercises), three times per week for 4 weeks. |
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| Sub-Occipital Muscle Energy Technique | Experimental | Participants will receive Sub-Occipital Muscle Energy Technique (MET) targeting the sub-occipital muscles, in addition to conventional physical therapy (hot pack and Kendall exercises), three times per week for 4 weeks. |
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| traditional physical therapy | Active Comparator | Participants will receive conventional physical therapy only, including application of a hot pack for 15 minutes followed by Kendall exercises for postural correction, three times per week for 4 weeks. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| upper cervical translatoric mobilisation | Other | (UC-TSM) is defined as a system of manual techniques using straight-line forces delivered in a parallel or perpendicular direction to an individual vertebral joint or motion segment there is also increasing in body of evidence supporting the its clinical effectiveness and safety in the management of patients with cervical impairments. |
| Measure | Description | Time Frame |
|---|---|---|
| Visual Analog Scale (VAS) for Pain Intensity | Pain intensity will be assessed using the Visual Analog Scale (VAS), a 10-cm line where 0 = "no pain" and 10 = "worst pain imaginable". A lower score indicates improvement. | Baseline and after 4 weeks of treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Visual Analog Scale (VAS) for Pain Intensity | Functional disability will be assessed using the Neck Disability Index (NDI), a 10-item questionnaire scored from 0 to 50, where higher scores indicate greater disability. | Baseline and after 4 weeks of treatment |
| Craniovertebral Angle (CVA) via Photographic Posture Analysis |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| reda K. Abdelrazik, associate professor | Benha University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Physical Therapy, Benha University | Cairo | Benha | Egypt |
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| sub occipital muscle energy technique | Other | Muscle Energy Technique (MET) is another form of a gentle manual therapy intervention that primarily targets the soft tissues, though it also contributes significantly to joint mobilization. It has been reported that, adding MET to exercise program resulted in better improvement in CVA and FHP than exercise group only |
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| traditional physical therapy | Other | hot pack and kendel exercise |
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The craniovertebral angle (CVA) will be measured using lateral-view photography and analyzed using Surgimap software. A higher CVA indicates improvement in forward head posture. |
| baseline and after 4 weeks |