Comparative Effects of Gong's Mobilization and Maitland Mobilization in Patients With Cervical Spondylosis

Comparative Effects of Gong's Mobilization and Maitland Cervical Mobilization on Pain, Range of Motion, and Muscle Strength in Patients With Cervical Spondylosis

Cervical spondylosis is a degenerative condition of the cervical spine that may cause neck pain, reduced cervical range of motion, muscle weakness, and functional disability. Manual therapy is commonly used as part of conservative physiotherapy management. This randomised controlled trial compares Gong's mobilisation with Maitland cervical mobilisation in patients with cervical spondylosis. This randomised controlled trial aims to compare the effects of Gong's mobilisation and Maitland's mobilisation on pain intensity, cervical range of motion, cervical muscle strength, and functional disability in individuals with cervical spondylosis. A total of 50 participants diagnosed with cervical spondylosis were randomly allocated into two equal groups using a computer-generated randomisation method. Group A received Gong's mobilisation combined with conventional physiotherapy, while Group B received Maitland mobilisation combined with the same conventional physiotherapy programme. Conventional treatment included transcutaneous electrical nerve stimulation (TENS) and cervical isometrics. Outcome measures included the Numeric Pain Rating Scale (NPRS) for pain intensity, a universal goniometer for cervical range of motion, Manual Muscle Testing (MMT) for cervical muscle strength, and the Neck Disability Index (NDI) for functional disability. Assessments were performed at baseline and after completion of the treatment period. The findings of this study were intended to determine the comparative effectiveness of Gong's mobilisation and Maitland mobilisation and to provide evidence-based recommendations for the physiotherapy management of patients with cervical spondylosis.

This randomised controlled trial was conducted to compare the effects of Gong's mobilisation and Maitland cervical mobilisation in patients with cervical spondylosis. The study evaluated changes in pain intensity, cervical range of motion, cervical muscle strength, and functional disability following a four-week physiotherapy intervention. A total of 50 participants with clinically diagnosed cervical spondylosis were randomly allocated into two equal groups using a computer-generated randomisation method. Group A received Gong's mobilisation combined with conventional physiotherapy, while Group B received Maitland cervical mobilisation combined with the same conventional physiotherapy programme. Both groups received treatment three times per week for four weeks, for a total of 12 treatment sessions. Outcome assessments were performed before and after the treatment period. Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS); cervical range of motion was assessed using a universal goniometer; cervical muscle strength was assessed using Manual Muscle Testing (MMT); and functional disability was assessed using the Neck Disability Index (NDI). Participant recruitment, treatment, and data collection were conducted at two clinical settings in Faisalabad, Punjab, Pakistan: Madina Teaching Hospital and Irfan Medical City. Participants were selected according to predefined eligibility criteria and were randomly allocated to the two intervention groups using a computer-generated randomisation sequence. The study aimed to determine whether Gong's mobilisation or Maitland cervical mobilisation produced greater improvements in clinical outcomes when combined with conventional physiotherapy. The findings were intended to contribute to evidence-based physiotherapy management of patients with cervical spondylosis.

Inclusion Criteria: • Individuals aged 40-60 years

• Both genders, male & female.
• Participants with a physician/orthopaedic diagnosis of cervical spondylosis, confirmed by cervical spine radiography (X-ray) demonstrating degenerative changes such as intervertebral disc-space narrowing, osteophyte formation, or facet/vertebral joint degeneration.
• Limited range of motion
• Symptoms present for more than one month
• Limited cervical range of motion for over 2 months.

Exclusion Criteria:

• Participants were excluded if they reported a history of

  • Cervical Radiculopathy: Patients who exhibit evidence of constriction of the normal cervical nerve roots, as indicated by positive findings from the Upper Limb Tension Test (ULTT1), Spurling's test, the cervical distraction test, and neurological examination.
  • Neck Sprain and Periarthritis of the Shoulder (Adhesive Capsulitis).
  • Rheumatic Myofibrositis: People with a medical history or a doctor's diagnosis of rheumatic or inflammatory musculoskeletal diseases.
  • Neurological conditions (Neurasthenia): Patients having history of illness and neurological examination indicate that they have neurological problems compromising neck mobility or pain perception
  • Fracture of the cervical spine.
  • Cervical instability/subluxation/spondylolisthesis.
  • Cervical Instability: Those who tested positive for upper cervical instability, either the Sharp-Purser Test or the Transverse Ligament Stress Test, were removed.
  • Vestibular basilar insufficiency, Cervicogenic headache, vertigo, dizziness
  • Thoracic outlet syndrome