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Multimodal Manual Therapy vs. Maitland Mobilization for Chronic Non-Specific Neck Pain
Sponsor: University of Management and Technology Lahore
Summary
Chronic non-specific neck pain (CNNP) is a common musculoskeletal disorder associated with persistent pain, functional disability, and reduced quality of life. Manual therapy techniques such as Maitland mobilization and multimodal manual therapy are frequently used in physiotherapy; however, evidence directly comparing their effectiveness remains limited. This study aims to compare the effects of Multimodal Manual Therapy and Maitland Mobilization on pain intensity, functional disability, and quality of life in patients with chronic non-specific neck pain. A randomized clinical trial will be conducted at Life Care Hospital, Bahawalnagar, involving 54 participants aged 18-35 years who meet the inclusion criteria. Participants will be randomly allocated into two equal groups. Group A will receive Maitland mobilization, while Group B will receive Multimodal Manual Therapy, including high thoracic manipulation (T4), cervical mobilization, and suboccipital muscle inhibition. Both groups will receive treatment three times per week for four weeks. Outcome measures will include the Numeric Pain Rating Scale (NPRS) for pain, the Neck Disability Index (NDI) for functional disability, and the Short Form-12 (SF-12) questionnaire for quality of life. Assessments will be performed at baseline, the second week, and the fourth week. Data will be analyzed using SPSS version 24, with appropriate parametric or non-parametric statistical tests based on data distribution. The findings of this study are expected to identify the more effective intervention for improving pain, disability, and quality of life in individuals with chronic non-specific neck pain. The results may assist physiotherapists in selecting evidence-based treatment strategies and contribute to improving clinical management of this condition
Official title: Comparative Effects of Multimodal Manual Therapy and Maitland Mobilization on Pain, Functional Disability and Quality of Life in Patients With Chronic Non-Specific Neck Pain.
Key Details
Gender
All
Age Range
18 Years - 35 Years
Study Type
INTERVENTIONAL
Enrollment
64
Start Date
2026-10-27
Completion Date
2026-12-31
Last Updated
2026-11-03
Healthy Volunteers
No
Conditions
Interventions
Maitland Mobilization Treatment Approach
Maitland Mobilization will be applied to the cervical and upper thoracic spine using Grade III and Grade IV oscillatory techniques. Before treatment, a detailed assessment including Active Movement Testing, Passive Physiological Intervertebral Movement (PPIVM), and Passive Accessory Intervertebral Movement (PAIVM) will be performed to identify hypomobile and symptomatic spinal segments. Grade III mobilization will be used to increase joint mobility and reduce stiffness, while Grade IV mobilization will be applied at the end range of motion to improve segmental movement and restore normal arthrokinematics. Mobilization will be directed to the restricted cervical and upper thoracic segments according to individual patient findings. Each treatment session will last approximately 60 minutes, three times per week, for a period of two weeks under the supervision of a qualified physiotherapist
Manual therapy protocol
1. High thoracic manipulation on T4; Patients are positioned supine with their arms crossed in a "V" shape over the chest. The therapist contacts the fist at the level of the spinous process of T4 and blocks the patient's elbows with his chest. Following this, he introduces flexion of the cervical spine until a slight tension is felt in the tissues at the point of contact. Downward and cranial manipulation is applied. If cavitation is not achieved on the first attempt, the therapist repositions the patient and performs a second manipulation. A maximum of two attempts will be allowed in each patient(22). 2. Cervical articular mobilization (2 Hz, 2 min × 3 series); The patient is placed on the stretcher in a prone position, placing both hands under his forehead. The therapist makes contact with his two thumbs on the spinous process of the patient vertebra and performs grade III posteroanterior impulses at a speed of 2Hz and for 2 min. There are 3 mobilization intervals with a minute of
Locations (1)
University of Management & Technology
Lahore, Punjab Province, Pakistan