Back to resultsEffect of Mulligan Snag and Diaphragmatic Release on Thoracic Kyphosis
Primary Purpose
Postural Kyphosis, Cervicothoracic Region
Status
Completed
Phase
Not Applicable
Locations
Egypt
Study Type
Interventional
Intervention
mulligan snag mobilization and diaphragmatic release
Sponsored by
About this trial
This is an interventional treatment trial for Postural Kyphosis, Cervicothoracic Region
Eligibility Criteria
Inclusion Criteria:
- Age ranged from 17 to 22 years .
- Body Mass Index from 20 to 25 kg/m² .
- All participants have an intensity of neck pain on VAS (4-8) (moderate cases) .
- The subjects were chosen from both sexes.
- All participants have kyphosis angle ≥42°
- All participants have mechanical neck pain and FHP (craniovertebral angle CVA < 49) CVA of < 49) .
Exclusion Criteria:
- Malignancy
- Fractures of the cervical spine
- Cervical radiculopathy or myelopathy
- Vascular syndromes such as vertebrobasilar insufficiency
- Rheumatoid arthritis
- Neck or upper back surgery
- Taking anticoagulants
- Local infection
- Whiplash injury
Sites / Locations
- Faculty of physical therapy Cairo university
- Faculty of physical therapy
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Experimental
Experimental
Experimental
Active Comparator
Arm Label
diaphragmatic release, and conventional
mulligan SNAG mobilization, and conventional
mulligan SNAG mobilization, diaphragmatic release, and conventional
the conventional therapy
Arm Description
Diaphragmatic release: The patients will be positioned in the supine position. The therapist stood at the head of the patient. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ) with hypothenar regions of the hands and the last three fingers. During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally, while elevating the ribs simultaneously. During exhalation, the therapist will deepen hand contact toward the inner coastal margins for 5 to 7 minute conventional therapy: the patient will receive chin-in, interscapular exercises, and pectoralis stretch
mulligan snag: Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement and then sustains it at the end range position for a few seconds. (3 sets,10 repetitions) conventional therapy: the patient will receive chin-in, interscapular exercises, and pectoralis stretch
Diaphragmatic release: The patients will be positioned in the supine position. The therapist stood at the head of the patient. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ) with hypothenar regions of the hands and the last three fingers. During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally, while elevating the ribs simultaneously. During exhalation, the therapist will deepen hand contact toward the inner coastal margins. (5 to 7 minutes) mulligan snag: Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement and then sustains it at the end range position for a few seconds(3 sets,10 repetitions) conventional therapy: the patient will receive chin-in, interscapular exercises, and pectoralis stretch
the patient will receive chin-in, inter-scapular exercises, and pectoralis stretch (3 sets,10 repetitions)
Outcomes
Primary Outcome Measures
pain intensity
The scale that will be used is the Visual analogue scale;each subject will be instructed to put point on a line from no pain to tolerable pain
Secondary Outcome Measures
cervical range of motion
theCROM device will placed on patient's head while he/she seated and looking forward the difference between the ponter value and the value after movement will be recorded as the motion angle of the cervical vertebrae
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05458206
Brief Title
Effect of Mulligan Snag and Diaphragmatic Release on Thoracic Kyphosis
Official Title
Effect of Mulligan Snag and Diaphragmatic Release on Thoracic Kyphosis
Study Type
Interventional
2. Study Status
Record Verification Date
November 2022
Overall Recruitment Status
Completed
Study Start Date
October 20, 2022 (Actual)
Primary Completion Date
March 20, 2023 (Actual)
Study Completion Date
March 20, 2023 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Cairo University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
the aim of this study is to investigate the efficacy of mulligan snag mobilisation and diaphragmatic release on upper crossed syndrome
Detailed Description
Acquired postural disorders can be a consequence, to a large extent, of contemporary living and working conditions. Some of the most typical factors include continuous use of mobile phones and computers, working in sedentary jobs. Prolonged incorrect posture and reduced physical activity present a dis-balance in the musculature . It can also lead to vision issues, as well as headaches, musculoskeletal issues, and pain, as well as a multitude of other symptoms.
Upon the available research studies, there is not study conducted to investigate the effect of mulligan SNAG mobilization and diaphragmatic release in upper crossed syndrome patients this trial has four groups; one will receive diaphragmatic release + conventional, the second will receive mulligan SNAG mobilization, and conventional, the third will receive mulligan SNAG mobilization+diaphragmatic release+conventional, the fourth subjects will receive conventional
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Postural Kyphosis, Cervicothoracic Region
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
EFFECT OF MULLIGAN SNAG MOBILISATION AND DIAPHRAGMATIC RELEASE
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
60 (Actual)
8. Arms, Groups, and Interventions
Arm Title
diaphragmatic release, and conventional
Arm Type
Experimental
Arm Description
Diaphragmatic release:
The patients will be positioned in the supine position. The therapist stood at the head of the patient. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ) with hypothenar regions of the hands and the last three fingers. During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally, while elevating the ribs simultaneously. During exhalation, the therapist will deepen hand contact toward the inner coastal margins for 5 to 7 minute conventional therapy: the patient will receive chin-in, interscapular exercises, and pectoralis stretch
Arm Title
mulligan SNAG mobilization, and conventional
Arm Type
Experimental
Arm Description
mulligan snag: Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement and then sustains it at the end range position for a few seconds. (3 sets,10 repetitions) conventional therapy: the patient will receive chin-in, interscapular exercises, and pectoralis stretch
Arm Title
mulligan SNAG mobilization, diaphragmatic release, and conventional
Arm Type
Experimental
Arm Description
Diaphragmatic release:
The patients will be positioned in the supine position. The therapist stood at the head of the patient. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ) with hypothenar regions of the hands and the last three fingers. During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally, while elevating the ribs simultaneously. During exhalation, the therapist will deepen hand contact toward the inner coastal margins. (5 to 7 minutes) mulligan snag: Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement and then sustains it at the end range position for a few seconds(3 sets,10 repetitions) conventional therapy: the patient will receive chin-in, interscapular exercises, and pectoralis stretch
Arm Title
the conventional therapy
Arm Type
Active Comparator
Arm Description
the patient will receive chin-in, inter-scapular exercises, and pectoralis stretch (3 sets,10 repetitions)
Intervention Type
Other
Intervention Name(s)
mulligan snag mobilization and diaphragmatic release
Intervention Description
The patients will be in the supine position. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ). During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally. During exhalation, the therapist will deepen hand contact toward the inner coastal margins.
mulligan snag, Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement
Primary Outcome Measure Information:
Title
pain intensity
Description
The scale that will be used is the Visual analogue scale;each subject will be instructed to put point on a line from no pain to tolerable pain
Time Frame
up to four weeks
Secondary Outcome Measure Information:
Title
cervical range of motion
Description
theCROM device will placed on patient's head while he/she seated and looking forward the difference between the ponter value and the value after movement will be recorded as the motion angle of the cervical vertebrae
Time Frame
up to four weeks
Other Pre-specified Outcome Measures:
Title
forward head
Description
the craniovertebral angle (CVA) (the angle between the horizontal lines passing through and a line extending from the tragus of the ear to C7 notably). Lesser CVA indicates greater FHP
Time Frame
up to four weeks
Title
kyphotic angle
Description
the bubble inclinometer is gravity-dependent, it is first zeroed on a vertical wall prior to measurement. Using a standard clinical procedure. the cephalic foot of the inclinometer will be placed on the pencil mark already on the C7 spinous process. This procedure will be repeated for the lower thoracic spine, with the caudal foot of the inclinometer placed on the pencil mark for T12. Both inclinometer angles will be recorded, taking care to minimize parallax error with each measurement by ensuring the recorder's eyes are on the same horizontal plane as the inclinometer. The thoracic kyphosis measure from the inclinometer readings will be obtained by taking the difference between the two measurements.
Time Frame
up to four weeks
Title
chest expansion
Description
Measurements will be taken with the participants in a standing position with their arms along the body. The physiotherapist placed the "0" of the cloth tape measure on the appropriate vertebrae. The cloth tape will be held with an index finger between the participant's body and the cloth tape, without generating any deformation or cutaneous folds. The inspiratory diameter will be subtracted from the expiratory diameter to calculate the CE value.
Time Frame
up to four weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
17 Years
Maximum Age & Unit of Time
22 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age ranged from 17 to 22 years .
Body Mass Index from 20 to 25 kg/m² .
All participants have an intensity of neck pain on VAS (4-8) (moderate cases) .
The subjects were chosen from both sexes.
All participants have kyphosis angle ≥42°
All participants have mechanical neck pain and FHP (craniovertebral angle CVA < 49) CVA of < 49) .
Exclusion Criteria:
Malignancy
Fractures of the cervical spine
Cervical radiculopathy or myelopathy
Vascular syndromes such as vertebrobasilar insufficiency
Rheumatoid arthritis
Neck or upper back surgery
Taking anticoagulants
Local infection
Whiplash injury
Facility Information:
Facility Name
Faculty of physical therapy Cairo university
City
Cairo
State/Province
Giza
ZIP/Postal Code
12613
Country
Egypt
Facility Name
Faculty of physical therapy
City
Cairo
State/Province
Giza
ZIP/Postal Code
12613
Country
Egypt
12. IPD Sharing Statement
Learn more about this trial
Effect of Mulligan Snag and Diaphragmatic Release on Thoracic Kyphosis
We'll reach out to this number within 24 hrs