Mid-term effects of Mulligan mobilization technique on pain intensity, cervical range of motion, and functional disability in individuals with chronic non-specific neck pain

Abstract

Chronic neck pain (CNP), defined as pain persisting beyond three months, and is a prevalent global health issue characterized by hyperalgesia and functional impairment. Among conservative interventions, Mulligan’s mobilization techniques are widely adopted in clinical practice for their established immediate and short-term benefits. However, the mid-term therapeutic effects of these techniques specifically for non-specific CNP (CNSNP) patients remain inadequately explored and constitute a significant gap in the current evidence base. The present research was therefore needed to address these gaps in the current evidence base with the aim to assess the mid-term clinical effectiveness of the Mulligan technique on pain intensity, cervical range of motion, and self-reported functional disability in individuals with non-specific CNSNP. In this randomized controlled trial, 100 participants were randomly assigned to two groups: an experimental group (n = 50), receiving Mulligan mobilization techniques, including natural apophyseal glides, sustained natural apophyseal glides, selfadministered sustained natural apophyseal glides, along with hot packs, or; and a control group (n = 50), receiving isometric exercises, stretching, active neck exercises, transcutaneous electrical nerve stimulation, ultrasound therapy, and hot packs. Both interventions were applied three times per week over a six week period. Outcome measures included pain intensity assessed by the visual analog scale, cervical range of motion measured with a cervical range of motion CROM basic spinal assessment device, and functional disability assessed using the Neck Disability. Assessments were conducted pre- and post-intervention, with both groups demonstrating statistically significant within-group improvements in all outcome measures following the intervention (p < 0.05). Between-group analyses indicated that the experimental group achieved significantly greater post-intervention improvements (p < 0.05) in pain intensity, cervical range of motion in all movements, and functional disability compared to the control group (p < 0.001). This finding suggested that the Mulligan technique was superior in clinical effectiveness to conventional physiotherapy.