Effect of Sustained Natural Apophyseal Glides and Myofascial Release on Chronic Nonspecific Neck Pain: Randomized Controlled Trial

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Amal A. Morsi
Maher A. Al-kabalawy
Yasser M. Aneis
Mohamed S. Hamza
Hanaa K. Atta


CNSNP, Manual therapy, SNAGs, MFR, combined effect


Objectives: Considering the comparative effects of different therapeutic modalities on Chronic nonspecific neck pain (CNSNP), the combined and tangled treatment may significantly impact treatment programs. The study aimed to investigate the impacts of Mulligan’s sustained natural apophyseal glides (SNAGs) in combination with Myofascial release on pain, pain pressure sensitivity, functional disability, and range of motion (ROM) in CNSNP cases.
Methods: 54 cases diagnosed with CNSNP were assigned randomly to this clinical trial. Cases aged 20 to 45 years were allocated to either Group A, who obtained SNAGs, group B, who experienced MFR, or Group C, who got the combined intervention (SNAGs combined with MFR). This investigation evaluated the combined effects of SNAGs and MFR in CNSNP on pain intensity through the visual analog scale (VAS), Pain sensitivity through the pressure pain threshold (PPT), functional disability through the Neck Disability Index (NDI), and range of motion through a cervical range of motion instrument (CROM).
Results: There was a substantial decline in VAS, NDI, and a marked increase of PPT and neck ROM at post-treatment compared with pre-treatment in the three groups. According to the effects of the combined strategy, there was a statistical disparity in results concerning Pain pressure sensitivity, functional disability, and cervical ROM.
Conclusion: The findings of this study stressed the idea that the combined effect between SNAGs and myofascial releases was more effective and promising than the unimodal methodology.

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