Immediate Effects of Mobilization With Movement Technique on Cervical Muscle Stiffness, Pain, and Range of Motion in Individuals With Mechanical Neck Pain: A Double-Blind Randomized Controlled Trial

Mulligan sustained natural apophyseal glide (SNAG) is a mobilization technique that aims to reduce pain and improve function by correcting positional errors in the facet joint. To investigate the immediate effects of the Mulligan SNAG application on muscle stiffness, pain, pressure pain threshold (PPT) and range of motion (RoM) in patients with chronic mechanical neck pain. A randomized, double-blind trial was conducted. Forty individuals with chronic mechanical neck pain (mean age = 39.35 ± 6.68 years) were randomized into two groups: Mobilization with movement group (MWMG), and sham group (SG). Muscle stiffness was measured with MyotonPro, pain intensity with Numerical Pain Rating Scale, cervical RoM with a digital inclinometer, and PPT with an algometer. Measurements were performed pre-and 5 minutes post-intervention in a single session. Muscle stiffness significantly changed in the MWMG for the left trapezius and right cervical extensors (p = .003, effect size (ES) = 0.42; p = .031, ES = 0.49, respectively), whereas no significant changes were observed in the SG (p = .097, ES = 0.12; p = .270, ES = 0.22, respectively). The MWMG showed improvements in pain (p = .001, ES = 0.70) and RoM (right: p = .0001, ES = 0.89; left: p = .0001, ES = 0.99). The SG also showed improvements in pain (p = .0001, ES = 0.76) and RoM (right: p = .0001, ES = 0.49; left: p = .0001, ES = 0.35). PPT improvements were observed in the MWMG for right and left trapezius (p = .0001, ES = 1.21; p = .040, ES = 0.43, respectively), whereas no significant changes occurred in the SG (p = .713, ES = 0.03; p = .839, ES = 0.01, respectively). The mobilization with movement technique leads to significant immediate improvements in muscle stiffness and pain-related parameters in individuals with chronic neck pain.