Comparison of Mulligan Sustained Natural Apophyseal Glides Versus Mulligan Natural Apophyseal Glides in Mechanical Neck Pain

  • Shoaib Waqas
  • Syed Haider Ali Shah
  • Usmara Zafar
  • Muhammad Fiaz Akhtar
Keywords: Sustained natural apophyseal glides (SNAGS), Neck strengthening exercises, natural apophyseal glides (NAGS) and short wave dia-thermy


Background: Mechanical neck pain is a discomfort that rises from posterior aspect of skull and travels towards the lower cervical spine and shoulders. In this discomfort, vertebral arrangements are disturbed and the joints of cervical spine and ribs fails to perform the proper biomechanical movements resulting indecreased mobility, which creates pain. In present study, Mulligan sustained natural apophyseal glides (SNAGS) and natural apophyseal glides (NAGS) were applied in mechanical neck pain subjects to reduce the immobility and pain.Methodology: A randomized clinical trial with simple random sampling by random number table was conducted. A sample size of 50 (n=50) subjects were taken from physiotherapy department National Hospital Lahore, who fulfilled the selection criteria and were distributed into two equal groups of twentyfiveeach. The researchers took a prior informed consent from all participants before any inspection or examination. The base line treatment remained same for both groups, which was neck range of motion, strengthening exercises and short wave diathermy (SWD). Group A received Mulligan SNAGS while group B received NAGS. Treatment frequency was three times per week for two weeks(1). Subjects were assessed at the start of the management and at the completion of second week. Whole data were collected using Numeric pain rating scale (NPRS) to asses change in pain intensity and demographic data by constructed questionnaire. The data were analysed using SPSS version 22.Results: The calculated mean value of pain on NPRS and standard deviation for both groups A & B before treatment was 3.72 ± 0.61373 and 3.84 ± 0.47258 respectively, while after 6 sessions the calculated mean value of pain on NPRS and standard deviation for group A & B was 1.28 ± 0.45826 and 1.92 ± 0.81240respectively. The calculated “t” value was -3.431 and “p” value 0.001, which was an illustration of statistically significant difference between the mean values of NPRS pre and post treatment in terms of pain reduction.Conclusion: The study concluded that Mulligan sustained natural apophyseal glides (SNAGS) are more effective than natural apophyseal glides (NAGS) in subjects with mechanical neck pain.