Comparison of Sustained Natural Apophyseal Glides and Maitland Manual Therapy in Non-Specific Neck Pain on Numeric Pain Rating Scale and Neck Disability Index

  • Fahad Tanveer
  • Adnan Afzal
  • Muhammad Adeel
  • Sana Shahid
  • Maham Masood
Keywords: Sustained apophyseal glide, Neck disability index, Physical therapy, Neck pain


Incidence of neck pain is increasing day by day due to changed, sedentary, non-ergonomic environment and life style. This becomes the reason of an increased load of human resource and cost. To shed this load of resources and cost, it’s essential to sort out means which give real relief to this increasinglysignificant problem. To compare outcomes of sustained natural apophyseal glides (SNAGs) versus Maitland manual therapy in improving non-specific neck pain. It was a quasi-experimental study design. The study was conducted in Chaudhary Muhammad Akram, Teaching & Research Hospital, Lahore and SuriyaAzeem Teaching Hospital, Lahore within six months from June 2015 to December 2015. A total of 75 subjects with non-specific neck pain using non-probability convenience sampling technique who fulfilled the specific inclusion and exclusion criteria were randomly allocated to three groups; group 1 received SNAGs,group 2 Maitland mobilization and group 3 conventional treatment. Baseline, post-intervention and follow up readings were taken through numeric pain rating scale (NPRS) for pain intensity, neck disability index (NDI) for functional status,goniometer for range of motion and manual muscle testing for muscle strengthof neck. The subject in each group were given twelve sessions, with three sessions a week. Data were analyzed through statistical package of social sciences (SPSS) 21. The results of each group showed pre-treatment pain intensity for group 1 was 7.04+1.338 that changed to 3.52+0.714 and for group 2 it was changed from 7.52+0.872 to 5.16+0.850 and 7.16+0.943 to 5.12+0.781 for group 3. The NDI score for group 1, 2 and 3 were 31.56+5.560, 25.040+7.086 and 25.560+5.477 that were changed to 13.120+2.759, 16.360+2.899 and 12.600+2.020 respectively. The one way ANOVA test compared mean of three groups and p-value for painintensity after treatment was p=0.000 and for functional status p=0.000. The study showed that SNAGs mobilization was more effective in the management of non-specific neck pain and also conventional treatment improved functional status of neck than Maitland mobilization.