Effects of Mulligan mobilization technique on pain, cervical range of motion, proprioception, and disability in cervical spondylosis.

Abstract

Background: Cervical spondylosis (CS) is a frequent aging-associated disorder (95%), impacting cervical spine joints and discs. Among various physical therapy interventions, the Mulligan Mobilization Technique (MMT) applies sustained passive accessory glides with active movement. Purpose: The primary aim of this study was to evaluate the effects of MMT combined with conventional physical therapy exercises on pain, cervical Range of Motion (ROM), proprioception, and functional disability in chronic CS patients. The secondary aim was to examine the interrelationships among these clinical outcomes. Methods: Twenty chronic CS patients (15 females, 5 males; ages 40-60 years) received a 4-week intervention combining MMT with conventional physical therapy exercises (ROM, isometric, and deep neck flexor exercises) three times per week. Outcome measures were recorded at baseline and post-intervention; these measures included the Visual Analogue Scale (VAS) for assessing pain, the Cervical Range of Motion (CROM) device to measure ROM and proprioception, and the Arabic version of the Neck Disability Index (NDI) to evaluate disability level. Results: Significant improvements were observed post-intervention across all outcome measures. Correlation analysis revealed strong negative correlations between neck pain intensity, NDI, and all cervical ROM. Additionally, the NDI showed strong positive correlations with target head position (THP) and neutral head position (NHP) (left rotation), along with moderate positive correlations with NHP (right rotation) and NHP. Conclusion: MMT effectively reduces pain and disability while enhancing cervical ROM and proprioception in chronic CS patients. The significant interrelationships among these outcomes emphasize the need for a multimodal rehabilitation approach.