Effect of Mulligan Mobilization on Active Trigger Points in Cervical Radiculopathy

Abstract

Purpose: To evaluate mulligan sustained natural apophyseal glides technique of C4/5 in pressure pain threshold, rhomboids muscle activity and functional activity level in patients with cervical radiculopathy with active trigger point in rhomboids muscles. Methods: Forty participants involved in current trial, their age range18-30 years old with body mass index between 18-25 kilogram/meter 2 of both genders, randomly allocated into 2 equal groups; Control 'B'; received conventional protocol in form of 20 minutes infrared, 10 minutes pulsed ultrasound therapy with 1.5 Watt/centimeter 2 and 1 Hertz, physical therapist deactivated active myofascial trigger points thought manual ischemic compression on rhomboids muscles for 10 minutes then muscle stretching 5 minutes and strengthening exercises for 15 minutes. Study 'A'; were applied in control B in combination with mulligan mobilization in form of sustained natural apophyseal glides (SNAGs) for cervical level at C4/5. Assessments were done using digital pressure algometer to assess pressure pain threshold, neck disability index to evaluate functional activity level, electromyography to measure rhomboids muscle activity and fatigue. Suggested protocol was applied 3 times weekly, measurements were conducted initially and by the end of suggested protocol. Results: Results revealed obvious difference in all measured outcomes within groups. Statistically significant difference was also found in post-treatment values of all measured outcomes in-between two groups with superiority to Mulligan`s group. Conclusion: Mulligan SNAGs technique of C4/5 combined with conventional physical therapy results in improvements in pressure pain threshold, increases EMG rhomboids muscle activity and functional activity level in patients with cervical radiculopathy and deactivates trigger point of rhomboids muscles.