Effectiveness of Mulligan Mobilization on Chronic Neck Pain and Range of Motion

Chronic mechanical neck pain is a common musculoskeletal condition associated with neck pain, reduced cervical mobility, and functional limitations. Conventional physiotherapy is commonly used in the management of chronic mechanical neck pain. Mulligan Mobilization with Movement (MWM) is a manual therapy technique that combines sustained joint mobilization with active movement and may be used as an adjunct to conventional physiotherapy.

This randomized controlled trial was conducted to investigate the effect of adding Mulligan Mobilization with Movement (MWM) to conventional physiotherapy in individuals with chronic mechanical neck pain.

A total of 76 participants aged 18 to 65 years were initially enrolled in the study. Six participants were excluded before randomization according to the study eligibility criteria. The remaining 70 participants were randomly allocated to one of two treatment groups: a control group receiving conventional physiotherapy alone (n = 32) and an experimental group receiving conventional physiotherapy combined with Mulligan Mobilization with Movement (n = 38).

Both groups received treatment three times per week for four consecutive weeks. The control group received the conventional physiotherapy program specified in the study protocol. The experimental group received the same conventional physiotherapy program with the addition of Mulligan Mobilization with Movement.

The primary outcome measures included pain intensity, cervical range of motion, and functional disability. Pain intensity was assessed using the Visual Analog Scale (VAS). Cervical range of motion was measured using goniometry. Functional disability related to neck pain was assessed using the Neck Disability Index (NDI).

Outcome measures were assessed at baseline and following completion of the four-week intervention period. The outcome measures were used to compare changes between the two treatment groups.

Statistical analysis was performed using analysis of covariance (ANCOVA), with adjustment for baseline measurements. Effect sizes were calculated using Cohen's d and partial eta squared (η²) to quantify the magnitude of between-group differences.

The study was designed as a randomized controlled trial to compare conventional physiotherapy alone with conventional physiotherapy combined with Mulligan Mobilization with Movement in individuals with chronic mechanical neck pain.

Inclusion criteria

• Age 18-65 years
• Chronic mechanical neck pain lasting ≥ 3 months
• NDI score ≥ 10
• Ability to attend 3 sessions per week

Exclusion criteria

• Previous cervical spine surgery
• Cervical radiculopathy or myelopathy
• Vertebral artery insufficiency
• Rheumatologic or neurological disorders
• Ongoing physiotherapy elsewhere