Skip to main content
OpenTrials
Not Yet Recruiting

NCT Number: NCT07086872

Impact of Adding Integrated Neuromuscular Inhibition Technique to Mulligan Therapy in Symptomatic Forward Head Posture

this study will be conducted to investigate the impact of adding integrated neuromuscular inhibition technique to mulligan therapy in symptomatic forward head posture.

Not Yet Recruiting

Trial opening soon.

Get Notified

Key information

Conditions

Forward Head Posture

Age range

18 year–35 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

Forward head posture is anterior positioning of the cervical spine, which is regarded as a "bad" head posture and is commonly found in patients who experience problems with the head and neck. Particularly, forward head posture is frequently found in people sitting in front of a computer for prolonged periods. Load increases in the muscles and joints of the cervical spine as a result of forward head posture are considered a major cause of musculoskeletal disorders. INIT is effective as it causes sustained or intermittent compression which causes ischemia reduces local circulation until pressure is released, after which a flushing of fresh oxygenated blood occurs. Mechanoreceptors impulses interface with slower pain messages reducing amount of pain messges reaching the brain, releasing pain relieving hormones, decreasing myofascial pain. Stretches the taut bands of muscles fibers. INIT along with strengthening excercises proved to be beneficial in decreasing disability improving Range of motion. The concept of SNAG is to increase the treatment effects by having patients perform active movements while removing pain in the lesions by means of manipulative therapy. This is a new concept in the manipulative therapy field, and differs from traditional manipulative therapy by combining the active movements of the patients with additional passive movements performed with the aid of therapists

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • CVA equal or less than 50
  • Had cervical pain for more than three months and had visited an orthopedist clinic

Exclusion criteria

  • cervical spine spondylosis
  • fractures or cervical spinal surgery
  • Cervical or shoulder neurological movement disorder.
  • Temporo-mandibular surgery, (5) Pathologic trauma

Treatment and study plan

Integrated Neuromuscular Inhibition Technique and mulligan therapy

Other

patients will receive Integrated Neuromuscular Inhibition Technique in the form of intermittent ischemic compression, strain counter strain and muscle energy technique and mulligan therapy for limited cervical range of motion

Integrated Neuromuscular Inhibition technique

Other

patients will receive Integrated Neuromuscular Inhibition Technique in the form of intermittent ischemic compression, strain counter strain and muscle energy technique

mulligan therapy

Other

patients will receive mulligan therapy for limited cervical range of motion

postural correction exercises

Other

the patients will receive two strengthening exercises (deep cervical flexors and scapular retractors) and two stretching: cervical extensors (sub-occipital muscles) and pectoral muscles). The program was based on a program by Harman and Kendall

Primary outcomes

  1. pain intensity

    Time frame: up to six weeks

    visual analogue scale will be used to asses pain intensity which patient will be instructed to put point on line from no pain to tolerable pain. The scale consists of a line, usually 100 mm long, ranging from no pain or discomfort (zero) , to the worst pain that could possibly feel

Secondary outcomes

  1. neck disability

    Time frame: up to 6 weeks

    will be measured by Arabic neck disability index. It contains ten category/classes. Each category contains six choices (zero-five).Score from zero to four no disability, from five to 15 this is mild, From 15 to 24 this is moderate, from 25 to 34 this is severe, more than 34 this is a complete disability

  2. pressure pain threshold

    Time frame: up to six weeks

    pressure pain threshold pressure pain threshold will be assessed by commander algometer

  3. cervical range of motion

    Time frame: up to six weeks

    range of motion will be measured by inclinometer CROM. The CROM (deluxe version - Performance Attainment Associates, Roseville, MN, USA) measures the cervical range of motion5- for fexion, extension, lateral fexion, and rotation using separate inclinometers. These inclinometers are attached to a frame similar to that for eyeglasses one in the sagittal plane for fexion - extension, second in the frontal plane for lateral fexion and a third in the horizontal plane for rotation.

  4. craniovertebral angle

    Time frame: up to six weeks

    The craniovertebral angle is identified as the intersection of a horizontal line passing through the C7 spinous process and a line joining the midpoint of the tragus of the ear to the skin overlying the C7 spinous process. it measured by photogrametric methods. when the angle less than or equal 50 degree

Study contacts

Contact information is provided by the study sponsor or research team.

alshaymaa abd elazeim, phd

CONTACT

[email protected]

01033771553

Sponsors and collaborators

Lead sponsor

Cairo University

Other

Registry information

Acronym: FHP

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Jul 25, 2025
Registry last updated
Jul 25, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Related clinical trials

Published trials that share one or more normalized conditions with this study.