Thesis (M.Sc.) - Cairo University - Faculty of Physical Therapy - Department of Basic Science

Background : Most individual suffered from neck pain at some time during the course of their lives with incidence of approximately 30% of the adult population worldwide . The zygapophyseal joints and myofascial trigger points can be cause of chronic non specific neck pain. Mulligan technique and integrated neuromuscular inhibition technique may decrease pain intensity , increase pressure pain threshold (PPT) , Range of motion (ROM) and improve neck function. Purposes: To investigate the efficacy of adding integrated neuromuscular inhibition technique ( INIT) to a multimodal treatment program that consisted of Mulligan technique (Natural Apophyseal Glides NAGS and Sustained Natural Apophyseal Glide SNAG) with isometric exercises in subjects with CNSNP on pain intensity, pressure pain threshold, ROM and neck function. Method: Thirty patients complaining of chronic non specific neck pain with active trigger point of upper trapezius (UT) and levator scapulae (LS) (15 females and 15 males), their age ranged from 18 to 26 years. Patients were randomly assigned with block randomization into three equal groups A, B & C. Group A received a multimodal treatment program that consisted of Mulligan (SNAG, NAGS) with isometric exercises . Group B received integrated neuromuscular inhibition technique (ischemic compression, positional release and muscle energy technique) and a multimodal treatment program . Group C (control group) received isometric exercises . Visual analogue scale (VAS) , Digital Algometer , CROM and Neck disability index (NDI) were used to evaluate pain intensity , pressure pain threshold (PPT) , ROM and neck function at two intervals ( pre treatment, post treatment ) before treatment and after 6 sessions through 2 weeks

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