15Aug 2017

EFFECT OF SNAGS TECHNIQUE ON HEART RATE AMONG PATIENTS WITH UPPER CERVICAL DYSFUNCTION.

  • Department Of Physiotherapy, SardarBhagwan Singh Post Graduate Institute of Biomedical Research HNB Garhwal University, Dehradun.
  • Professor, Department Of Physiotherapy, SardarBhagwan Singh Post Graduate Institute of Biomedical Research HNB Garhwal University, Dehradun.
  • MPT,PhD, Associate Professor Department of Physiotherapy, SardarBhagwan Singh Post Graduate Institute of Biomedical Research HNB Garhwal University, Dehradun).
Crossref Cited-by Linking logo
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Background: Cervical spine dysfunction may lead to misalignment most commonly of upper cervical joint complex especially the atlas.Many vital structures pass through the upper cervical joint complex, upper cervical joint complex, one of the most important being the vagus nerve. Any misalignment of atlas vertebra in the upper cervical joint complex leads to effect on vagal action which consequently does not carry out its function of antagonist to the sympathetic system properly, causing increased heart rate. Mulligan's mobilization techniques are thought to increase the range of motion as well as correct the alignment of spine. The aim of this study was to investigate the effect of SNAGS technique on heart rate among patients with upper cervical dysfunction with vagus nerve impingement. Methodology: 80 subjects participated in the study. Heart rate was taken as an outcome measure which was recorded prior to SNAGs technique given to the patient?s atlas vertebrae to side it was stuck. The HR was compared with the post intervention HR. Data was analyzed using SPSS version 16. Descriptive statistics was used to summarize the variables. Paired T Test was used to see the effects of intervention on heart rate in our study population Result: There was reduction in heart rate by 5.2 beats/min following SNAGs technique which was found to be highly significant (p ˂ 0.001) statistically. Conclusion: The study concluded that SNAGS technique was effective in correcting the impingement caused to vagus nerve as measured through HR in patients with upper cervical dysfunction.


  1. Page P. Sep 2011. Cervicogenic headaches: an evidence led approach to clinical management. international journal of sports physical therapy ;vol 6(3):254-256
  2. zito et.al. May 2006. Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. manual therapy;Vol 11, ( 2):?118?129
  3. Jain A.K, 2012. Textbook of physiology. 5edition. avichal publishing company; vol 1:349- 357
  4. Peter L. Williams (DSC, MA, MB, FRCS).1995, gray?s anatomy, 38edition, Churchill Livingstone.
  5. Jaeger, B. (1989). Are ?cervicogenic? headaches due to myofascial pain and cervical spine dysfunction.Cephalalgia, 9: 157?164.
  6. Hearn ,D.A. Rivett. May 2002,Cervical SNAGs: a biomechanical analysis. Elsevier. Vol 7 (2):71- 79.
  7. Manual therapy NAGS,SNAGS,MWMS,etc by Brian R.Mulligan, 6th edition, 2010
  8. Wendy Rheault, Geertje A.M. Arie ?ns, Willem van Mechelen, et .al. 1992. Inter tester Reliability of the Cervical Range of Motion Device Journal of Orthopaedic& Sports Physical Therapy; Vol:15(3):147?150
  9. Mfrekemfon P. Inyang et .al. Apr 2015.Sedentary Lifestyle: Health Implications. Journal of Nursing and Health Science ;Vol 4(2): 20-25
  10. Carmen E. Quatmanal. June 2008. The Effects of Gender and Maturational Status on Generalized Joint Laxity in Young Athletes. J sci med sport ; vol11(3):257 263
  11. Quek Jal, Feb. 2013. Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults. manual therapy; vol18 (1):65-71
  12. Black, Kathleen et.al. Jan 1996. The Influence of Different Sitting Positions on Cervical and Lumbar Posture. spine ; vol21 (1):65-70
  13. Lau EMC, Sham A, Wong KC. 1996. The prevalence of and risk factors for neck pain in Hong Kong. J Pub Health Med 18:396-399.
  14. Raj Rao, MD.2002 Oct. Neck Pain, Cervical Radiculopathy, and Cervical Myelopathy Pathophysiology, Natural History, and Clinical Evaluation, J Bone Joint Surg Am; vol84 (10): 1872 -1881
  15. Hooftman, Wendela E et.al. March 2005. Gender Differences in Self-Reported Physical and Psychosocial Exposures in Jobs With Both Female and Male Workers, Journal of Occupational & Environmental Medicine;Vol47( 3) : 244-252
  16. Jain A.K, 2012, textbook of physiology, 5edition, avichal publishing company, vol1 :333- 345
  17. Geertje A.M. Arie?ns, Willem van Mechelen, Paulien M. Bongers et.al. Psychosocial Risk factors for neck pain: a systematic review. American journal of industrial medicine; vol39:180-193.
  18. Skov T, Borg V, ?rhede E. 1996. Psychosocial and physical risk factors for musculoskeletal disorders of the neck, shoulders, and lower back in salespeople. Occup Environ Med; 53:351-356
  19. Abid Ali, Rehman, Fozia. 2014 Jul-Aug The efficacy of Sustained Natural Apophyseal Glides with and without Isometric Exercise Training in Non-specific Neck Pain. Pak j med sci.; vol 30(4): 872?874.

[Mitali Babulkar BPT, Maneesh Arora and Parul Raj Agarwal. (2017); EFFECT OF SNAGS TECHNIQUE ON HEART RATE AMONG PATIENTS WITH UPPER CERVICAL DYSFUNCTION. Int. J. of Adv. Res. 5 (Aug). 749-752] (ISSN 2320-5407). www.journalijar.com


Dr. Parul Raj Agarwal
Associate Professor Department of Physiotherapy, Sardar Bhagwan Singh Post Graduate Institute of Biomedical Research HNB Garhwal University, Dehradun

DOI:


Article DOI: 10.21474/IJAR01/5115      
DOI URL: http://dx.doi.org/10.21474/IJAR01/5115