Sustained natural apophyseal glides mobilization versus manipulation in the treatment of cervical spine disorders: a randomized controlled trial

The aim of the present study was to compare the effects between sustained natural apophyseal glides (SNAGs) mobilization and manipulation in the treatment of patients with cervical spine disorders. Forty-nine male patients participated and completed the study. They were randomly assigned into three groups: SNAGs group, manipulation group, and exercise group. Patients in all groups received exercise therapy. The SNAGs group received the specialized SNAGs mobilization. The manipulation group was treated with high-velocity, low-amplitude manipulation. The cervical range of motion (CROM) was measured using CROM device, with the pain assessed using the visual analogue scale (VAS) and the grade of functional recovery measured using the neck disability index (NDI). The patients received two sessions per week for 6 weeks. Evaluations were carried out before treatment, immediately after treatment, and at one month follow up. Repeated measures analysis, Friedman’s test, and Wilcoxon signed ranked test respectively revealed a significant increase in ROM, pain reduction, and improved function after treatment and at one-month follow-up. The results showed significant difference in the ROM, VAS, and NDI between the exercise group and both the SNAGs group and the manipulation group. No significant difference was found between the SNAGs group and the manipulation group in terms of ROM, VAS, and NDI after treatment and after one month follow up. The SNAGs mobilization and manipulation were found to be effective treatments more than the exercises alone in the treatment of cervical spine disorders.