High Velocity Low Amplitude Manipulation versus Sustained Apophyseal Glides on Pain and Range of Motion in Patients with Mechanical Neck Pain: An Immediate Effect

Background: Mechanical neck pain (MNP) is a very common musculoskeletal disorder in which zygapophyseal joint dysfunction is a common source of disorder. Objective: To explore and compare effects of cervical high velocity low amplitude (HVLA) manipulation versus sustained natural apophyseal glides (SNAGs) on pain, intervertebral mobility and cervical range of motion (ROM). Subjects: Forty patients with chronic (MNP) participated in this study, their age ranged from 20 to 40 years with a mean 26.33 ± 5.45 years. Methods: Patients were randomly assigned into HVLA and SNAGs groups. Variables were evaluated pre and immediately after treatment, including pain intensity (by Visual Analogue Scale), X-Ray fluoroscopy was used to assess Intervertebral Mobility in Lateral bending to the Affected side "IVMLBAS" and Intervertebral Mobility in Lateral bending to the Contralateral Side "IVMLBCS" CROM device was used to assess Range of Motion of Lateral Bending to the Affected side “ROMLBAS” and Range of Motion of Lateral Bending to the Contralateral side "ROMLBCS". Results: Results showed that both techniques were effective in improving evaluated variables. Post-treatment evaluations revealed that mean values and pain intensity, IVMLBAS, IVMLBCS, IVMF, IVME, ROMLBAS, ROMLBCS, were (3.98 ± 1.47, 3.08 ± 1.19), (22.61± 1.81, 22.49 ± 2.16), (22.43± 2.19, 22.4± 2.3) , (37.15± 6.57, 35.8 ± 5.66), (36.9± 5.00, 36.85±5.47), for group-I and II respectively. Conclusion: Both cervical HVLA and SNAGs proved to be effective in improving pain intensity, IVMLBAS, IVMLBCS, ROMLBAS, ROMLBCS. SNAGs yielded more favorable effects on pain intensity than manipulation.