Proprioceptive Neuromuscular Facilitation and Passive Vertebral Mobilization for Neck Disability in Patients with Mechanical Neck Pain

Abstract

Background: Mechanical neck pain is a common musculoskeletal disorder impacting functional mobility, frequently resulting in disability and reduced quality of life. Both proprioceptive neuromuscular facilitation and passive vertebral mobilization are common manual therapy interventions used in clinical practice. Objective: To compare the effects of proprioceptive neuromuscular facilitation and passive vertebral mobilization on neck disability, pain intensity, and cervical mobility in subjects with mechanical neck pain. Methodology: A single-blinded randomized controlled trial was conducted in the Department of Physiotherapy, University of Lahore Teaching Hospital, Lahore. Participants aged between 18 and 35 years diagnosed with pain localized in the neck region were included in the study. Participants who were diagnosed with ankylosing spondylitis, rheumatoid arthritis, fracture, congenital anomalies, positive neurological findings, uncontrolled dizziness, malignancy, or pregnancy were excluded. Data was gathered at baseline, as well as at the end of the second and fourth weeks. Group A was treated with the proprioceptive neuromuscular facilitation techniques employed included rhythmic initiation, a blend of isotonics, dynamic reversals, and contract-relax methods. Group B was treated with passive vertebral mobilization in the prone position. Numerical variables are summarized using mean and standard deviation, while categorical variables are presented as frequencies with corresponding percentages. The data were normally distributed using the Kolmogorov-Smirnov test, and parametric tests like the paired sample t-test and ANOVA were employed. Results: Both groups demonstrated significant improvement over time in neck disability index (F=355.16, p<0.00), numeric pain rating scale (F=544.09, p<0.00), and cervical range of motion (F=33.41, p<0.00). No group effect was found to be significant for neck disability index (p=0.76) or cervical range of motion (p=0.98). Group A demonstrated significantly greater pain decrease on pain score at baseline (p=0.03) and 4^th week (p=0.04). Conclusion: Both proprioceptive neuromuscular facilitation and passive vertebral mobilization were effective in improving neck disability, pain intensity, and cervical range of motion in patients with mechanical neck pain over four weeks. While no significant differences were observed between groups for disability or mobility.