Comparative Analysis of McKenzie Protocol and Mulligan Sustained Natural Apophyseal Glides (SNAGs) for Pain, Range of Motion, and Functional Recovery in Chronic Cervical Radiculopathy
DOI:
https://doi.org/10.61919/5vzf5f10Keywords:
Chronic cervical radiculopathy, McKenzie protocol, Mulligan SNAGs, pain, range of motion, Neck Disability Index, randomized controlled trial, rehabilitationAbstract
Background: Chronic cervical radiculopathy (CCR) is a disabling condition characterized by cervical nerve root compression leading to pain, restricted range of motion (ROM), and impaired functional ability. Conservative interventions such as the McKenzie protocol and Mulligan Sustained Natural Apophyseal Glides (SNAGs) are frequently used in clinical practice, yet high-quality comparative evidence regarding their relative effectiveness remains limited. Objective: To compare the clinical effectiveness of the McKenzie protocol versus Mulligan SNAGs in improving pain intensity, cervical ROM, and functional recovery in adults with CCR. Methods: A randomized controlled trial was conducted at XYZ Hospital’s Neuro-Rehabilitation Unit from March to August 2025. Sixty adults aged 30–60 years with MRI-confirmed CCR and symptom duration >3 months were randomized to either McKenzie protocol or Mulligan SNAGs interventions for six weeks (three sessions per week). Primary outcomes were pain intensity (Visual Analog Scale, VAS), cervical ROM (flexion, extension, rotation measured by goniometer), and functional disability (Neck Disability Index, NDI). Statistical analyses included paired and independent t-tests with significance set at p<0.05. Results: Both interventions significantly improved all outcomes (p<0.001). The McKenzie group showed greater reductions in pain (mean difference 1.4 points on VAS, p=0.02), superior ROM gains (e.g., flexion +8°, p=0.04), and larger NDI improvements (mean difference 7.5 points, p=0.01), with large effect sizes. Conclusion: While both interventions were effective, the McKenzie protocol provided significantly greater clinical benefit across pain, ROM, and functional outcomes, supporting its preferential use in CCR rehabilitation.
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Copyright (c) 2025 Karan Parkash, Saadia Aziz, Hamza Shabbir, Abdul Haseeb, Rimsha Akbar, Warda Shafique, Tahreem Munir (Author)
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