SynthesisPhysiotherapy research international : the journal for researchers and clinicians in physical therapy2025
The Effectiveness of Mulligan's Techniques in Non-Specific Neck Pain: A Systematic Review and Meta-Analysis.
Synthesis in Physiotherapy research international : the journal for researchers and clinicians in physical therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07725861 (Effects of Strain Counter Strain With and Without Sustained Natural Aphophyseal Glide on Pain Range Of Motion ,Craniovertebral Angle and Disability in Patients With Non Specific Neck Pain), which is not on this map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Strain Counter Strain With and Without Sustained Natural Aphophyseal Glide on Pain Range Of Motion ,Craniovertebral Angle and Disability in Patients With Non Specific Neck Pain
Who cites it
1 citing paper in PubMed.
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeMulligan's techniques, such as Sustained Natural Apophyseal Glides (SNAGs) and Natural Apophyseal Glides (NAGs), are commonly applied by physiotherapists when treating patients with non-specific neck pain (NP). However, there has been no comprehensive synthesis of their effects in NP. This review aimed to assess the effectiveness of Mulligan's techniques in reducing pain, improving disability, and enhancing cervical range of motion (CROM) in adults with acute, subacute, or chronic NP.
methodsA systematic review with meta-analysis was conducted on randomized controlled trials (RCTs) comparing Mulligan's techniques with other interventions in adults with NP. Two reviewers independently conducted study selection, data extraction, and risk of bias (RoB) assessment. Meta-analyses were performed when clinical homogeneity was present; otherwise, a narrative synthesis was used. Certainty of evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.
resultsThirty-three studies were included. For acute and mixed (acute/subacute/chronic) NP, Mulligan's techniques were no more effective than other interventions for pain reduction, disability improvement, or CROM enhancement. However, in patients with chronic or uncertain chronicity NP, SNAGs combined with other interventions demonstrated superior outcomes-both statistically and sometimes clinically-compared to certain treatments like exercises and muscle-energy techniques, for reducing pain and disability and improving CROM. The certainty of evidence was rated very low. DISCUSSION: Mulligan's techniques appear to be safe, simple, and potentially beneficial for managing mixed or chronic NP when combined with other interventions, presenting results that may be comparable or occasionally superior to other standard techniques. IMPLICATIONS FOR PHYSIOTHERAPY PRACTICE: Physiotherapists may consider incorporating Mulligan's techniques, especially SNAGs, within broader NP treatment strategies, as they offer a feasible, low-risk option for improving patient outcomes, particularly for chronic NP cases when used alongside other therapies.
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