{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T03:06:57Z","timestamp":1777518417595,"version":"3.51.4"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T00:00:00Z","timestamp":1730073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>This study aimed to assess the impact of Mulligan Reverse Natural Apophyseal Glides (RNAGS) applied to the upper thoracic region on pain, movement limitation, and function in individuals with mechanical neck pain.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Conducted between January 2021 and May 2021, the study involved 69 participants randomly assigned to a sham group, physiotherapy group, and Mulligan group. A two-week, 11-session treatment program was administered with shared physiotherapy interventions and stretching exercises to all groups. The Mulligan group received additional mobilization with the Mulligan RNAGS technique. The sham group received sub-standard Mulligan mobilization. Outcome measures included Range of Motion (ROM), Visual Analogue Scale (VAS), and Neck Disability Index (NDI).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>No baseline differences were found in measurements among the groups. After the intervention, all groups showed increased ROM and decreased VAS and NDI scores (p&lt;0.001). The Mulligan group exhibited significantly greater improvement in VAS, ROM, and NDI compared to other groups (p&lt;0.001). The sham group demonstrated greater improvement in NDI and extension ROM compared to the physiotherapy group (p&lt;0.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Mulligan RNAGS technique in the upper thoracic region proved beneficial for pain relief, range of motion, and functionality in mechanical neck pain. Long-term effects warrant further exploration through population-based studies.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0311206","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T17:23:06Z","timestamp":1730136186000},"page":"e0311206","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Effects of upper thoracic Mulligan mobilization on pain, range of motion and function in patients with mechanical neck pain: A randomized placebo-controlled trial"],"prefix":"10.1371","volume":"19","author":[{"given":"Ramazan","family":"Cevik","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1826-5723","authenticated-orcid":true,"given":"Omer Osman","family":"Pala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,10,28]]},"reference":[{"key":"pone.0311206.ref001","doi-asserted-by":"crossref","first-page":"955367","DOI":"10.3389\/fneur.2022.955367","article-title":"Global, regional, and national neck pain burden in the general population, 1990\u20132019: An analysis of the global burden of disease study 2019","volume":"13","author":"DW Shin","year":"2022","journal-title":"Front Neurol"},{"issue":"14","key":"pone.0311206.ref002","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1001\/jama.2018.0158","article-title":"The state of US health, 1990\u20132016: burden of diseases, injuries, and risk factors among US states","volume":"319","author":"AH Mokdad","year":"2018","journal-title":"JAMA"},{"key":"pone.0311206.ref003","doi-asserted-by":"crossref","first-page":"m791","DOI":"10.1136\/bmj.m791","article-title":"Global, regional, and national burden of neck pain in the general population, 1990\u20132017: systematic analysis of the Global Burden of Disease Study 2017","volume":"368","author":"S Safiri","year":"2020","journal-title":"BMJ"},{"issue":"6","key":"pone.0311206.ref004","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.berh.2011.01.019","article-title":"The epidemiology of neck pain","volume":"24","author":"DG Hoy","year":"2010","journal-title":"Best Practice & Research Clinical Rheumatology"},{"key":"pone.0311206.ref005","doi-asserted-by":"crossref","first-page":"j3221","DOI":"10.1136\/bmj.j3221","article-title":"Advances in the diagnosis and management of neck pain","volume":"358","author":"SP Cohen","year":"2017","journal-title":"BMJ"},{"issue":"9","key":"pone.0311206.ref006","article-title":"Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment","volume":"23","author":"A Gross","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"pone.0311206.ref007","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s12891-021-04957-4","article-title":"Neck pain: global epidemiology, trends and risk factors","volume":"23","author":"S Kazeminasab","year":"2022","journal-title":"BMC Musculoskelet Disord"},{"issue":"7","key":"pone.0311206.ref008","doi-asserted-by":"crossref","first-page":"A1","DOI":"10.2519\/jospt.2017.0302","article-title":"Neck pain: revision 2017: clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Association","volume":"47","author":"PR Blanpied","year":"2017","journal-title":"J Orthop Sports Phys Ther"},{"issue":"3","key":"pone.0311206.ref009","first-page":"150","article-title":"Neck Pain: Initial Evaluation and Management","volume":"102","author":"MA Childress","year":"2020","journal-title":"Am Fam Physician"},{"issue":"4","key":"pone.0311206.ref010","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.math.2010.04.002","article-title":"Manipulation or mobilisation for neck pain","volume":"15","author":"A Gross","year":"2010","journal-title":"A Cochrane Review. 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