Dowagers HumDHNCT07705841
Effect of Mulligan Technique on Craniovertebral Angle in Females With Dowager's Hump
A study testing : Mulligan Technique and conventional treatment. in people with Dowagers Hum, run by Cairo University.
Trial summary
this study will be conducted to investigate the effect of Mulligan technique on craniovertebral angle, pain intensity, function neck disability, cervical range of motion, thoracic range of motion in females with dowager's hump. Read more about this study
- Who is it for?
- Ages 39 to 58 years, women only
- Conditions the study is for
- Dowagers Hum
- What is being tested?
- : Mulligan Technique and conventional treatment.
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 56 participants
- Where
- No sites listed yet
- Study dates
- 30 Jul 2026to 20 Feb 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 39 to 58 years
- Women only
- No healthy volunteers
- Adult
Who may be able to join
- The age of patients will be ranged from 39 to 58 years old; mean menopausal age
- The patients with CVA were less than 50°.
- Pain intensity level will be examined by VAS which will be more than 3.
- Limited cervical range of motion .
- Limited thoracic range of motion (flexion, extension)
- BMI will be more than 30 kg \m2.
Who cannot join
- Patients with any neck surgeries.
- Neurological infection and spinal cord injury.
- Patients with congenital musculoskeletal deformities or ankylosing spondylitis.
- Patients with cervical trauma or car accident.
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
this study will be conducted to investigate the effect of Mulligan technique on craniovertebral angle, pain intensity, function neck disability, cervical range of motion, thoracic range of motion in females with dowager's hump.
Read the detailed description
Dowager's hump is an abnormal outward curvature of the lower cervical and upper thoracic vertebrae in upper back which leads to the compression or wedging of the anterior portion of certain thoracic vertebrae. Hyperkyphosis is commonly reported in post- menopausal women due to associated osteoporosis. The curvature results in the forward bending of the spine (hyperkyphosis) and the formation of a hump at cervicothoracic junction and upper thoracic area . The Mulligan Technique is extensively applied in managing various cervical spine dysfunctions, particularly mechanical neck pain, cervicogenic headaches, and restricted cervical range of motion. Mobilizations with Movement (MWMs) targeting the cervical facet joints can effectively reduce pain and improve mobility in patients with neck stiffness and discomfort.Despite increasing interest in conservative treatment options, there remains a notable gap in the literature regarding the range and effectiveness of therapeutic approaches specifically targeting Dowager's hump. Most existing research has focused on general postural training or corrective exercises, with limited investigation into manual therapy techniques. To date, no studies have exclusively examined the use of the Mulligan concept as a treatment for Dowager's hump, even though it has demonstrated benefits in improving spinal alignment, joint mobility, and neuromuscular control in other musculoskeletal conditions.
- Conditions
- Dowagers Hum
- Being tested
- : Mulligan Technique, conventional treatment.
- Keywords
- Mulligan Technique, Craniovertebral Angle, Females With Dowager's Hump
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
: Mulligan TechniqueOther
the patients will receive Mulligan technique in the form of Natural Apophyseal Glide (NAG) for cervical, Sustained natural apophysial glide ( SNAG ) for cervical,Sustained natural apophysial glide ( SNAG ) for Thoracic
conventional treatment.Other
The exercise program will consist of postural correction exercises to be performed under the supervision of a physical therapist. Each session will last 15-20 minutes per day, either under supervision or practiced individually at home. The exercises will include the following:
- While seated, participants will lift both hands together above the head
- While seated or standing with their back against a wall, participants will straighten their back as much as possible
- While seated on a chair with both hands placed on the neck or crossed over the chest on the shoulders, participants will lift their arms and extend the upper back without compensating with hip or lumbar spine movement
- While standing in front of a wall, participants will slide both hands upward along the wall as high as possible , Retraction in supine position,Retraction with extension,Pectoral stretch exercise training,Upper back extension exercise from prone training
| Study group | Role | What they receive |
|---|---|---|
| Mulligan Technique | Experimental | 28 female patients will receive Mulligan technique for cervical \& thoracic region and conventional treatment three times per week for four weeks Receives: Other: : Mulligan Technique; Other: conventional treatment. |
| conventional treatment. | Active comparator | 28 female patients will receive conventional treatment three times per week for four weeks Receives: Other: conventional treatment. |
What is being measured
The primary outcome is the main question the study is designed to answer.
pain intensity
The patient will choose a number from the scale which represents value of pain intensity, VAS will be more than 3. Scores are based on self-reported measures of symptoms that are recorded with a single handwritten mark placed at one point along the length of a 10-cm line that represents a continuum between the two ends of the scale- "no pain" on the left end (0 cm) of the scale and the "worst pain" on the right end of the scale (10 cm).
Measured: up to four weeks
craniovertebral angle
The Craniovertebral Angle (CVA) was assessed using a standardized photographic method. Participants were instructed to stand or sit in a relaxed natural posture with the head maintained in a neutral position while facing forward. The spinous process of the seventh cervical vertebra (C7) and the tragus of the ear were identified by palpation and marked with adhesive markers to improve measurement accuracy. A lateral photograph was then captured using a digital camera positioned perpendicular to the participant's sagittal plane, approximately 1 m away at shoulder height. The image was analyzed using Kinovea software by drawing a horizontal line through the C7 marker and a second line connecting the C7 marker to the tragus. The angle formed between these two lines at C7 was recorded as the CVA. A smaller CVA indicates a greater degree of forward head posture, with values below 50° commonly considered indicative of forward head posture
Measured: up to four weeks
Secondary outcomes (3)
neck disability
neck disability index will be used to assess neck disability.The patient will set relaxed and asked to complete the neck disability index before treatment and after treatment. which consists of 10 items. Each item is scored from zero (no disability) to five (total disability), with the maximum possible total score being 50. For each item, the subject asked to choose one answer that best defined his/her neck functional disability level. Scores for each item tallied and the total score will recorded. Mean duration of the test: 3 to 7.8 minutes. Vernon and Mior presented the following interpretation.
Measured: up to four weeks
thoracic range of motion
Thoracic Schober test will be used to test thoracic range of motion by tape measurement. The tape measure is placed at the marked points, from the spinous process of T1 to the level of T12, and active flexion of the thoracic spine is requested. After completing the movement, the difference between the initial and final measurements (T1 and T12) is recorded as the Schober test flexion value of the thoracic spine. Normal mobility values are those that show a gain of at least 5 cm on the tape measure
Measured: up to four weeks
cervical range of motion
cervical range of motion will be measured by CROM device
Measured: up to four weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Jul 2026
- Study start30 Jul 2026 (estimated)
- Primary completion20 Feb 2027 (estimated)
- Study completion20 Feb 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Dowagers HumStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Mulligan Technique and tradional therapy
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 56 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Nadia Abdelmoniem Abdelmeged, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07705841
- Sponsor's protocol ID
- P.T.REC/012/006007
- Acronym
- DH
- Status last verified
- Jul 2026
- First submitted
- 10 Jul 2026
- Last updated
- 15 Jul 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 15 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Mulligan Technique on Craniovertebral Angle in Females With Dowager's Hump
- ClinicalTrials.gov ID
- NCT07705841
- Acronym / sponsor ID
- DH / P.T.REC/012/006007
- Conditions
- Dowagers Hum
- Keywords
- Mulligan Technique, Craniovertebral Angle, Females With Dowager's Hump
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 56 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 30 Jul 2026 (estimated)
- Primary completion
- 20 Feb 2027 (estimated)
- Study completion
- 20 Feb 2027 (estimated)
- First posted
- 15 Jul 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
this study will be conducted to investigate the effect of Mulligan technique on craniovertebral angle, pain intensity, function neck disability, cervical range of motion, thoracic range of motion in females with dowager's hump.
Detailed description
Dowager's hump is an abnormal outward curvature of the lower cervical and upper thoracic vertebrae in upper back which leads to the compression or wedging of the anterior portion of certain thoracic vertebrae. Hyperkyphosis is commonly reported in post- menopausal women due to associated osteoporosis. The curvature results in the forward bending of the spine (hyperkyphosis) and the formation of a hump at cervicothoracic junction and upper thoracic area . The Mulligan Technique is extensively applied in managing various cervical spine dysfunctions, particularly mechanical neck pain, cervicogenic headaches, and restricted cervical range of motion. Mobilizations with Movement (MWMs) targeting the cervical facet joints can effectively reduce pain and improve mobility in patients with neck stiffness and discomfort.Despite increasing interest in conservative treatment options, there remains a notable gap in the literature regarding the range and effectiveness of therapeutic approaches specifically targeting Dowager's hump. Most existing research has focused on general postural training or corrective exercises, with limited investigation into manual therapy techniques. To date, no studies have exclusively examined the use of the Mulligan concept as a treatment for Dowager's hump, even though it has demonstrated benefits in improving spinal alignment, joint mobility, and neuromuscular control in other musculoskeletal conditions.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Mulligan Technique and tradional therapy
| Arm | Type | Receives |
|---|---|---|
| Mulligan Technique | Experimental | Other: : Mulligan Technique, Other: conventional treatment.28 female patients will receive Mulligan technique for cervical \& thoracic region and conventional treatment three times per week for four weeks |
| conventional treatment. | Active comparator | Other: conventional treatment.28 female patients will receive conventional treatment three times per week for four weeks |
Who may qualify
- Ages
- 39 to 58 years
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (6 listed)
- The age of patients will be ranged from 39 to 58 years old; mean menopausal age
- The patients with CVA were less than 50°.
- Pain intensity level will be examined by VAS which will be more than 3.
- Limited cervical range of motion .
- Limited thoracic range of motion (flexion, extension)
Key exclusion criteria (4 listed)
- Patients with any neck surgeries.
- Neurological infection and spinal cord injury.
- Patients with congenital musculoskeletal deformities or ankylosing spondylitis.
- Patients with cervical trauma or car accident.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| : Mulligan Techniquethe patients will receive Mulligan technique in the form of Natural Apophyseal Glide (NAG) for cervical, Sustained natural apophysial glide ( SNAG ) for cervical,Sustained natural apophysial glide ( SNAG ) for Thoracic | Other | Mulligan Technique |
| conventional treatment.The exercise program will consist of postural correction exercises to be performed under the supervision of a physical therapist. Each session will last 15-20 minutes per day, either under supervision or practiced individually at home. The exercises will include the following: * While seated, participants will lift both hands together above the head * While seated or standing with their back against a wall, participants will straighten their back as much as possible * While seated on a chair with both hands placed on the neck or crossed over the chest on the shoulders, participants will lift their arms and extend the upper back without compensating with hip or lumbar spine movement * While standing in front of a wall, participants will slide both hands upward along the wall as high as possible , Retraction in supine position,Retraction with extension,Pectoral stretch exercise training,Upper back extension exercise from prone training | Other | Mulligan Technique, conventional treatment. |
Primary outcome
pain intensity
Time frame: up to four weeks
The patient will choose a number from the scale which represents value of pain intensity, VAS will be more than 3. Scores are based on self-reported measures of symptoms that are recorded with a single handwritten mark placed at one point along the length of a 10-cm line that represents a continuum between the two ends of the scale- "no pain" on the left end (0 cm) of the scale and the "worst pain" on the right end of the scale (10 cm).
craniovertebral angle
Time frame: up to four weeks
The Craniovertebral Angle (CVA) was assessed using a standardized photographic method. Participants were instructed to stand or sit in a relaxed natural posture with the head maintained in a neutral position while facing forward. The spinous process of the seventh cervical vertebra (C7) and the tragus of the ear were identified by palpation and marked with adhesive markers to improve measurement accuracy. A lateral photograph was then captured using a digital camera positioned perpendicular to the participant's sagittal plane, approximately 1 m away at shoulder height. The image was analyzed using Kinovea software by drawing a horizontal line through the C7 marker and a second line connecting the C7 marker to the tragus. The angle formed between these two lines at C7 was recorded as the CVA. A smaller CVA indicates a greater degree of forward head posture, with values below 50° commonly considered indicative of forward head posture
3 secondary outcomes
neck disability
Time frame: up to four weeks
thoracic range of motion
Time frame: up to four weeks
cervical range of motion
Time frame: up to four weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Jul 2026.
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
A study testing : Mulligan Technique and conventional treatment. in people with Dowagers Hum, run by Cairo University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 15 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact nadia abdelmeged, phd (01143372716, dr.nadiasalem91@yahoo.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
pain intensity (time frame: up to four weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jul 2026; AzTrials last refreshed its copy on 8 Nov 2026.