Movilización traslatoria cervical superior versus técnica de energía muscular suboccipital en pacientes con dolor mecánico de cuello y postura de la cabeza hacia adelante

Autores/as

  • Reda Kotb Abdelrazik Assistant Professor, Department of Physical Therapy for Musculoskeletal Disorders and its Surgery, Faculty of Physical Therapy, Benha University, Qaluybia, Egypt.
  • Waleed Talat Mansour Professor, Department of Physical Therapy for Neuromuscular Disorders and its Surgery, Faculty of Physical Therapy, Benha University, Benha, Egypt.
  • Ahmed Salim Mohmed Salim Lecturer, Department of Physical Therapy for Pediatrics and its Surgery, Faculty of Physical Therapy, Elsalam University, Khafr El-Zayat, Egypt.
  • Mohamed Nabil Fiaad Lecturer, Department of Basic Science, Faculty of Physical Therapy, Modern University for Information and Technology, Cairo, Egypt.
  • Ali Essawy Ali Mostafa Lecturer, Department of Physical Therapy for Neuromuscular Disorders and its Surgery, Faculty of Physical Therapy, Al Salam University, Khafr El-Zayat, Egypt.
  • Ahmed Abd El-Moneim Abd El-Hakim Lecturer, Department of Basic Science, Faculty of Physical Therapy, Beni-Suef University, Beni-Suef, Egypt.
  • Sarah Mohamed Samir Assistant Professor, Department of Physical Therapy for Musculoskeletal Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt & Assistant Professor, Department of Physical Therapy, Faculty of Allied Medical Sciences, Najran University, Najran, Kingdom of Saudi Arabia

DOI:

https://doi.org/10.47197/retos.v80.119229

Palabras clave:

Postura de la cabeza hacia adelante, movilización traslatoria cervical superior , técnica de energía muscular suboccipital, dolor mecánico de cuello

Resumen

Antecedentes: El dolor mecánico de cuello (MNP) se asocia frecuentemente con la postura de la cabeza hacia adelante (FHP), pero el manejo óptimo sigue siendo debatido. Objetivos: comparar los efectos de la movilización translatoria cervical superior (CU-TSM) versus la técnica de energía muscular suboccipital (MET), cuando se combina con fisioterapia tradicional, en pacientes con MNP y FHP.

Sujetos y Métodos: Cuarenta y cuatro pacientes de edad 25-40 años fueron asignados al azar en tres grupos: Grupo a (n=15) recibió de la UC-TSM además de la terapia convencional, el Grupo B (n=15) recibió suboccipitales se REUNIÓ además de la terapia convencional, y el Grupo C (n=14) recibieron terapia convencional solo. Tres veces por semana durante cuatro semanas. Medidas de resultados: fueron evaluados antes y después del tratamiento incluyen la intensidad del dolor (Escala Visual Analógica), el rango de movimiento (CROM dispositivo), el cuello de la discapacidad (Índice de Discapacidad cervical), y craniovertebral ángulo fotográfico a través de análisis de Surgimap software).

Resultados: Las características basales fueron comparables entre los grupos (p>0,05). Todos los grupos demostraron mejoras significativas dentro del grupo después del tratamiento en dolor, discapacidad, rango de movimiento y ángulo craneovertebral (p < 0,05). Sin embargo, el Grupo A mostró reducciones significativamente mayores en el dolor y la discapacidad, y una mejora del ángulo craneovertebral más pronunciada en comparación con los Grupos B y C (p < 0,05). No se observaron diferencias significativas entre grupos en el rango de movimiento cervical (p>0,05).

Conclusión: Agregar UC-TSM a la fisioterapia tradicional produce resultados superiores para aliviar el dolor, reducir la discapacidad y corregir la postura de la cabeza hacia adelante en comparación con MET suboccipital o terapia convencional sola en pacientes con dolor de cuello mecánico y FHP.

Biografía del autor/a

  • Reda Kotb Abdelrazik, Assistant Professor, Department of Physical Therapy for Musculoskeletal Disorders and its Surgery, Faculty of Physical Therapy, Benha University, Qaluybia, Egypt.

    Assistant Professor, Department of Physical Therapy for Musculoskeletal Disorders and its Surgery, Faculty of Physical Therapy, Benha University, Qaluybia, Egypt.

  • Waleed Talat Mansour, Professor, Department of Physical Therapy for Neuromuscular Disorders and its Surgery, Faculty of Physical Therapy, Benha University, Benha, Egypt.

    Professor, Department of Physical Therapy for Neuromuscular Disorders and its Surgery, Faculty of Physical Therapy, Benha University, Benha, Egypt.

  • Ahmed Salim Mohmed Salim, Lecturer, Department of Physical Therapy for Pediatrics and its Surgery, Faculty of Physical Therapy, Elsalam University, Khafr El-Zayat, Egypt.

    Lecturer, Department of Physical Therapy for Pediatrics and its Surgery, Faculty of Physical Therapy, Elsalam University, Khafr El-Zayat, Egypt.

  • Mohamed Nabil Fiaad, Lecturer, Department of Basic Science, Faculty of Physical Therapy, Modern University for Information and Technology, Cairo, Egypt.

    Lecturer, Department of Basic Science, Faculty of Physical Therapy, Modern University for Information and Technology, Cairo, Egypt.

  • Ali Essawy Ali Mostafa, Lecturer, Department of Physical Therapy for Neuromuscular Disorders and its Surgery, Faculty of Physical Therapy, Al Salam University, Khafr El-Zayat, Egypt.

    Lecturer, Department of Physical Therapy for Neuromuscular Disorders and its Surgery, Faculty of Physical Therapy, Al Salam University, Khafr El-Zayat, Egypt.

  • Ahmed Abd El-Moneim Abd El-Hakim, Lecturer, Department of Basic Science, Faculty of Physical Therapy, Beni-Suef University, Beni-Suef, Egypt.

    Lecturer, Department of Basic Science, Faculty of Physical Therapy, Beni-Suef University, Beni-Suef, Egypt.

  • Sarah Mohamed Samir, Assistant Professor, Department of Physical Therapy for Musculoskeletal Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt & Assistant Professor, Department of Physical Therapy, Faculty of Allied Medical Sciences, Najran University, Najran, Kingdom of Saudi Arabia

    Assistant Professor, Department of Physical Therapy for Musculoskeletal Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt & Assistant Professor, Department of Physical Therapy, Faculty of Allied Medical Sciences, Najran   University, Najran, Kingdom of Saudi Arabia

Referencias

Aafreen, Khan, A., Ahmad, A., Khan, A. R., Maurya, N., Alameer, M. M., Alghadir, A. H., & Anwer, S. (2023). Clinimetric properties of a smartphone application to measure the craniovertebral angle in dif-ferent age groups and positions. Heliyon, 9(9), Article e19336. https://doi.org/10.1016/j.heliyon.2023.e19336

Abd Elrazik, R. K., Battesha, H. H. M., & Samir, S. M. (2021). Muscle energy technique versus active re-lease technique on motor functions in patients with carpal tunnel syndrome. International Journal of Therapy and Rehabilitation, 28(7). https://doi.org/10.12968/ijtr.2020.0114

Abd Elrazik, R. K., Battesha, H. H. M., & Samir, S. M. (2021). Shock wave versus iontophoresis in patients with carpal tunnel syndrome. Physiotherapy Quarterly, 29(1), 1–6. https://doi.org/10.5114/pq.2020.96420

Afonso, J., Ramirez-Campillo, R., Moscão, J., Rocha, T., Zacca, R., Martins, A., Milheiro, A. A., Ferreira, J., Sarmento, H., & Clemente, F. M. (2021). Strength Training versus Stretching for Improving Range of Motion: A Systematic Review and Meta-Analysis. Healthcare(Basel,Switzerland), 9(4),427.https://doi.org/10.3390/healthcare9040427

Apoorva Srivastava, Dr. Digvijay Sharma (2025). Prevalence of Forward Head Posture (FHP) in Young Individuals: A cross-sectional Study. Journal of Applied Bioanalysis, 11(7), 134-139. https://doi.org/10.53555/jab.v11i7.1180

Audette I, Dumas JP, Côté JN, De Serres SJ. Validity and between-day reliability of the cervical range of motion (CROM) device. J Orthop Sports Phys Ther. 2010 May;40(5):318-23. https://www.jospt.org/doi/10.2519/jospt.2010.3180.

Balaji, T., Ramalingam, V., & Santhana Lakshmi, S. (2025). Comparing the effects of post-isometric re-laxation and hold-relax technique for cervicogenic headache among computer users. Neurology Asia, 30(1). https://doi.org/10.54029/2025tmx https://doi.org/10.54029/2025tmx

Bialosky, J. E., Bishop, M. D., Price, D. D., Robinson, M. E., & George, S. Z. (2009). The mechanisms of manual therapy in the treatment of musculoskeletal pain: A comprehensive model. Manual Therapy, 14(5), 531–538. https://doi.org/10.1016/j.math.2008.09.001

Blanpied, P. R., Gross, A. R., Elliott, J. M., Devaney, L. L., Clewley, D., Walton, D. M., Sparks, C., & Robert-son, E. K. (2017). Neck pain: Revision 2017: Clinical practice guidelines linked to the Interna-tional Classification of Functioning, Disability and Health from the Orthopaedic Section of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Thera-py,47(7),A1–A83. https://www.jospt.org/doi/10.2519/jospt.2017.0302

Chaitow, L. (2014). Muscle energy techniques (4th ed.). Churchill Livingstone.

Clijsen, R., Stoop, R., Hohenauer, E., Clarys, P., Deflorin, C., & Taeymans, J. (2022). Local heat applica-tions as a treatment of physical and functional parameters in acute and chronic musculoskeletal disorders or pain. Archives of Physical Medicine and Rehabilitation, 103(3), 505–522. https://doi.org/10.1016/j.apmr.2021.07.804

Coulter, I. D., Crawford, C., Vernon, H., Hurwitz, E. L., Khorsan, R., Booth, M. S., & Herman, P. M. (2019). Manipulation and Mobilization for Treating Chronic Nonspecific Neck Pain: A Systematic Re-view and Meta-Analysis for an Appropriateness Panel. Pain physician, 22(2),E55–E70. https://pmc.ncbi.nlm.nih.gov/articles/PMC6800035/

Cramer, H., Baumgarten, C., Choi, K. E., Lauche, R., Saha, F. J., Musial, F., Dobos, G., & Michalsen, A. (2012). Thermotherapy self-treatment for neck pain relief: A randomized controlled trial. Eu-ropean Journal of Integrative Medicine, 4(4), e371–e378. http://hdl.handle.net/10453/114808

Dunning, J., Butts, R., Cook, C., Flynn, T., Meekins, T. W., Boyles, R., McMillian, M., & Link, C. (2012). Up-per cervical and upper thoracic thrust manipulation versus non thrust mobilization in patients with mechanical neck pain: A multicenter randomized clinical trial. Journal of Orthopaedic & Sports Physical Therapy, 42(1), 5–18. https://doi.org/10.2519/jospt.2012.3894

Durall C. J. (2012). Therapeutic exercise for athletes with nonspecific neck pain: a current concepts review. Sports health, 4(4),293–301. https://doi.org/10.1177/1941738112446138

Edmondston, S. J., Sharp, M., Symes, A., Alhabib, N., & Allison, G. T. (2011). Changes in mechanical load and extensor muscle activity in the cervico-thoracic spine induced by sitting posture modifica-tion. Ergonomics, 54(2), 179–186.. https://doi.org/10.1080/00140139.2010.544765

Fernández-de-las-Peñas, C., Alonso-Blanco, C., & Miangolarra, J. C. (2006). Myofascial trigger points in subjects presenting with forward head posture and mechanical neck pain. Manual Therapy, 11(1), 36–42. https://doi.org/10.1016/j.math.2006.02.002

Ferrari, R., & Russell, A. S. (2003). Regional musculoskeletal conditions: Neck pain. Best Practice& Re-search Clinical Rheumatology, 17(1), 57–70. https://doi.org/10.1016/S1521-6942(02)00097-9

Ghulam HS, Alqhtani RS, Alshahrani A, Ahmed H, Khan AR, Khan A. Efficacy of cervical mobilization with post-isometric relaxation in managing mechanical neck pain, ROM, and functional limita-tions associated with myofascial trigger points. Medicine (Baltimore). 2023 Dec 29;102(52):e36710. https://doi: 10.1097/MD.0000000000036710. PMID: 38206736; PMCID: PMC10754601

Gross A, Miller J, D'Sylva J, et al. Manipulation and mobilisation for neck pain contrasted against an in-active control or another active treatment. Cochrane Database Syst Rev. 2015;(9):CD004249. https://doi.org/10.1002/14651858.CD004249.pub4

Hole, D. E., Cook, J. M., & Bolton, J. E. (1995). Reliability and concurrent validity of two instruments for measuring cervical range of motion. Manual Therapy, 1(1), 36–42. https://doi.org/10.1054/math.1995.0248

Iqbal, A., Khan, K., Ansari, M., Jan, N., & Kuriakose, D. (2015). Immediate effects of upper cervical trans-latory segmental mobilization on cervical mobility and pressure pain threshold in cervicogenic headache. International Journal of Physiotherapy Research, 3(3), 1068–1073. https://doi.org/10.1016/j.jmpt.2017.07.007

Jaganjyoti Das, Dr. Pooja Anand, & Dr. Pooja Bhati. (2024). Head Forward Posture and Cervical Joint Position Sense with Electrical Muscle Activity in Upper Cross Syndrome: A Correlational Analy-sis. Educational Administration: Theory and Practice, 30(3), 3054–3060. https://doi.org/10.53555/kuey.v30i3.9041

Joshi, R., & Poojary, N. (2022). The effect of muscle energy technique and posture correction exercises on pain and function in patients with non-specific chronic neck pain having forward head pos-ture: A randomized controlled trial. International Journal of TherapeuticMas-sage&Bodywork,15(2),14https://doi.org/10.3822/ijtmb.v15i2.673

Kay, T. M., Gross, A., Goldsmith, C. H., Graham, N., Brønfort, G., & Hoving, J. L. (2012). Exercises for me-chanical neck disorders. Cochrane Database of Systematic Reviews, (8), Article CD004250. https://doi.org/10.1002/14651858.CD004250.pub5

Kendall, F. P., McCreary, E. K., Provance, P. G., Rodgers, M. M., & Romani, W. A. (2005). Muscles: Testing and function with posture and pain (5th ed.). Lippincott Williams & Wilkins.

Kulkarni, V., Chandy, M. J., & Babu, K. S. (2001). Quantitative study of muscle spindles in suboccipital muscles of human foetuses. Neurology India, 49(4), 355–359. http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2001;volume=49;issue=4;spage=355;epage=9;aulast=Kulkarni

Li, Y., Yang, L., Dai, C., & Peng, B. (2022). Proprioceptive Cervicogenic Dizziness: A Narrative Review of Pathogenesis, Diagnosis, and Treatment. Journal of clinical medicine, 11(21), 6293. https://doi.org/10.3390/jcm11216293

Malviya, T. (2025). Effect of posture management and strengthening of deep neck flexors in cervical pain with forward head posture due to increased screen time in young adults. International Journal for Multidisciplinary Research,7(3). https://doi.org/10.36948/ijfmr.2025.v07i03.46934

Mohamed E.E, Abd Elrazik R.K (2020). Sustained Natural Apophyseal Glides versus Positional Release Therapy in the Treatment of Chronic Mechanical Neck Dysfunction. International Journal of Human Movement and Sports Sciences, 8(6), 384 - 394. DOI: 10.13189/saj.2020.080610.

Peng, B., Yang, L., Li, Y., Liu, T., & Liu, Y. (2021). Cervical proprioception impairment in neck pain—Pathophysiology, clinical evaluation, and management: A narrative review. Pain and Therapy, 10(1), 143–164. https://doi.org/10.1007/s40122-020-00230-z

Phadke, A., Bedekar, N., Shyam, A., & Sancheti, P. (2016). Effect of muscle energy technique and static stretching on pain and functional disability in patients with mechanical neck pain: A random-ized controlled trial. Hong Kong Physiotherapy Journal, 35, 5–11. https://doi.org/10.1016/j.hkpj.2015.12.002

Picher, P., Seixas, A., Moreira-Silva, I., Azevedo, J., & Cardoso, R. (2025). Effects of Global Postural Re-Education on Pain, Functionality, and Range of Motion in Chronic Non-Specific Neck Pain: A Systematic Review of Randomized Controlled Trials. Healthcare, 13(14), 1689. https://doi.org/10.3390/healthcare13141689.

Rana, H., Yasir, S., Qazi, T., Iqbal, F., Maqbool, A., Anis, B., Afzal, H., & Nasir, N. (2025). Comparative effec-tiveness of cervical spine mobilization vs. neuromuscular re-education for cervicogenic dizzi-ness on pain, balance, function, and cervical mobility. Journal of Health, Wellness and Commu-nity Research,3(15). https://doi.org/10.61919/hejcym13

Sachin Mohan Kajale, Dr. Vaishnavi Sanjay Chawake, Dr. Madhavi Mahadeo Kandarkar, Dr. Anjali Bais, (2026), "Effectiveness of Muscle Energy Technique versus Myofacial Release Technique Along with Ultrasound on Cervical Pain, Range of Motion and Neck Disability in Patients with Upper Trapezitis - A Comparative Study", International Journal of Science and Research (IJSR), 15(4), 1114-1122. https://dx.doi.org/10.21275/SR26418121440,

Shaheen, A. A., Omar, M. T., & Vernon, H. (2013). Cross-cultural adaptation, reliability, and validity of the Arabic version of neck disability index in patients with neck pain. Spine, 38(10), E609–E615. https://doi.org/10.1097/BRS.0b013e31828b2d09.

Stanton, T. R., Leake, H., Bowering, K. J., & Moseley, G. L. (2015). Evidence of impaired proprioception in chronic idiopathic neck pain: A systematic review and meta-analysis. Physiothera-py,101(Suppl.1),e1432–e1433. https://doi.org/10.1016/j.physio.2015.03.1392

Sun, A., Yeo, H.-G., Kim, T.-U., Hyun, J.-K., & Kim, J.-Y. (2014). Radiologic assessment of forward head posture and its association with myofascial pain syndrome. Annals of Rehabilitation Medicine, 38(6), 821–826. https://doi.org/10.5535/arm.2014.38.6.821

Waje, M.S., & Satralkar, A.N. (2020). Effects of suboccipital muscle energy technique (MET) versus sub-occipital release technique (SOR) on craniovertebral angle, cervical range of motion and chron-ic neck pain in medical students with upper cross syndrome at the end of 6 weeks: A compara-tive study. International journal of applied research, 6, 153-160. http://www.allresearchjournal.com/archives/2020/vol6issue7/PartC/6-6-73-486.pdf

Zaidi, S., Khan, S. A., Zaki, S., Sundus, H., Alam, M. F., & Nuhmani, S. (2025). Effectiveness of sensorimo-tor training on pain, cervical joint position sense, range of motion, balance, and disability in chronic neck pain: A systematic review. Heliyon, 11(10), Article e43409. https://doi.org/10.1016/j.heliyon.2025.e43409.

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Publicado

12-05-2026

Número

Vol. 80 (2026)

Sección

Artículos de carácter científico: investigaciones básicas y/o aplicadas

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Derechos de autor 2026 Reda Kotb Abdelrazik, Waleed Talat Mansour, Ahmed Salim Mohmed Salim, Mohamed Nabil Fiaad, Ali Essawy Ali Mostafa, Ahmed Abd El-Moneim Abd El-Hakim, Sarah Mohamed Samir

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Cómo citar

Abdelrazik, R. K., Mansour, W. T., Salim, A. S. M., Fiaad, M. N., Mostafa, A. E. A., Abd El-Hakim, A. A. E.-M., & Samir, S. M. (2026). Movilización traslatoria cervical superior versus técnica de energía muscular suboccipital en pacientes con dolor mecánico de cuello y postura de la cabeza hacia adelante. Retos, 80, 736-746. https://doi.org/10.47197/retos.v80.119229