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Immediate effects of a single session of cervical spine manipulation on cervical movement patterns in people with nonspecific neck pain: a randomized controlled trial [with consumer summary]
Serra-Ano P, Venegas W, Page A, Ingles de la Torre M, Aguilar-Rodriguez M, Espi-Lopez G
Journal of Manipulative and Physiological Therapeutics 2023 Jan;46(1):17-26
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: The aim of the present study was to assess the immediate effects of a single session of cervical spine manipulation on cervical movement patterns, disability, and the patient's perceived improvement in people with nonspecific neck pain. METHODS: A single-blinded, randomized, sham-controlled trial was carried out at a biomechanics institute. Fifty participants diagnosed with acute and chronic nonspecific neck pain (minimum duration of the symptoms being 1 month) were randomized to an experimental group (EG, n = 25) or a sham-control group (CG, n = 25, 23 of whom completed the study). EG received a single cervical spine manipulation session; CG received a single placebo intervention. Both groups received manipulation or sham from the same physiotherapist. Main outcome measures were neck kinematics (ie, range of motion and movement harmony) during cyclic movements, self-reported neck disability, and impression of change assessed before and 5 minutes after treatment. RESULTS: The EG showed no significant improvements (p > 0.05) in any of the studied biomechanical variables, except for right-side bending and left rotation, in which we found a range of motion significant mean difference of 1.97degree and 1.95degree, respectively (p < 0.05). The CG showed enhanced harmonic motion during flexion (p < 0.05). Both groups showed a significant decrease in self-reported neck disability after treatment (p < 0.05), and EG participants perceived a significantly larger improvement after manipulation compared with the CG (p < 0.05). CONCLUSIONS: A single session of cervical manipulation provided by a physiotherapist had no impact on cervical motion during cyclic movements, but rather induced self-reported perceived improvement in neck disability and impression of change after treatment in people with nonspecific neck pain.
Reprinted from the Journal of Manipulative and Physiological Therapeutics with copyright permission from the National University of Health Sciences.

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