Use the Back button in your browser to see the other results of your search or to select another record.

Detailed Search Results

Effect of cervical versus thoracic spinal manipulation on peripheral neural features and grip strength in subjects with chronic mechanical neck pain: a randomized controlled trial [with consumer summary]
Bautista-Aguirre F, Oliva-Pascual-Vaca A, Heredia-Rizo AM, Bosca-Gandia JJ, Ricard F, Rodriguez-Blanco C
European Journal of Physical and Rehabilitation Medicine 2017 Jun;53(3):333-341
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*

BACKGROUND: Cervical and thoracic spinal manipulative therapy has shown positive impact for relief of pain and improve function in non-specific mechanical neck pain. Several attempts have been made to compare their effectiveness although previous studies lacked a control group, assessed acute neck pain or combined thrust and non-thrust techniques. AIM: To compare the immediate effects of cervical and thoracic spinal thrust manipulations on mechanosensitivity of upper limb nerve trunks and grip strength in patients with chronic non-specific mechanical neck pain. DESIGN: Randomized, single-blinded, controlled clinical trial. SETTING: Private physiotherapy clinical consultancy. POPULATION: Eighty-eight subjects (32.09 +/- 6.05 years; 72.7% females) suffering neck pain (grades I or II) of at least 12 weeks of duration. METHODS: Participants were distributed into three groups: (1) cervical group (n = 28); (2) thoracic group (n = 30); and (3) control group (n = 30). One treatment session consisting of applying a high-velocity low-amplitude spinal thrust technique over the lower cervical spine (C7) or the upper thoracic spine (T3) was performed, while the control group received a sham-manual contact. Measurements were taken at baseline and after intervention of the pressure pain threshold over the median, ulnar and radial nerves. Secondary measures included assessing free-pain grip strength with a hydraulic dynamometer. RESULTS: No statistically significant differences were observed when comparing between-groups in any of the outcome measures (p > 0.05). Those who received thrust techniques, regardless of the manipulated area, reported an immediate increase in mechanosensitivity over the radial (both sides) and left ulnar nerve trunks (p < 0.05), and grip strength (p < 0.001). For those in the control group, right hand grip strength and pain perception over the radial nerve also improved (p <= 0.025). CONCLUSIONS: Low-cervical and upper-thoracic thrust manipulation is no more effective than placebo to induce immediate changes on mechanosensitivity of upper limb nerve trunks and grip strength in patients with chronic non-specific mechanical neck pain.

Full text (sometimes free) may be available at these link(s):      help