None listed
Conditions
Brief summary
The aim of the study is to compare the effectiveness of hight-velocity low-amplitude (HVLA) spinal manipulation in the atlantoaxial joint (C1-C2) with a combination of HVLA spinal manipulation on the cervicothoracic spine (C3-C4, C7-T1 and T6) and its influence on the range of motion, neck pain and disability in patients with chronic mechanical neck pain. Study Design: Randomized controlled trial. Setting: Single rehabilitation center. Participants: Ninety (n=90) patients diagnosed with chronic mechanic neck pain were randomly divided into two groups: the upper cervical spine (UCS) manipulation group (n=45) and cervicothoracic spine (CTS) manipulations group (n=45). All participants completed the interventions and follow-up evaluations. Interventions: A single C1-C2 spinal manipulation technique was performed in the group 1, whereas the group 2 received a combination of HVLA spinal manipulation on the cervicothoracic spine (C3-C4, C7-T1 and T6). Main Outcome Measures: Measures included assessing the neck disabiliy using the Neck Disability Index (NDI). Subsequently, the outcome measures that included the cervical range of motion using a Cervical Range of Motion (CROM) device and neck pain using a Numeric Pain Rating Scale (NPRS) were performed. Results: The intra-group comparison indicated a significant improvement in ROM in both groups (p<0.05). An improvement in neck pain was observed inmediately after the interventions. We also observed a decrease in pain and NDI after 15 days of treatment. In the between-group comparison of the mean differences from pre- to post-intervention, there was no statistical significance for all variables. Conclusions: Both upper cervical spine manipulation and cervicothoracic spine manipulations increase the cervical range of motion and decrease neck pain and disability in patients with chronic mechanical neck pain.
Interventions
The study will be carried out in single rehabilitation center.
The intervention was performed by a physiotherapist with more than 5 years of experience in manual therapy.
Intervention: Upper cervical spine manipulation; A single HVLA thrust manipulation directed to the upper cervical spine (C1-C2) with the patient supine was performed. For this technique, the patient’s left posterior arch of the atlas was contacted with the lateral aspect of the proximal phalanx of the therapist’s left second
The study will be carried out in single rehabilitation center. The intervention was performed by a physiotherapist with more than 5 years of experience in manual therapy. Intervention: Upper cervical spine manipulation; A single HVLA thrust manipulation directed to the upper cervical spine (C1-C2) with the patient supine was performed. For this technique, the patient’s left posterior arch of the atlas was contacted with the lateral aspect of the proximal phalanx of the therapist’s left second finger using a “cradle hold.” To localize the forces to the left C1-C2 articulation, secondary levers of extension, posterior-anterior shift, ipsilateral side-bend, and contralateral side-shift were used. While maintaining the secondary levers, the therapist performed a single HVLA thrust manipulation to the left atlanto-axial joint, using the combined thrusting primary levers of right rotation in an arc toward the underside eye and translation toward the table. This was repeated using the same procedure but directed to the right C1-C2 articulation. Data Collection Protocol: The participants were evaluated and intervened in three different sessions (1st session: after signing the informed consent, 2nd session: 7 days after the start, 3rd session: 15 days after the start). The intervention was carried out five minutes after the evaluation and the re-evaluation process began five minutes after the intervention. The order carried out during the data collection protocol was always the same in each of the sessions held both before and after the intervention, with the exception of the disability, which was collected only in the first and the last session. In each session the range of motion was measured first and then the neck pain, before and after the intervention. Prior to the intervention, all participants will sign the informed consent.
Sponsors
Raúl Romero del Rey
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
(a) age between 18-55 years; (b) subject diagnosed with chronic mechanical neck pain (> 3 months of evolution); (c) negative result in orthopedic diagnostic tests (Spurling test, Jackson test, Valsalva test, Klein test, Sharp-Purser test).
Exclusion criteria
(a) surgical history in cervical and / or thoracic spine; (b) signs of vertebro-basilar insufficiency; (c) diagnosis of disc pathology; (d) diagnosis of fibromyalgia or any rheumatic disease; (e) pharmacological treatment (analgesics, NSAIDs, anxiolytics, antidepressants, etc.); (f) present some contraindication to the thrust techniques under study (tumors, infections, rheumatism, fractures, osteoporosis, psychic alterations, congenital malformations, neurological pathologies, etc.)
Outcome results
None listed