Ion Lascurain-Aguirrebeña1, Di J Newham2, Xabat Casado-Zumeta3, Aitana Lertxundi4, Duncan J Critchley5. 1. Division of Health and Social Care Research, Faculty of Life Sciences & Medicine, King's College London, London, SE1 1UL, United Kingdom; Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Leioa, 48940, Spain. Electronic address: ion.lascurain@ehu.eus. 2. Centre of Human & Applied Physiological Sciences, Faculty of Life Sciences & Medicine, King's College London, London, SE1 1UL, United Kingdom. Electronic address: di.newham@kcl.ac.uk. 3. Atlas Fisioterapia, Donostia-San Sebastian, 20008, Spain. Electronic address: xabatcasado@gmail.com. 4. Department of Preventive Medicine and Public Health, University of the Basque Country UPV/EHU, Leioa, 48940, Spain; Health Research Institute, Biodonostia, San Sebastian, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain. Electronic address: aitana.lertxundi@ehu.eus. 5. Division of Health and Social Care Research, Faculty of Life Sciences & Medicine, King's College London, London, SE1 1UL, United Kingdom. Electronic address: duncan.critchley@kcl.ac.uk.
Abstract
BACKGROUND:Neck pain is prevalent, costly and disabling. Cervical mobilisations are frequently used to treat it but their effectiveness has been questioned by several systematic reviews. Evidence suggests that better outcomes are achieved with mobilisations when they are applied to specific patient subgroups. A criteria for patients suitable for neck mobilisations has been proposed, but the effectiveness on this patient subgroup has not been tested. OBJECTIVE: To assess the effectiveness of cervical mobilisations applied to a subgroup of patients with neck pain who fulfil specific criteria. DESIGN: Randomised controlled trial. METHOD:40 patients with neck pain attending a Physiotherapy clinic were recruited and randomised to a single session of either cervical mobilisations or motionless manual contact placebo. The immediate effects on global perceived effect, range of movement (ROM), movement velocity and movement associated pain were assessed. RESULTS: mobilisation participants reported significantly better global perceived effect (p˂0.001) and improvements in movement associated pain (p = 0.041). Mobilisations produced a significant increase in ROM in side flexion (p = 0.006) and rotation (p = 0.044) when compared with placebo, but only in patients with pre-intervention ROM restriction. 29-47% of all movement associated pains were resolved following mobilisations and 11-27% following placebo. Patients in both groups showed a significant (p < 0.05) increase in movement velocity, but only in those who had a velocity restriction pre-intervention. CONCLUSIONS:Cervical mobilisations are effective in improving movement-associated pain, increasing ROM and velocity, and patient perceived improvement when applied to patients with neck pain that fulfil a criteria. Their use should be advocated.
RCT Entities:
BACKGROUND:Neck pain is prevalent, costly and disabling. Cervical mobilisations are frequently used to treat it but their effectiveness has been questioned by several systematic reviews. Evidence suggests that better outcomes are achieved with mobilisations when they are applied to specific patient subgroups. A criteria for patients suitable for neck mobilisations has been proposed, but the effectiveness on this patient subgroup has not been tested. OBJECTIVE: To assess the effectiveness of cervical mobilisations applied to a subgroup of patients with neck pain who fulfil specific criteria. DESIGN: Randomised controlled trial. METHOD: 40 patients with neck pain attending a Physiotherapy clinic were recruited and randomised to a single session of either cervical mobilisations or motionless manual contact placebo. The immediate effects on global perceived effect, range of movement (ROM), movement velocity and movement associated pain were assessed. RESULTS: mobilisation participants reported significantly better global perceived effect (p˂0.001) and improvements in movement associated pain (p = 0.041). Mobilisations produced a significant increase in ROM in side flexion (p = 0.006) and rotation (p = 0.044) when compared with placebo, but only in patients with pre-intervention ROM restriction. 29-47% of all movement associated pains were resolved following mobilisations and 11-27% following placebo. Patients in both groups showed a significant (p < 0.05) increase in movement velocity, but only in those who had a velocity restriction pre-intervention. CONCLUSIONS: Cervical mobilisations are effective in improving movement-associated pain, increasing ROM and velocity, and patient perceived improvement when applied to patients with neck pain that fulfil a criteria. Their use should be advocated.