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• CHRONIC MECHANICAL NECK PAIN IN ADULTS TREATED |
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By:Howard Vernon, DC, PhD1, Barry Kim Humphreys, DC, PhD1
Abstract: We report a systematic analysis of group change scores of subjects with
chronic neck pain not due to whiplash and without headache or arm pain, in randomized
clinical trials of a single session of manual therapy. A comprehensive literature search of
clinical trials of chronic neck pain treated with manual therapies up to December 2006 was
conducted. Trials that scored above 60% on the PEDro Scale were included. Change scores
were analyzed for absolute, percentage change and effect size (ES) whenever possible. Nine
trials were identified: 6 for spinal manipulation, 4 for spinal mobilization or non-manipulative
manual therapy (2 overlapping trials), and 1 trial using ischemic compression. No trials
were identified for massage therapy or manual traction. Four manipulation trials (five
groups) reported mean immediate changes in 100-mm VAS of –18.94 (9.28) mm. ES for
these changes ranged from .33 to 2.3. Two mobilization trials reported immediate VAS
changes of –11.5 and –4 mm (ES of .36 and .22, respectively); one trial reported no difference
in immediate pain scores versus sham mobilization. The ischemic compression study
showed statistically significant immediate decreases in 100-mm pain VAS (average = –14.6
mm). There is moderate-to-high quality evidence that immediate clinically important improvements
are obtained from a single session of spinal manipulation. The evidence for
mobilization is less substantial, with fewer studies reporting smaller immediate changes.
There is insufficient evidence for ischemic compression to draw conclusions. There is no
evidence for a single session of massage or manual traction for chronic neck pain.
Read the entire article on the JMMT website: http://jmmtonline.com/ |
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