Short-term effects of manipulative treatment versus a therapeutic home exercise protocol for chronic cervical pain: A randomized clinical trial
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Andersen, Lars L
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BACKGROUND: While both manipulative treatment and physical exercises are used to treat cervical pain, it remains unclear which is most effective. OBJECTIVE: To compare the short-term effects of high-velocity, low-amplitude manipulation techniques (MT) with those of home-exercise (HE) with stretching and low-intensity (10% of max) isometric contractions on pain and function. METHODS: Single-blind randomized clinical trial was performed. A total of 27 asymptomatic subjects were randomly assigned to 2 groups: manipulation techniques (MT, n= 13) and home exercise (HE, n= 14). The visual analogue scale (VAS); neck disability index (NDI); pressure pain thresholds; cervical spine range of motion and electromyography during the cranio-cervical flexion test was measured before and one week after the intervention. RESULTS: After the intervention, both groups showed improved (P less than 0.05) NDI and VAS scores and flexion in both rotation ranges compared with the pre-intervention values. For the NDI, pain intensity, and neck flexion, the effects sizes were large; for the majority of the other measurements, the effect sizes were small to moderate. The MT group showed significantly better results than the HE group for 2 out of 17 tests. CONCLUSIONS: Both interventions improved function and pain after one week, with only marginal between-group differences in favor of MT. © 2018 - IOS Press and the authors. All rights reserved.
Article , Spinal , Clinical article , Controlled study , Cranio cervical flexion test , Electromyography , Female , Function test , Home exercise therapy , Human , Kinesiotherapy , Male , Manipulative medicine , Neck Disability Index , Neck pain , Pain intensity , Priority journal , Randomized controlled trial , Range of motion , Single blind procedure , Visual analog scale , Adult , Chronic pain , Follow up , Kinesiotherapy , Middle aged , Neck pain , Pain measurement , Pain threshold , Pathophysiology , Physiology , Procedures , Spine manipulation , Time factor , Treatment outcome , Young adult , Adult , Chronic Pain , Electromyography , Exercise Therapy , Female , Follow-Up Studies , Humans , Male , Manipulation , Middle Aged , Neck Pain , Pain Measurement , Pain Threshold , Single-Blind Method , Time Factors , Treatment Outcome , Young Adult , Cervical vertebrae , Electromyography , Neck pain , Spinal manipulation , Thoracic vertebrae