Different Types of Manual Therapy Techniques in Patients With Chronic Neck Pain
Condition: Neck Pain
MeSH terms: Neck Pain
Study type: Interventional

Summary: 
      The purpose of this study was to investigate the comparative effectiveness of high velocity
      and low amplitude (HVLA)vs Mobilization (Mob) vs Mobilization with movement technique (MWMT)
      in sample of patients with chronic neck pain (CNP). Secondly to evaluate the immediate
      effects in range of motion and pain thresholds, and the interaction between psychological
      factors and the outcomes of these three types of manual therapy.

      The hypothesis is that all manual therapies techniques will produce similar effects.
    

Detailed description: 
      The randomized controlled trial included patients with mechanically reproducible CNP, ≥ age
      18-years who are randomized into three groups of treatment. The main outcome measures were
      the Visual Analogue scale (VAS), and, with secondary measures of Neck Disability Index (NDI),
      Global Rating Of Change (GROC), Cervical Range Of Motion (CROM), Pressure Pain Threshold
      (PPT), State Trait Anxiety Inventory (STAI-T), Beck depression Inventory (BDI-II), Tampa
      Scale for Kinesiophobia, Pain Catastrophizing Scale (PCS).
    

Intervention name(s): Manipulation; Mobilization; Mobilization with movement
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): The Cervical Spine Manipulation is a manual therapy technique directed at the hypomobile and painful vertebral level. The subject was supine with the cervical spine in a neutral position. The index finger of the therapist applies contact over the posterolateral aspect of the zygapophyseal joint of the hypomobile vertebra. The therapist performs the technique taking account the most limited movement; lateral or rotational. A maximum of 2 attempts will performed on each subject regardless audible cavitation.; The mobilization is a passive oscillatory technique, applied over cervical region in the hypomobile cervical level, the patient will be in prone and the therapist standing at the head of the patients with his thumbs in opposition placed at the level of the facet of the hypomobile cervical vertebra. A posteroanterior(PA) oscillatory pressure is applied, through the thumbs, over the process of the hypomobile vertebra. This oscillatory mobilization, is performed at a frequency of 2Hz (with metronome control/steps) for 2 minutes and repeated 3 times. The rest time between each mobilization was 1 minute.; This is a manual therapy technique that consist of applied a sustain pressure over cervical hypomobile symptomatic level and request to patient a pain free movement.
For performs it, the therapist placed his thumbs on the articular process of that level. The patient sitting. Then, the subject had to perform actively the painful motion while the therapist guides the movement of that vertebra and resists it while returning to neutral. The strength applied was parallel to the plane of the joint, and the procedure was performed in 3 sets of 10 repetitions.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Posterior Neck Pain; Cervical spine pain; Manual therapy