Short-Term Effects of Thrust Versus Nonthrust Mobilization/Manipulation Directed at the Thoracic Spine in Patients With Neck Pain: A Randomized Clinical Trial (original) (raw)
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National Journal of Physiology, Pharmacy and Pharmacology, 2020
Background: Neck pain (NP) is a major public health problem, both in terms of personal health and overall well-being as well as indirect expenses. Recently, published clinical practice guidelines suggest that the combination of manual therapy and therapeutic exercise is effective in patients with mechanical NP. One approach to conservative treatment of NP includes cervical mobilization, but it causes complications such as vertebra-basilar artery injury and paraplegia. Alternatively, thoracic spine thrust manipulation may effectively address mechanical NP. Aim and Objective: This study aims to compare the effect of thrust versus non-thrust mobilization of the thoracic spine in patients with mechanical NP. Materials and Methods: Seventy-five participants participated with 38 in Group 1 and 37 in Group 2. Group 1 received thrust mobilization whereas Group 2 received non-thrust mobilization. Outcomes were measured in the form of the numerical rating scale and neck disability index pre-intervention, immediately after treatment, and after 5 days of intervention. Results: Data were analyzed using paired and unpaired "t-test" and results showed that there was a significant improvement in both outcomes immediately and after 5 days of intervention in both groups. However, the greater improvement was seen in Group 1 compared to Group 2. Conclusion: It is concluded that thrust and non-thrust mobilizations of the thoracic spine are effective in patients with NP but thrust mobilization is more effective.
https://www.ijhsr.org/IJHSR\_Vol.8\_Issue.5\_May2018/IJHSR\_Abstract.026.html, 2018
Introduction: Mechanical neck pain has a lifetime prevalence of nearly 50%, estimates suggest that 70% of the population will experience neck pain during their life. Several studies implicate cervical and thoracic spine in causing neck pain. Recent evidence suggests that symptoms of mechanical neck pain can be effectively reduced by using non-thrust mobilisation and thrust manipulation directed to thoracic spine. This study was aimed to find the efficacy of two treatment techniques in reducing symptoms of patients with mechanical neck pain. Experimental Section: A total of 25 patients were included in this study, later randomised into two groups, Group A received upper thoracic junction manipulation and group B received non thrust mobilisation. Both groups received treatment twice a week for three weeks. Efficacy was assessed by NDI, NPRS at baseline and end of third week. Results: Both Groups showed significant improvement with in groups but no significance between groups. Thrust manipulation group has immediate pain relief comparing to non thrust Conclusion: The present study concluded that Both Thrust and non thrust mobilisation are effective in reducing pain and disability.
Journal of Manual & Manipulative Therapy, 2009
It has been demonstrated that patients receiving mobilization techniques do not exhibit tolerance to repeated applications. However, this phenomenon has not been investigated for thoracic manipulation. Our aim was to determine if patients receiving thoracic thrust manipulation exhibit tolerance to repeated applications in acute mechanical neck pain. Forty-five patients were randomly assigned to two groups. The control group received electro-and thermotherapy for 5 sessions, and the experimental group received the same program and also received a thoracic thrust manipulation once a week for 3 consecutive weeks. Outcome measures included neck pain and cervical mobility. Within-session change scores for pain and mobility during treatment sessions #1, 3, and 5 were examined with a one-way repeated measured ANOVA. A 2-way ANOVA with session as within-subject variable and group as between-subject variable was used to compare change scores for each visit between groups to ascertain if there were significant between-group differences in within-session changes for the experimental versus the control group. The ANOVA showed that for either group the 3 within-session change scores were not significantly different (P > 0.1). The 2-way ANOVA revealed significant differences between groups for both pain and neck mobility in within-session change scores (all, P < 0.001). Change scores in each session were superior in the experimental group then in the control group. The results suggest that patients receiving thoracic manipulation do not exhibit tolerance to repeated applications with regard to pain and mobility measures in acute mechanical neck pain. Further studies should investigate the dose-response relationship of thoracic thrust manipulation in this population.
Immediate effects of thoracic manipulation in patients with neck pain: a randomized clinical trial
Mechanical neck pain is a common occurrence in the general population resulting in a considerable economic burden. Often physical therapists will incorporate manual therapies directed at the cervical spine including joint mobilization and manipulation into the management of patients with cervical pain. Although the effectiveness of mobilization and manipulation of the cervical spine has been well documented, the small inherent risks associated with these techniques has led clinicians to frequently utilize manipulation directed at the thoracic spine in this patient population. It is hypothesized that thoracic spine manipulation may elicit similar therapeutic benefits as cervical spine manipulation while minimizing the magnitude of risk associated with the cervical technique. The purpose of this randomized clinical trial was to investigate the immediate effects of thoracic spine manipulation on perceived pain levels in patients presenting with neck pain. The results suggest that thoracic spine manipulation results in immediate analgesic effects in patients with mechanical neck pain. Further studies are needed to determine the effects of thoracic spine manipulation in patients with neck pain on long-term outcomes including function and disability. r
Ita.J. Sports Reh.Po., 2020
Study Design: Randomized clinical trial. Background: Mechanical neck pain has a lifetime prevalence of nearly 50%, estimates suggest that 70% of the population will experience neck pain during their life. Several studies implicate cervical and thoracic spine in causing neck pain. Recent evidence suggests that symptoms of mechanical neck pain can be effectively reduced by using high velocity low amplitude thrust manipulation directed to cervical and thoracic spine. This study was aimed to find the efficacy of two treatment techniques in reducing symptoms of patients with mechanical neck pain. Objective: To investigate the long-term effects of cervical spine thrust manipulation (cervical group) versus thoracic spine thrust manipulation (thoracic group) in individuals with mechanical neck pain. Methods: Ninety patients with persistent chronic mechanical neck pain participated in this study. Patients were evaluated using the Neck Disability Index and a numeric pain rating scale for pain. Patients with CMNP were randomly allocated to multi-level cervical manipulation (MCM) or multi-level thoracic manipulation (MTM). both groups also received global postural re-education (GPR). Outcome measures Numeric pain rating scale (NPRS) and Neck Disability Index (NDI) scores were measured at baseline, 1 month, 3 month and at 6-month follow-up. Results: Numeric pain rating scale (NPRS), and Neck Disability Index (NDI) were (P<0.05) improved in the both MCM and MTM groups. But significant improvement seen in cervical manipulation group. Participants in the cervical manipulation group demonstrated significantly greater improvements (P<.001) on both the numeric pain rating scale and Neck Disability Index in all follow-up period compared to those in the comparison of thoracic group. Conclusion: These results suggest that both multi-level cervical and thoracic spine high velocity low amplitude thrust manipulation plus global posture re-education demonstrated better overall long -term outcomes on the numeric pain rating scale, and Neck Disability Index at baseline,1 month,3 month and at 6-month follow-up in Patients with chronic mechanical neck pain. Authorship Credit. “Equal Contribution” (EC). Citation. Mehul Padasala, Sharmila B, Rosario D’Onofrio, Claudio Civitillo, Jaymin Bhatt : Long term effects of cervical thrust versus thoracic thrust Manipulation in patients with chronic mechanical neck pain: Double blinded randomized clinical trial. Ita. J. Sports Reh. Po. 2022; 9 (19); 1;2; 1964 – 1988-; ISSN 2385-1988 [online]; IBSN 007-111-19-55; CGI J OAJI 0,101)]. Published online. Corresponding Author email: padasalamehulkumar@gmail.com,