The effect of cervical spine manipulation compared to muscle energy technique on neck muscle activity and range of motion in asymptomatic participants (original) (raw)
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International Journal of Physiotherapy, 2017
Background: Neck pain has been reported as a prevalent musculoskeletal disorder globally with more than half of the general population being affected once or more within their life span. Methods: A randomized clinical trial research design was used which investigated the immediate effect of cervical manipulation on neck pain and cervical range of motion among patients with chronic mechanical neck pain. 20 male and female participants between the ages of 26 to 60 years with chronic mechanical neck pain attending physiotherapy clinics were recruited. They were randomly assigned into two groups (A and B) of 10 patients each. Group A received soft tissue massage, and cervical manipulation and group B served as the control group, and they received only soft tissue massage. There were two outcomes measured; Pain intensity was rated using visual analog scale (VAS) before and immediately after the intervention. Pre and Post intervention measurements of cervical spine range of motion using Goniometer were also taken. Results: Findings of the study revealed significant immediate improvement of pain and Cervical Range of Motions (p<0.05) in all dimensions in the experimental group while Pain, flexion and right side Cervical flexion significantly improved in the control group. It was also found out after comparing the outcomes between the two groups that, the experimental group had significantly (p<0.05) better improvement than the control group in post-intervention pain, cervical flexion, cervical extension and cervical (right and left) lateral rotations. Conclusion: Cervical manipulation is effective in immediate pain relief and improvement in cervical range of motion in patients with mechanical neck pain.
Effects of spinal manipulation in patients with mechanical neck pain
Coluna/Columna, 2014
Objective: To analyse changes in the range of motion (ROM) and pain after spinal manipulation of the cervical spine and thoracic spine in subjects with mechanical neck pain. Methods : Spinal manipulations were performed in the cervical and thoracic spine with the Gonstead and Diversified DTV techniques. To assess cervical ROM an inclinometer was used. Cervical pain was assessed by Visual Analogue Scale (VAS). The participation of 73 patients was obtained. Ages ranged from 18 to 63 years, with an average of 42.27 years. The subjects of this study were characterized by having mechanical neck pain and restricted cervical ROM. Results: We observed a reduction in the intensity of pain perceived by patients and increased cervical ROM. There were significant differences between pre-treatment values (first visit) and the fifth and tenth visits (p<0.01), and between the fifth and tenth visits (p<0.01) in all parameters except in the cervical extension of 70º. Conclusions: The results o...
International journal of applied research, 2020
Background and Objectives: In routine life style various causes traumatic, inflammation, degenerative changes alters the biomechanics of cervical spine produce chronic neck pain, reduce the active ROM, reduce functional mobility and produce disability in neck. There for the present study aims to evaluate the effectiveness of HVLAT manipulation with muscle energy technique versus muscle energy technique alone in subjects with chronic neck pain as assessed by VAS, ROM, NDI and PSFS. Materials and Methods: A randomized controlled trial study was done and 120 subjects with diagnosis of chronic neck pain mean age 18-45 years both male and female were included in the study. Group A received HVLAT manipulation and Muscle Energy Technique and Group B received Muscle Energy Technique alone. The outcome was assessed in terms of Visual analog scale (VAS), active cervical ROM, Neck Disability Index (NDI) and Patient Specific Functional Scale (PSFS) at baseline and immediately post intervention....
Journal of the Pakistan Medical Association
Neck is one of the most common site of musculoskeletal symptom manifestations. An impaired spinal curvature is a common finding in patients with mechanical neck pain. A pre-post quasi experimental pilot study was conducted at Fauji Foundation Hospital from January-March 2017,in which 12 patients with mechanical neck pain and straightening of the cervical spine were included and treated for 7 consecutive sessions consisting of muscle energy techniques (MET) in combination with facet joint mobilization. The objective of this study was to determine the effects of MET and facet joint mobilization on spinal curvature and functional outcomes in patients with neck pain. Outcome measurement tools that were included comprised of pain severity, neck disability index (NDI), cervical lordosis which was measured via x-ray based posterior tangential method, goniometry for cervical range of motion (ROM) and modified sphygmomanometer dynamometry (MSD) for isometric muscle strength. A significant difference was observed in pre and post treatment scores for all outcomes (p<0.05); demonstrating an effective combination therapy in terms of improved spinal curvature, pain, disability, ROM and isometric muscle strength.
2016
Neck pain is one of the most common problems seen in medical practice. There are various factors that can cause or provoke neck pain. Myofascial trigger points in shoulder and neck regions are among the most effective factors that may provoke neck and head pain. Recently, it has been revealed that there is a clinical relationship between myofascial trigger points and joints dysfunction. Accordingly, different studies have been conducted in order to evaluate therapeutic effects of different manual approaches including mobilization and manipulation on improving Pressure Pain Threshold (PPT) as an indicator of changes in sensitivity of muscles. The aim of the present study was to conduct a narrative review to evaluate effects of manipulation and mobilization techniques of cervical spine on PPT in neck and shoulder muscles. From among different studies which have assessed the effectiveness of manual techniques directed on cervical spine, 10 most related studies were selected and the the...
Pakistan BioMedical Journal, 2022
The goal of this study was to examine the effectiveness of muscular energy method with deep neck flexors training on pain, range of motion, and functional impairment in individuals with mechanical neck pain. This randomized controlled trial was carried out at the Mayo Hospital's OPD physiotherapy department in Lahore. In this study, 30 patients were chosen at random and divided into two groups: Group 1 was treated with deep neck flexors training, while Group 2 was treated with muscular energy method (post isometric relaxation). Every patient signed a Performa and gave their informed permission. The questioner used to collect data was based on the NDI, Visual analogue scale (VAS), and Ranges of motion (flexion, extension, rotation, and side bending at neck). Patients in group 1 showed marked improvement as compared to group 2. Both groups showed improvement but group 1 showed statistically more improvement (p value<or =to 0.05). It is concluded from the study that, patients wi...
Journal of Manipulative and Physiological Therapeutics, 2016
Objective: The purpose of this study was to compare the effects of 2 different cervical manipulation techniques for mechanical neck pain (MNP). Methods: Participants with MNP of at least 1 month's duration (n = 65) were randomly allocated to 3 groups: (1) stretching (control), (2) stretching plus manually applied manipulation (MAM), and (3) stretching plus instrument-applied manipulation (IAM). MAM consisted of a single high-velocity, low-amplitude cervical chiropractic manipulation, whereas IAM involved the application of a single cervical manipulation using an (Activator IV) adjusting instrument. Preintervention and postintervention measurements were taken of all outcomes measures. Pain was the primary outcome and was measured using visual analogue scale and pressure pain thresholds. Secondary outcomes included cervical range of motion, hand grip-strength, and wrist blood pressure. Follow-up subjective pain scores were obtained via telephone text message 7 days postintervention. Results: Subjective pain scores decreased at 7-day follow-up in the MAM group compared with control (P = .015). Cervical rotation bilaterally (ipsilateral: P = .002; contralateral: P = .015) and lateral flexion on the contralateral side to manipulation (P = .001) increased following MAM. Hand grip-strength on the contralateral side to manipulation (P = .013) increased following IAM. No moderate or severe adverse events were reported. Mild adverse events were reported on 6 occasions (control, 4; MAM, 1; IAM, 1). Conclusion: This study demonstrates that a single cervical manipulation is capable of producing immediate and short-term benefits for MNP. The study also demonstrates that not all manipulative techniques have the same effect and that the differences may be mediated by neurological or biomechanical factors inherent to each technique.
Brain Sciences, 2019
To investigate the effects of a single session of spinal manipulation (SM) on voluntary activation of the elbow flexors in participants with subclinical neck pain using an interpolated twitch technique with transcranial magnetic stimulation (TMS), eighteen volunteers with subclinical neck pain participated in this randomized crossover trial. TMS was delivered during elbow flexion contractions at 50%, 75% and 100% of maximum voluntary contraction (MVC) before and after SM or control intervention. The amplitude of the superimposed twitches evoked during voluntary contractions was recorded and voluntary activation was calculated using a regression analysis. Dependent variables were analyzed with two-way (intervention × time) repeated measures ANOVAs. Significant intervention effects for SM compared to passive movement control were observed for elbow flexion MVC (p = 0.04), the amplitude of superimposed twitch (p = 0.04), and voluntary activation of elbow flexors (p =0.03). Significant ...
BMC Musculoskeletal Disorders
Background: Neck pain is a major health issue with high rates of recurrence. It presents with a variety of altered sensorimotor functions. Exercise is a cornerstone of rehabilitation and many training methods are used. Exercise is evaluated in most randomized controlled trials on its pain relieving effects. No review has assessed the effect of exercise on the altered physiological functions or determined if there are differential effects of particular training methods. This review investigated the effects of deep cervical flexor (DCF) training, a training method commonly used for patients with neck pain, and compared it to other training methods or no training on outcomes of cervical neuromuscular function, muscle size, kinematics and kinetics. Methods: Web of Science, Scopus, CINAHL, PubMed were searched from inception until January 2018. Twelve randomized controlled trials were included that compared DCF training as sole intervention to other training or no interventions in persons with neck pain. The Cochrane Risk of Bias tool was used to assess the method quality. All outcome measures were analysed descriptively and meta-analyses were performed for measures evaluated in three or more studies. Results: DCF training was compared to cervical endurance, strength, proprioception and mobility training, muscle stretching, and no intervention control groups. Physiological outcome measures included neuromuscular coordination (craniocervical flexion test), functional tasks, muscle fatigability, muscle size, kinematics (joint position sense, posture and range of motion) and kinetics (strength, endurance and contraction accuracy). Strong evidence was found for effectiveness of DCF training on neuromuscular coordination, but it had no or small effects on strength and endurance at higher loads. DCF training improved head and cervical posture, while evidence was limited or contradictory for other measures. Conclusions: DCF training can successfully address impaired neuromuscular coordination, but not cervical flexor strength and endurance at higher contraction intensities. A multimodal training regime is proposed when the aim is to specifically address various impaired physiological functions associated with neck pain.
Extension and flexion in the upper cervical spine in neck pain patients
Manual therapy, 2014
Neck pain is a common problem in the general population with high risk of ongoing complaints or relapses. Range of motion (ROM) assessment is scientifically established in the clinical process of diagnosis, prognosis and outcome evaluation in neck pain. Anatomically, the cervical spine (CS) has been considered in two regions, the upper and lower CS. Disorders like cervicogenic headache have been clinically associated with dysfunctions of the upper CS (UCS), yet ROM tests and measurements are typically conducted on the whole CS. A cross-sectional study assessing 19 subjects with non-specific neck pain was undertaken to examine UCS extension-flexion ROM in relation to self-reported disability and pain (via the Neck Disability Index (NDI)). Two measurement devices (goniometer and electromagnetic tracking) were employed and compared. Correlations between ROM and the NDI were stronger for the UCS compared to the CS, with the strongest correlation between UCS flexion and the NDI-headache ...