title: Thoracic spine thrust manipulation improves pain, range of motion, and self-reported function in patients with mechanical neck pain: a systematic review.
abstract: METHODS
  Systematic review.
  
  
  BACKGROUND
  Neck pain is a common diagnosis in the physical therapy setting, yet there is no gold standard for treatment. This study is part of a growing body of literature on the use of thoracic spine thrust manipulation for the treatment of individuals with mechanical neck pain.
  
  
  OBJECTIVE
  The purpose of this systematic review was to determine the effects of thoracic spine thrust manipulation on pain, range of motion, and self-reported function in patients with mechanical neck pain.
  
  
  METHODS
  Six online databases were comprehensively searched from their respective inception to October 2010. The primary search terms included "thoracic mobilization," "thoracic spine mobilization," "thoracic manipulation," and "thoracic spine manipulation." Of the 44 studies assessed for inclusion, 6 randomized controlled trials were retained. Between-group mean differences and effect sizes for pretreatment-to-posttreatment change scores, using Cohen's d formula, were calculated for pain, range of motion, and subjective function at all stated time intervals.
  
  
  RESULTS
  Effect size point estimates for the pain change scores were significant for global assessment across all studies (range, 0.38-4.03) but not conclusively significant at the end range of active rotation (range, 0.02-1.79). Effect size point estimates were large among all range-of-motion change measures (range, 1.40-3.52), and the effect size point estimates of the change scores among the functional questionnaires (range, 0.47-3.64) also indicated a significant treatment effect.
  
  
  CONCLUSIONS
  Thoracic spine thrust manipulation may provide short-term improvement in patients with acute or subacute mechanical neck pain. However, the body of literature is weak, and these results may not be generalizable.
  
  
  METHODS
  Therapy, level 1b-.
authors: Kevin M
authors: KM
authors: Cross
authors: Chris
authors: C
authors: Kuenze
authors: Terry L
authors: TL
authors: Grindstaff
authors: Jay
authors: J
authors: Hertel
mesh_terms: D006801:Humans; D008297:Male; D020393:Manipulation, Spinal / Q000009:adverse effects / Q000379:methods*; D019547:Neck Pain / Q000628:therapy*; D016059:Range of Motion, Articular / Q000502:physiology*; D013904:Thoracic Vertebrae / Q000503:physiopathology; D016896:Treatment Outcome