title: Chinese manipulation for mechanical neck pain: a systematic review.
abstract: OBJECTIVE
  To assess whether Chinese manipulation improves pain, function/disability and global perceived effect in adults with acute/subacute/chronic neck pain.
  
  
  METHODS
  CAJ Full-text Database (Chinese), Wanfang Database (Chinese), Cochrane Database (English) and Medline (English).
  
  
  METHODS
  Literature searching was performed with the following keywords and their combination: 'manual therapy/bone setting/Chinese manipulation', 'neck/cervical pain', 'cervical vertebrae', 'cervical spondylosis/radiculopathy' and 'randomized controlled trial/review.' Two independent reviewers selected studies, extracted data and assessed risk of bias for each included study. Randomized controlled trials or quasi-randomized controlled trials on the effect of Chinese manipulation in treating adult patients with neck pain were selected. Mean differences with 95% confidence intervals (CI) were calculated. Quality of the evidence was assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
  
  
  RESULTS
  Four studies (610 participants) were included in this review. There was very low-quality evidence suggesting that, compared to cervical traction in sitting, Chinese manipulation produced more immediate post-intervention pain relief (mean difference: -1.06; 95% CI: -1.37~ -0.75; P < 0.001) and improvement of global signs and symptoms (mean difference: -3.81; 95% CI: -4.71 ~ -2.91; P < 0.001). Very low-quality evidence showed that Chinese manipulation alone was superior to Chinese traditional massage in immediate post-intervention pain relief (mean difference: -2.02; 95% CI: -2.78~ -1.26; P < 0.001).
  
  
  CONCLUSIONS
  There was limited evidence showing Chinese manipulation could produce short-term improvement for neck pain.
authors.affiliation: Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
authors.forename: Jian Hua
authors.initials: JH
authors.lastname: Lin
authors.forename: Thomas Tai Wing
authors.initials: TT
authors.lastname: Chiu
authors.forename: Jia
authors.initials: J
authors.lastname: Hu
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries / Q000503:physiopathology; D006801:Humans; D008516:Medicine, Chinese Traditional / Q000379:methods*; D026201:Musculoskeletal Manipulations / Q000379:methods*; D019547:Neck Pain / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D014143:Traction; D016896:Treatment Outcome