Is one better than another?: A randomized clinical trial of manual therapy for patients with chronic neck pain.
Our purpose was to compare the effectiveness of three manual therapy techniques: high velocity, low amplitude (HVLA), mobilization (Mob) and sustained natural apophyseal glide (SNAG) in patients with chronic neck pain (CNP). The randomized controlled trial included patients with mechanically reproducible CNP, who were randomized to the treatment group. Outcome measures were the Visual Analogue scale (VAS), Neck Disability Index (NDI), Global Rating of Change (GROC) and Cervical Range of Motion (CROM). Two-way repeated measures analysis of variance compared outcomes at baseline, at the end of treatment and 1, 2 and 3 months after treatment. A total of 51 subjects completed the trial. No significant differences were found between HVLA, Mob and SNAG at the end of treatment and during the follow-up in any of the analysed outcomes. There were no differences in satisfaction for all techniques. The results lead to the conclusion that there is no long-term difference between the application of HVLA, Mob and SNAG in pain, disability and cervical range of motion for patients with CNP.
Department of Physiotherapy, Universidad Europea de Madrid, Villaviciosa de Odon, Madrid, Spain.
Honorio
H
Izquierdo Pérez
Department of Physiotherapy, Universidad Europea de Madrid, Villaviciosa de Odon, Madrid, Spain; Research Group in Musculoskeletal Pain and Motor Control, Universidad Europea de Madrid, Villaviciosa de Odon, Spain; Department of Physical Therapy, University Hospital del Henares, Coslada, Madrid, Spain.
Jose Luis
JL
Alonso Perez
Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain; Faculty of Health Science, Department of Physiotherapy, The Center for Advanced Studies University La Salle, Autonoma University of Madrid, Aravaca, Madrid, Spain.
Alfonso
A
Gil Martinez
Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain; Faculty of Health Science, Department of Physiotherapy, The Center for Advanced Studies University La Salle, Autonoma University of Madrid, Aravaca, Madrid, Spain.
Roy
R
La Touche
Faculty of Health Science, Department of Physiotherapy, The Center for Advanced Studies University La Salle, Autonoma University of Madrid, Aravaca, Madrid, Spain; Movement Analysis Laboratory, University Hospital Niño Jesus, Madrid, Spain.
Sergio
S
Lerma-Lara
Research Group in Musculoskeletal Pain and Motor Control, Universidad Europea de Madrid, Villaviciosa de Odon, Spain.
Noelia
N
Commeaux Gonzalez
Department of Physical Therapy, University Hospital del Henares, Coslada, Madrid, Spain.
Hector
H
Arribas Perez
University of Florida, Department of Physical Therapy, United States.
Mark D
MD
Bishop
Research Group in Musculoskeletal Pain and Motor Control, Universidad Europea de Madrid, Villaviciosa de Odon, Spain; Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. Electronic address: josue.fernandez@urjc.es.
Josue
J
Fernández-Carnero
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D059350:Chronic Pain; D004185:Disability Evaluation; D004311:Double-Blind Method; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020393:Manipulation, Spinal / Q000379:methods*; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods; D019547:Neck Pain / Q000175:diagnosis / Q000534:rehabilitation*; D010147:Pain Measurement; D056888:Patient Positioning; D016059:Range of Motion, Articular / Q000502:physiology*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
Chronic neck pain; Manual therapy; Musculoskeletal manipulations; Randomized controlled trial