title: Comparative short-term effects of two thoracic spinal manipulation techniques in subjects with chronic mechanical neck pain: a randomized controlled trial.
abstract: Spinal Manipulation (SM) has been purported to decrease pain and improve function in subjects with non-specific neck pain. Previous research has investigated which individuals with non-specific neck pain will be more likely to benefit from SM. It has not yet been proven whether or not the effectiveness of thoracic SM depends on the specific technique being used. This double-blind randomized trial has compared the short-term effects of two thoracic SM maneuvers in subjects with chronic non-specific neck pain. Sixty participants were distributed randomly into two groups. One group received the Dog technique (n = 30), with the subject in supine position, and the other group underwent the Toggle-Recoil technique (n = 30), with the participant lying prone, T4 being the targeted area in both cases. Evaluations were made of self-reported neck pain (Visual Analogue Scale); neck mobility (Cervical Range of Motion); and pressure pain threshold at the cervical and thoracic levels (C4 and T4 spinous process) and over the site described for location of tense bands of the upper trapezius muscle. Measurements were taken before intervention, immediately afterward, and 20 min later. Both maneuvers improved neck mobility and mechanosensitivity and reduced pain in the short term. No major or clinical differences were found between the groups. In the between-groups comparison slightly better results were observed in the Toggle-Recoil group only for cervical extension (p = 0.009), right lateral flexion (p = 0.004) and left rotation (p < 0.05).
authors.affiliation: Madrid Osteopathic School, Madrid, Spain.
authors.forename: Amaloha
authors.initials: A
authors.lastname: Casanova-Méndez
authors.affiliation: Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, c/Avicena s/n, 41009 Sevilla, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Oliva-Pascual-Vaca
authors.affiliation: Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, c/Avicena s/n, 41009 Sevilla, Spain.
authors.forename: Cleofás
authors.initials: C
authors.lastname: Rodriguez-Blanco
authors.affiliation: Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, c/Avicena s/n, 41009 Sevilla, Spain. Electronic address: amheredia@us.es.
authors.forename: Alberto Marcos
authors.initials: AM
authors.lastname: Heredia-Rizo
authors.affiliation: Madrid Osteopathic School, Madrid, Spain.
authors.forename: Kristobal
authors.initials: K
authors.lastname: Gogorza-Arroitaonandia
authors.affiliation: Madrid Osteopathic School, Madrid, Spain.
authors.forename: Ginés
authors.initials: G
authors.lastname: Almazán-Campos
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000175:diagnosis / Q000534:rehabilitation*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020393:Manipulation, Spinal / Q000379:methods*; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis / Q000534:rehabilitation*; D010147:Pain Measurement; D056888:Patient Positioning / Q000379:methods*; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D012720:Severity of Illness Index; D013904:Thoracic Vertebrae; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cervical spine; Neck pain; Randomized controlled trial; Spinal manipulation