title: A randomized clinical trial to compare the immediate effects of seated thoracic manipulation and targeted supine thoracic manipulation on cervical spine flexion range of motion and pain.
abstract: METHODS
  Randomized clinical trial.
  
  
  OBJECTIVE
  To determine the effectiveness of seated thoracic manipulation versus targeted supine thoracic manipulation on cervical spine pain and flexion range of motion (ROM). There is evidence that thoracic spine manipulation is an effective treatment for patients with cervical spine pain. This evidence includes a variety of techniques to manipulate the thoracic spine. Although each of them is effective, no research has compared techniques to determine which produces the best outcomes.
  
  
  METHODS
  A total of 39 patients with cervical spine pain were randomly assigned to either a seated thoracic manipulation or targeted supine thoracic manipulation group. Pain and flexion ROM measures were taken before and after the intervention.
  
  
  RESULTS
  Pain reduction (post-treatment-pre-treatment) was significantly greater in those patients receiving the targeted supine thoracic manipulation compared to the seated thoracic manipulation (P<0.05). Although not significant, we did observe greater improvement in flexion ROM in the targeted supine thoracic manipulation group. The results of this study indicate that a targeted supine thoracic manipulation may be more effective in reducing cervical spine pain and improving cervical flexion ROM than a seated thoracic manipulation. Future studies should include a variety of patients and physical therapists (PTs) to validate our findings.
authors: Physical Therapy Program, Chatham University, Pittsburgh, PA, USA.
authors: Steve
authors: S
authors: Karas
authors: Department of Biostatistics, University of Pittsburgh, PA, USA.
authors: Megan J
authors: MJ
authors: Olson Hunt
keywords: Cervical spine pain; Orthopedic manipulative therapy; Thoracic spine; Thoracic spine manipulation