The immediate effects of thoracic transverse mobilization in patients with the primary complaint of mechanical neck pain: a pilot study.
OBJECTIVE
Posterior-to-anterior (PA) vertebral mobilization to the thoracic spine has been studied as an intervention for neck pain. Our purpose was to explore effects of a different mobilization technique, transverse vertebral pressure, on cervical range of motion (ROM) and pain when applied to the thoracic spine among participants with neck pain.


METHODS
A single-blinded quasi-experimental study with a one-group pretest-posttest design. A transverse group consisted of 21 participants whose neck pain increased with active movements. A non-intervention group of 20 asymptomatic participants was included simply to ensure rater blinding. The treatment group received Grades IV to IV+ transverse mobilizations at T1 through T4 bilaterally. Measurements taken immediately after intervention included pre/post cervical ROM, distant pressure pain threshold (PPT), and a numerical pain rating scale (NPRS). Analysis utilized t-tests and ordinal counterparts.


RESULTS
The transverse group demonstrated significant gains in extension and bilateral rotation (P≤0.005) but not flexion or side-bend. A total of 57% of mobilized participants reported clinically meaningful decreased pain (P<0.001). Seven participants exceeded the PPT MDC95 of 0.36 kg/cm(2). The non-intervention group had no significant changes in ROM or NPRS scores.


CONCLUSIONS
After 8 minutes of transverse mobilization to the upper thoracic spine, significant gains in cervical extension and bilateral rotation, and decreased pain scores were found. There were no adverse effects. Unlike other mobilization studies, PPT changes at a remote site were statistically but not clinically meaningful. Findings suggest that transverse mobilization would be a productive topic for controlled clinical trials.
University of Puget Sound, Physical Therapy, Tacoma, WA, USA.
CIndy
C
McGregor
University of Puget Sound, Physical Therapy, Tacoma, WA, USA.
Robert
R
Boyles
MOSAIC Rehabilitation, USA.
Laura
L
Murahashi
Alaska Native Medical Center, USA.
Tanya
T
Sena
Belltown Physical Therapy, USA.
Robert
R
Yarnall
Neck pain; Thoracic mobilization; Transverse vertebral pressure