title: Acute effects of single and multiple level thoracic manipulations on chronic mechanical neck pain: a randomized controlled trial.
abstract: BACKGROUND
  Thoracic spine manipulation has become a popular alternative to local cervical manipulative therapy for mechanical neck pain. This study investigated the acute effects of single-level and multiple-level thoracic manipulations on chronic mechanical neck pain (CMNP).
  
  
  METHODS
  Forty-eight patients with CMNP were randomly allocated to single-level thoracic manipulation (STM) at T6-T7 or multiple-level thoracic manipulation (MTM), or to a control group (prone lying). Cervical range of motion (CROM), visual analog scale (VAS), and the Thai version of the Neck Disability Index (NDI-TH) scores were measured at baseline, and at 24-hour and at 1-week follow-up.
  
  
  RESULTS
  At 24-hour and 1-week follow-up, neck disability and pain levels were significantly (P<0.05) improved in the STM and MTM groups compared with the control group. CROM in flexion and left lateral flexion were increased significantly (P<0.05) in the STM group when compared with the control group at 1-week follow-up. The CROM in right rotation was increased significantly after MTM compared to the control group (P<0.05) at 24-hour follow-up. There were no statistically significant differences in neck disability, pain level at rest, and CROM between the STM and MTM groups.
  
  
  CONCLUSIONS
  These results suggest that both single-level and multiple-level thoracic manipulation improve neck disability, pain levels, and CROM at 24-hour and 1-week follow-up in patients with CMNP.
authors.affiliation: School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand ; Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Rungthip
authors.initials: R
authors.lastname: Puntumetakul
authors.affiliation: School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand ; Physical Therapy Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Thavatchai
authors.initials: T
authors.lastname: Suvarnnato
authors.affiliation: School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Phurichaya
authors.initials: P
authors.lastname: Werasirirat
authors.affiliation: Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Sureeporn
authors.initials: S
authors.lastname: Uthaikhup
authors.affiliation: Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan ; Future Institute for Sport Sciences, Tokyo, Japan.
authors.forename: Junichiro
authors.initials: J
authors.lastname: Yamauchi
authors.affiliation: School of Health Sciences (Physiotherapy), University of South Australia, Adelaide, SA, Australia.
authors.forename: Rose
authors.initials: R
authors.lastname: Boucaut
keywords: neck disability; neck pain; pain level; thoracic manipulation