title: The immediate effects of soft tissue mobilization versus therapeutic ultrasound for patients with neck and arm pain with evidence of neural mechanosensitivity: a randomized clinical trial.
abstract: METHODS
  Randomized clinical trial.
  
  
  OBJECTIVE
  To investigate the immediate effects of soft tissue mobilization (STM) versus therapeutic ultrasound (US) in patients with neck and arm pain who demonstrate neural mechanical sensitivity.
  
  
  BACKGROUND
  While experts have suggested that individuals with neck and arm pain associated with neural tissue mechanical sensitivity may benefit from STM, there has been little research to investigate this hypothesis.
  
  
  METHODS
  Twenty-three patients with neck and arm pain and a positive upper limb neurodynamic test (ULNT) were randomly assigned to receive STM or therapeutic US during a single session. Outcome measures were collected immediately before and after treatment, and at 2-4 day follow-up. Primary outcomes were the Global Rating of Change (GROC), range of motion (ROM) during the ULNT, and pain rating during the ULNT. Secondary measures included the Neck Disability Index (NDI), Patient-Specific Functional Scale (PSFS), Numeric Pain Rating Scale (NPRS), and active range of shoulder abduction motion combined with the wrist neutral or wrist extension.
  
  
  RESULTS
  A greater proportion of patients in the STM group reported a significant improvement on the GROC immediately after treatment (P = 0·003, STM = 75%, US = 9%), and at 2-4 day follow-up (P = 0·027, STM = 58%, US = 9%). Patients who received STM demonstrated greater improvements in ROM during ULNT (P = 0·026), PSFS (P = 0·007), and shoulder active ROM combined with wrist extension (P = 0·028). Improvements in Numeric Pain Rating Scale and pain during the ULNT were observed only in the STM group. There was no difference between groups for the NDI or shoulder abduction ROM with wrist neutral.
  
  
  CONCLUSIONS
  Patients with neck and arm pain demonstrated greater improvements in ULNT ROM, GROC, and PSFS, and pain following STM than after receiving therapeutic US.
  
  
  METHODS
  Therapy, level 1b.
authors: Orthopedic Physical Therapy Residency Program, Cayuga Medical Center, Ithaca, NY 14850, USA.
authors: Michael
authors: M
authors: Costello
authors: Department of Physical Therapy, University of Nevada, USA.
authors: Emilio 'Louie' J
authors: E'
authors: Puentedura
authors: Physical Therapy Program, Franklin Pierce University, Manchester, NH, USA.
authors: Josh
authors: J
authors: Cleland
authors: Department of Physical Therapy, Ithaca College, USA.
authors: Charles D
authors: CD
authors: Ciccone
keywords: Cervical radiculopathy; Soft tissue mobilization; Upper limb neurodynamic test; Whiplash