Does inter-vertebral range of motion increase after spinal manipulation? A prospective cohort study
Jonathan Branney,Alan Breen +1 more
TLDR
There was a modest dose-response relationship between the number of manipulations given and number of levels increasing IV-RoM - providing evidence that neck manipulation has a mechanical effect at segmental levels, however, patient-reported outcomes were not related to this.Abstract:
Background: Spinal manipulation for nonspecific neck pain is thought to work in part by improving inter-vertebral range of motion (IV-RoM), but it is difficult to measure this or determine whether it is related to clinical outcomes. Objectives: This study undertook to determine whether cervical spine flexion and extension IV-RoM increases after a course of spinal manipulation, to explore relationships between any IV-RoM increases and clinical outcomes and to compare palpation with objective measurement in the detection of hypo-mobile segments. Method: Thirty patients with nonspecific neck pain and 30 healthy controls matched for age and gender received quantitative fluoroscopy (QF) screenings to measure flexion and extension IV-RoM (C1-C6) at baseline and 4-week follow-up between September 2012-13. Patients received up to 12 neck manipulations and completed NRS, NDI and Euroqol 5D-5L at baseline, plus PGIC and satisfaction questionnaires at follow-up. IV-RoM accuracy, repeatability and hypo-mobility cut-offs were determined. Minimal detectable changes (MDC) over 4 weeks were calculated from controls. Patients and control IV-RoMs were compared at baseline as well as changes in patients over 4 weeks. Correlations between outcomes and the number of manipulations received and the agreement (Kappa) between palpated and QF-detected of hypo-mobile segments were calculated. Results: QF had high accuracy (worst RMS error 0.5o) and repeatability (highest SEM 1.1o, lowest ICC 0.90) for IV-RoM measurement. Hypo-mobility cut offs ranged from 0.8o to 3.5o. No outcome was significantly correlated with increased IV-RoM above MDC and there was no significant difference between the number of hypo-mobile segments in patients and controls at baseline or significant increases in IV-RoMs in patients. However, there was a modest and significant correlation between the number of manipulations received and the number of levels and directions whose IV-RoM increased beyond MDC (Rho=0.39, p=0.043). There was also no agreement between palpation and QF in identifying hypo-mobile segments (Kappa 0.04-0.06). Conclusions: This study found no differences in cervical sagittal IV-RoM between patients with non-specific neck pain and matched controls. There was a modest dose-response relationship between the number of manipulations given and number of levels increasing IV-RoM - providing evidence that neck manipulation has a mechanical effect at segmental levels. However, patient-reported outcomes were not related to this.read more
Citations
More filters
Journal ArticleDOI
The acute effects of joint manipulative techniques on markers of autonomic nervous system activity: a systematic review and meta-analysis of randomized sham-controlled trials
Mathieu Picchiottino,Mathieu Picchiottino,Charlotte Leboeuf-Yde,Olivier Gagey,Olivier Gagey,David Hallman +5 more
TL;DR: Some types of mobilizations probably produce an immediate and short-term, statistically significant increase in skin sympathetic nerve activity when compared to a sham procedure, whereas spinal SNAGs and spinal HVLA techniques may have no acute effect on the studied markers of ANS activity.
Journal ArticleDOI
Does cervical lordosis change after spinal manipulation for non-specific neck pain? A prospective cohort study
TL;DR: This study found no difference in cervical lordosis (sagittal alignment) between patients with mild non-specific neck pain and matched healthy volunteers and there was no significant change in lordosis in patients after 4 weeks of cervical spinal manipulation.
Journal ArticleDOI
The effect of a single spinal manipulation on cardiovascular autonomic activity and the relationship to pressure pain threshold: a randomized, cross-over, sham-controlled trial
Mathieu Picchiottino,Mathieu Picchiottino,Margaux Honoré,Margaux Honoré,Charlotte Leboeuf-Yde,Olivier Gagey,Olivier Gagey,François Cottin,François Cottin,David Hallman +9 more
TL;DR: The results suggest that a single SM of the thoracic spine has no specific effect on cardiovascular autonomic activity and the relationship between autonomic outcomes and pressure pain threshold after the SM is found.
Journal ArticleDOI
Accuracy and repeatability of quantitative fluoroscopy for the measurement of sagittal plane translation and finite centre of rotation in the lumbar spine.
Alexander Breen,Alan Breen +1 more
TL;DR: Quantitative fluoroscopy was found to have a high level of accuracy and with a few exceptions, moderate to substantial repeatability for the measurement of translation and FCR from fluoroscopic motion sequences.
Journal ArticleDOI
Cervical flexion and extension includes anti-directional cervical joint motion in healthy adults
TL;DR: This is the first report of quantified anti-directional cervical flexion and extension motion and it document that large proportions of anti- Directional cervical Flexion and Extension motions were normal.
References
More filters
Journal ArticleDOI
Spinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: a randomized trial.
TL;DR: For participants with acute and subacute neck pain, SMT was more effective than medication in both the short and long term, however, a few instructional sessions of HEA resulted in similar outcomes at most time points.
Journal ArticleDOI
Clinical practice implications of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders: from concepts and findings to recommendations
Jaime Guzman,Scott Haldeman,Scott Haldeman,Linda J. Carroll,Eugene J. Carragee,Eric L. Hurwitz,Paul M. Peloso,Margareta Nordin,J. David Cassidy,Lena W. Holm,Pierre Côté,Gabrielle van der Velde,Sheilah Hogg-Johnson +12 more
TL;DR: The best available evidence suggests initial assessment for neck pain should focus on triage into 4 grades, and those with common neck pain might be offered the listed noninvasive treatments if short-term relief is desired.
Journal ArticleDOI
Reference values of mechanical and thermal pain tests in a pain-free population.
Alban Y. Neziri,Pasquale Scaramozzino,Ole Kæseler Andersen,Anthony H. Dickenson,Lars Arendt-Nielsen,Michele Curatolo +5 more
TL;DR: In this paper, the reference values of pain thresholds for mechanical and thermal stimuli, as well as withdrawal time for the cold pressor test in 300 pain-free subjects were determined at three body sites: lower back, suprascapular region and second toe (for pressure) or the lateral aspect of the leg.
Journal ArticleDOI
Immediate effects on neck pain and active range of motion after a single cervical high-velocity low-amplitude manipulation in subjects presenting with mechanical neck pain: a randomized controlled trial.
Raquel Martínez-Segura,César Fernández-de-las-Peñas,Mariana Ruiz-Sáez,Cristina López-Jiménez,Cleofás Rodríguez-Blanco +4 more
TL;DR: The results suggest that a single cervical HVLA manipulation was more effective in reducing neck pain at rest and in increasing active cervical range of motion than a control mobilization procedure in subjects suffering from mechanical neck pain.
Journal ArticleDOI
Sagittal plane segmental motion of the cervical spine. A new precision measurement protocol and normal motion data of healthy adults.
TL;DR: The new protocol measures segmental motion with high precision and corrects for radiographic distortion, variation in stature and alignment errors of patients, and allows segmental hypo-, normal or hypermobility to be quantified.