A randomized clinical trial of manual therapy for cervico-brachial pain syndrome – a pilot study

Allison, Garry; Nagy, Balázs; Hall, Toby

doi:10.1054/math.2002.0453

Cited by 121 publications

(124 citation statements)

References 18 publications

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“…Moderate to low level evidence from clinical trials and case studies indicates that neural mobilisation has beneficial effects in patients with evidence of PNS in the lumbar spine [27][28][29] and in the cervical spine [30][31][32][33]. Patients included in these studies were comparable to the subjects in the present study: all had radiating pain in the extremities and positive nerve provocation tests in the absence of neurological deficits.…”

Section: Discussionmentioning

confidence: 63%

“…Patients included in these studies were comparable to the subjects in the present study: all had radiating pain in the extremities and positive nerve provocation tests in the absence of neurological deficits. However, treatment effects found in two controlled trials were low [27,30]. Also, a recent systematic review [34] of the therapeutic efficacy of neural mobilisation for a variety of conditions concludes that there is limited evidence to support its use.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study

et al. 2010

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The objective is to determine if pain and disability outcomes of patients treated with neural mobilisation differ for sub-classifications of low back and leg pain (LB&LP). Radiating leg pain is a poor prognostic factor for recovery in patients with LBP. To improve outcome, a new pathomechanism-based classification system was proposed: neuropathic sensitization (NS), denervation (D), peripheral nerve sensitization (PNS) and musculoskeletal (M). Seventy-seven patients with unilateral LB&LP were recruited. Following classification, all subjects were treated seven times with neural mobilisation techniques. A successful outcome was defined as achieving a minimal clinically important change in pain intensity (11-point numerical rating scale), physical function (Roland Morris disability questionnaire) and global perceived change (7-point Likert scale: from 1 = ''completely recovered'' to 7 = ''worse than ever''). The proportion of responders was significantly greater in PNS (55.6%) than the other three groups (NS 10%; D 14.3% and M10%). After adjusting for baseline differences, mean magnitude of improvement of the outcome measures were significantly greater in PNS compared to the other groups. Patients classified as PNS have a more favourable prognosis following neural mobilisation compared to the other groups.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study

et al. 2010

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“…Other trials using similar inclusion criteria reported similar recruitment rates. Allison et al 19 recruited 18.8% of screened patients, while Nee and Butler 16 recruited 10.2% of screened volunteers, and also stopped enrollment shy of their a priori sample size due to time constraints. To improve recruitment, future research should widen inclusion criteria without sacrificing homogeneity.…”

Section: Study Limitationsmentioning

confidence: 99%

“…17 It has been suggested that neural mobilization, a treatment approach focusing on facilitating movement of the nerve and surrounding structures, may be beneficial for those who present with cervicobrachial syndrome. 9,10,15,[19][20][21] The goal of interventions is either to encourage gliding of the nerve by controlled angular movements or to allow more space for the nerve to move by improving mobility of the structures that surround the nerve (the neural container). 9,11,15,[19][20][21][22][23] An example of such an intervention includes the cervical lateral glide mobilization with the involved upper extremity placed in a position designed to take up the slack in the brachial plexus.…”

Section: Introductionmentioning

confidence: 99%

“…9,10,15,[19][20][21] The goal of interventions is either to encourage gliding of the nerve by controlled angular movements or to allow more space for the nerve to move by improving mobility of the structures that surround the nerve (the neural container). 9,11,15,[19][20][21][22][23] An example of such an intervention includes the cervical lateral glide mobilization with the involved upper extremity placed in a position designed to take up the slack in the brachial plexus. 16,21,24,25 However, several authors have advised against applying cervical spine mobilization techniques to patients who demonstrate either normal or excessive mobility of the cervical spine, 26,27 which may include some patients with cervicobrachial syndrome.…”

Section: Introductionmentioning

confidence: 99%

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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

Costello

Puentedura

Cleland

et al. 2016

Journal of Manual & Manipulative Therapy

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Study design: Randomized clinical trial. Objectives: 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 (P50.003, STM575%, US59%), and at 2-4 day follow-up (P50.027, STM558%, US59%). Patients who received STM demonstrated greater improvements in ROM during ULNT (P50.026), PSFS (P50.007), and shoulder active ROM combined with wrist extension (P50.028). 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. Conclusion: Patients with neck and arm pain demonstrated greater improvements in ULNT ROM, GROC, and PSFS, and pain following STM than after receiving therapeutic US. Level of evidence: Therapy, level 1b.

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Manipulation and mobilisation for mechanical neck disorders

Gross

Hoving

Haines

et al. 2004

Cochrane Database of Systematic Reviews

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Multimodal care has short-term and long-term maintained benefits for subacute/chronic MND with or without headache. The common elements in this care strategy were mobilisation and/or manipulation plus exercise. The evidence did not favour manipulation and/or mobilisation done alone or in combination with various other physical medicine agents; when compared to one another, neither was superior. There was insufficient evidence available to draw conclusions for neck disorder with radicular findings. The added benefit of exercise needs to be further explored. Factorial design would help determine the active treatment agent(s) within a treatment mix. Phase II trials would help identify the most effective treatment characteristics and dosages. Greater attention to methodological quality is needed.

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A randomized clinical trial of manual therapy for cervico-brachial pain syndrome – a pilot study

Cited by 121 publications

References 18 publications

Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study

Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study

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

Manipulation and mobilisation for mechanical neck disorders

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