Comparison of 2 Manual Therapy and Exercise Protocols for Cervical Radiculopathy: A Randomized Clinical Trial Evaluating Short-Term Effects

Langevin, Pierre; Desmeules, François; Lamothe, Mélanie; Robitaille, Simon; Roy, Jean-Sébastien

doi:10.2519/jospt.2015.5211

Cited by 44 publications

(57 citation statements)

References 41 publications

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“…Two recent RCTs had not yet been included in a review [41, 42]. The authors of one RCT concluded that a combination of a cervical “lateral glide’ mobilisation technique [43, 44] and neurodynamic mobilisation was more effective at short-term follow up on pain and disability than a wait-and-see policy [42].…”

Section: Resultsmentioning

confidence: 99%

“…The authors of one RCT concluded that a combination of a cervical “lateral glide’ mobilisation technique [43, 44] and neurodynamic mobilisation was more effective at short-term follow up on pain and disability than a wait-and-see policy [42]. Results of one other RCT suggested that based on the size of the treatment effect on pain and activity limitations, a combination of manual therapy and specific exercises was more effective at short term follow up than a wait-and-see policy [41]. …”

Section: Resultsmentioning

confidence: 99%

“…Manual therapy in RCTs of patients with CR is often an umbrella term encompassing multimodal interventions such as cervical manipulations and mobilisations combined with thoracic manipulations/mobilisation, traction, massage, neurodynamic mobilisation and specific exercises [18, 19, 30, 31, 36, 40, 41]. …”

Section: Resultsmentioning

confidence: 99%

“…Results from one study of high methodological quality suggested that, based on the size of the treatment effect on pain and activity limitations, a combination of manual therapy and motor control exercises was more effective at short term follow up (4 and 8 weeks) than a wait-and-see policy [41]. One study of low methodological quality reported more effectiveness of a combination of segmental spinal mobilisation and specific motor control exercises on pain and activity limitations than separate interventions of manual therapy or exercises alone in patients with CR [18].…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of manual therapy for cervical radiculopathy, a review

Thoomes¹

2016

Chiropr Man Therap

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Manual therapy is often used for patients with neck pain with or without radicular symptoms. There is sparse evidence on the effectiveness in cervical radiculopathy. The aim of this study was to assess current levels of evidence on the effectiveness of manual therapy interventions for patients with cervical radiculopathy.Electronic data bases were systematically searched for clinical guidelines, reviews and randomised clinical trials (RCTs) reporting on the effectiveness of manual therapy for patients with cervical radiculopathy. Eight relevant reviews, two guidelines and two recent RCTs, that had not yet been included in either, were retrieved. The overall quality of the evidence of included studies was evaluated using the GRADE method. Most interventions were only studied in one single RCT.There is low level evidence that cervical manipulation and mobilisation as unimodal interventions are effective on pain and range of motion at the immediate follow up, but no evidence on the effectiveness of thoracic manipulation or mobilisation as unimodal interventions. There is low level evidence that a combination of spinal mobilisation and motor control exercises is more effective on pain and activity limitations than separate interventions or a wait-and-see policy. There is low level evidence of the effectiveness of cervical mobilisation with a neurodynamical intent as unimodal intervention, on the effectiveness of a multimodal intervention with neurodynamic intent on pain activity limitations and global perceived effect compared to a wait-and-see policy. There is also low level evidence that a multimodal intervention consisting of spinal and neurodynamic mobilisations and specific exercises is effective on pain in patients with CR. There is low level evidence that traction is no more effective than placebo traction.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Effectiveness of manual therapy for cervical radiculopathy, a review

Thoomes¹

2016

Chiropr Man Therap

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“…The incidence of cervical radiculopathy has been reported to be 83 per 100 000 in the general population, with increased prevalence in the fifth decade of life, [73][74][75][76][77] making this a condition of concern for aging and older adults. Most individuals suffering from cervical radiculopathy improve with nonoperative treatment.…”

Section: Cervial Radiculopathymentioning

confidence: 99%

Cervical Spine Manual Therapy for Aging and Older Adults

Tudini

Chui

Grimes

et al. 2016

Topics in Geriatric Rehabilitation

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Neck pain is a common problem in aging and older adults. This narrative review synthesizes recent literature on manual therapy to the cervical spine and adjacent regions. Emphasis has been placed on summarizing high-quality randomized clinical trials, systematic reviews with a narrative synthesis or meta-analysis, and clinical practice guidelines. The synthesis suggests that although there is limited high-quality evidence, a multimodal approach including manual therapy and exercise seems safe and effective, especially in the short term, for improving outcomes in aging and older adults with neck pain. The results for cervicogenic dizziness and headache were too varied to arrive at a firm conclusion. Additional research using consistent outcome measures is needed to establish the optimal manual therapy techniques and parameters for these common cervical conditions. , PT, DPT, MS, OCS, ATC 20% of individuals 70 years of age and older experience neck pain at least one time per month. 11 Within this population, neck pain is associated with other health complaints and poorer self-rated health. 12 Physical therapy is one of the first treatment options for patients with mechanical, insidious neck pain, often with manual therapy as the preferred approach. 13 This is especially true in the elderly population where pain medication must be used cautiously because of the risk of drug interactions and associated comorbidities. 14 For this review, neck pain is classified into 4 categories: chronic nonspecific neck pain, cervical radiculopathy, cervicogenic dizziness and headache, and acute and subacute neck pain including whiplash.Although beyond the scope of this article, there are several useful reviews on pathophysiology, imaging, and conservative and surgical management of cervical spine pathology. 15-18 What follows is a synthesis of recent literature on manual therapy to the cervical spine for 4 common classifications of neck pain. Emphasis has been placed on summarizing high-quality randomized clinical trials, systematic reviews with a narrative synthesis or meta-analysis, and clinical practice guidelines. CHRONIC NONSPECIFIC NECK PAINNonspecific neck pain is defined as cervical pain without pathogenic and/or pathognomonic signs and symptoms. 13 When serious pathology and specific diseases have been excluded, the anatomical source of symptoms is difficult to establish. 19 Thus, this type of pain has also been named cervical pain of unknown origin. 20 Other popular names include the cervical syndrome, which refers to a set of disorders caused by changes in the cervical spine and the soft tissue surrounding it, with pain as the predominant symptom, 21 or chronic mechanical neck pain. Chronic nonspecific neck pain is very common, affecting up to 46% to 54% of the population. 22 It is also described as a significant predictor of sickness absence. 23 SafetyAn analytical review of orthopedic manual therapy including manipulation, specifically to the cervical spine and in an older population, should be preceded by a discussion ...

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