Immediate and Short-Term Effects of Upper Cervical High-Velocity, Low-Amplitude Manipulation on Standing Postural Control and Cervical Mobility in Chronic Nonspecific Neck Pain: A Randomized Controlled Trial

Abstract

This study aimed to determine the immediate and short-term effects of a single upper cervical high-velocity, low-amplitude (HVLA) manipulation on standing postural control and cervical mobility in chronic nonspecific neck pain (CNSNP). A double-blinded, randomized placebo-controlled trial was performed. Forty-four patients with CNSNP were allocated to the experimental group (n = 22) or control group (n = 22). All participants were assessed before and immediately after the intervention, with a follow-up on the 7th and 15th days. In each evaluation, we assessed global and specific stabilometric parameters to analyze standing postural balance and performed the cervical flexion-rotation test (CFRT) to analyze upper cervical mobility. We obtained statistically significant differences, with a large effect size, in the limited cervical rotation and global stabilometric parameters. Upper cervical HVLA manipulation produced an improvement in the global stabilometric parameters, significantly decreasing the mean values of velocity, surface, path length, and pressure in all assessments (p < 0.001; ƞ 2 p = 0.323–0.856), as well as significantly decreasing the surface length ratio (L/S) on the 7th (−0.219 1/mm; p = 0.008; 95% confidence interval (CI): 0.042–0.395) and 15th days (−0.447 1/mm; p < 0.001; 95% CI: 0.265–0.629). Limited cervical rotation values increased significantly immediately after manipulation (7.409°; p < 0.001; 95% CI: 6.131–8.687) and were maintained during follow-up (p < 0.001). These results show that a single upper cervical HVLA manipulation produces an improvement in standing postural control and increases the rotational range of motion (ROM) in the upper cervical spine in patients with CNSNP.

Comparison of Prescribed Physical Therapy to a Home Exercise Program for Pediatric Sports-Related Concussion Patients

“…Headache and cervical injury symptoms often overlap [ 12 ], thus, all PPT patients received a comprehensive physical examination including a cervical passive/active range of motion (ROM) assessment to rule out spinal involvement, and an assessment for muscle trigger points through cervical and thoracic regions [ 26 ]. If decreased cervical ROM was present, manual interventions such as High Velocity Low Amplitude Thrust spinal manipulation was used to improve cervical ROM while reducing cervical strain [ 27 , 28 ]. Then, the PPT patients completed vestibular/ocular motor rehabilitation (e.g., moving target pursuits, horizontal and vertical saccades, and vestibulo-ocular reflex [VOR] and visual motion sensitivity [VMS]).…”

Comparing the acute effects of diagonal mobilization and Nordic hamstring curls on the vertical jump performances, static and dynamic balance, and landing stabilization in youth soccer players: a randomized multi-arm study design

“…To mimic real mobilization, the therapist positioned their hands on the same points of contact, employing minimal movement (1st degree). Both active and placebo interventions had a duration of eight minutes [21].…”

The effects of the Alexander Technique on Chronic Non-specific Neck Pain: A Systematic Review and Meta-analysis

“…Nevertheless, with the changes in our lifestyle habits, the prevalence of chronic neck pain becomes progressively higher and the risks of permanent pain also increases. Chronic Non-speci c neck pain (CNSNP) is de ned as persistent pain in the neck and shoulder at least 12 weeks without pathological or neurological nding [4] , and there could be discomfort symptoms on the individuals with chronic neck pain [5] . Previous literatures indicated that the acupuncture and chiropractic interventions as well as physical therapy were effective for chronic neck pain patients [6,7] .…”