Immediate Effects of the Audible Pop From a Thoracic Spine Thrust Manipulation on the Autonomic Nervous System and Pain: A Secondary Analysis of a Randomized Clinical Trial

Sillevis, Rob; Cleland, Joshua A.

doi:10.1016/j.jmpt.2010.11.007

Cited by 33 publications

(51 citation statements)

References 69 publications

(118 reference statements)

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“…An audible cavitation was noted for every manipulation in the present study, whereas this outcome was not reported in previous studies, but the audible cavitation may not be a good indicator of clinical benefit. [5][6][7] In addition, lumbar manipulation may not always be accurate for the target joint, although multiple cavitations typically occur with this procedure, making cavitation likely to occur at the target joint. 34 Although cavitation of the target joint cannot be confirmed, the study tested an HVLA manipulation procedure that aimed to cavitate the L5/S1 joints, and it was likely that this joint cavitated in most participants.…”

Section: Discussionmentioning

confidence: 99%

“…4 Spinal manipulation is often accompanied with an audible pop or cavitation, but the importance of this noise to clinical effects has been disputed. [5][6][7] The effect of HVLA techniques on muscle relaxation and motor control is still unclear. Some authors have reported reductions in lumbar paraspinal muscle electromyography (EMG) during the flexion-relaxation phase of trunk flexion, 8 whereas others have reported greater contraction amplitudes after HVLA manipulation.…”

mentioning

confidence: 99%

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The Effect of Lumbosacral Manipulation on Corticospinal and Spinal Reflex Excitability on Asymptomatic Participants

Fryer

Pearce

2012

Journal of Manipulative and Physiological Therapeutics

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The Effect of Lumbosacral Manipulation on Corticospinal and Spinal Reflex Excitability on Asymptomatic Participants

Fryer

Pearce

2012

Journal of Manipulative and Physiological Therapeutics

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“…Immediately following a single HVLA thrust manipulation directed to T3-4, Sillevis et al 85 found no significant betweengroup difference in pain when compared to a placebo intervention. 85 In contrast, at 6-month follow-up, Lau et al 60 found that patients experienced significantly greater reductions in disability when 8 sessions of thoracic HVLA thrust manipulation were included as part of a multimodal intervention 60 ; however, between-group differences in pain were not statistically significant. Moreover, the most recent systematic review 38 found low-quality evidence favoring a single session of thoracic HVLA thrust manipulation when compared to placebo for pain relief in patients with chronic neck pain.…”

Section: T T Conclusionmentioning

confidence: 99%

Section: T T Conclusionmentioning

confidence: 99%

“…59,84 Only 2 studies 60,85 have examined the effect of thoracic HVLA thrust manipulation in patients with chronic neck pain. Immediately following a single HVLA thrust manipulation directed to T3-4, Sillevis et al 85 found no significant betweengroup difference in pain when compared to a placebo intervention. 85 In contrast, at 6-month follow-up, Lau et al 60 found that patients experienced significantly greater reductions in disability when 8 sessions of thoracic HVLA thrust manipulation were included as part of a multimodal intervention 60 ; however, between-group differences in pain were not statistically significant.…”

Section: T T Conclusionmentioning

confidence: 99%

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Upper Cervical and Upper Thoracic Thrust Manipulation Versus Nonthrust Mobilization in Patients With Mechanical Neck Pain: A Multicenter Randomized Clinical Trial

Dunning¹,

Cleland²,

Waldrop³

et al. 2012

Journal of Orthopaedic & Sports Physical Therapy

136

110

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A pproximately 54% of individuals have experienced neck pain within the last 6 months, 24 and the incidence of neck pain may be increasing. 76 The economic burden associated with the management of patients with neck pain is high, second only to low back pain in annual workers' compensation costs in the United States. 98Two recent clinical prediction rules 17,21,22,81 have been developed in an attempt to guide treatment selection for patients with neck pain. However, one has yet to be validated and only identifies those patients with neck pain likely to benefit from cervical traction, 81 and the other, which attempted to identify those patients with neck pain likely to benefit from thoracic manipulation and a general cervical range-of-motion (ROM) exer- T T METHODS:Patients completed the Neck Disability Index, the numeric pain rating scale, the flexion-rotation test for measurement of C1-2 passive rotation range of motion, and the craniocervical flexion test for measurement of deep cervical flexor motor performance. Following the baseline evaluation, patients were randomized to receive either HVLA thrust manipulation or nonthrust mobilization to the upper cervical (C1-2) and upper thoracic (T1-2) spines. Patients were reexamined 48-hours after the initial examination and again completed the outcome measures. The effects of treatment on disability, pain, C1-2 passive rotation range of motion, and motor performance of the deep cervical flexors were examined with a 2-by-2 mixed-model analysis of variance (ANOVA). T T RESULTS:One hundred seven patients satisfied the eligibility criteria, agreed to participate, and were randomized into the HVLA thrust manipulation (n = 56) and nonthrust mobilization (n = 51) groups. The 2-by-2 ANOVA demonstrated that patients with mechanical neck pain who received the combination of upper cervical and upper thoracic HVLA thrust manipulation experienced significantly (P<.001) greater reductions in disability (50.5%) and pain (58.5%) than those of the nonthrust mobilization group (12.8% and 12.6%, respectively) following treatment. In addition, the HVLA thrust manipulation group had significantly (P<.001) greater improvement in both passive C1-2 rotation range of motion and motor performance of the deep cervical flexor muscles as compared to the group that received nonthrust mobilization. The number needed to treat to avoid an unsuccessful outcome was 1.8 and 2.3 at 48-hour follow-up, using the global rating of change and Neck Disability Index cut scores, respectively. T T CONCLUSION:The combination of upper cervical and upper thoracic HVLA thrust manipulation is appreciably more effective in the short term than nonthrust mobilization in patients with mechanical neck pain. T T LEVEL OF EVIDENCE:Therapy, level 1b.

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Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment

Gross

Langevin

Burnie

et al. 2015

Cochrane Database of Systematic Reviews

158

136

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Although support can be found for use of thoracic manipulation versus control for neck pain, function and QoL, results for cervical manipulation and mobilisation versus control are few and diverse. Publication bias cannot be ruled out. Research designed to protect against various biases is needed. Findings suggest that manipulation and mobilisation present similar results for every outcome at immediate/short/intermediate-term follow-up. Multiple cervical manipulation sessions may provide better pain relief and functional improvement than certain medications at immediate/intermediate/long-term follow-up. Since the risk of rare but serious adverse events for manipulation exists, further high-quality research focusing on mobilisation and comparing mobilisation or manipulation versus other treatment options is needed to guide clinicians in their optimal treatment choices.

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Immediate Effects of the Audible Pop From a Thoracic Spine Thrust Manipulation on the Autonomic Nervous System and Pain: A Secondary Analysis of a Randomized Clinical Trial

Cited by 33 publications

References 69 publications

The Effect of Lumbosacral Manipulation on Corticospinal and Spinal Reflex Excitability on Asymptomatic Participants

The Effect of Lumbosacral Manipulation on Corticospinal and Spinal Reflex Excitability on Asymptomatic Participants

Upper Cervical and Upper Thoracic Thrust Manipulation Versus Nonthrust Mobilization in Patients With Mechanical Neck Pain: A Multicenter Randomized Clinical Trial

Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment

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