Is there a role for premanipulative testing before cervical manipulation?

Licht, Peter B.; Christensen, Henrik Wulff; Høilund-Carlsen, Poul Fl.

doi:10.1016/s0161-4754(00)90247-1

Cited by 57 publications

(27 citation statements)

References 16 publications

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“…56,57,63,65,92 Screening questions for cervical artery disease were negative, and premanipulative cervical artery testing was not used. This study was approved by the Institutional Review Boards of the University of South Carolina, Northeast Hospital Corporation, and the Corporate Clinical Research Committee.…”

mentioning

confidence: 99%

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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mentioning

confidence: 99%

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

View full text Add to dashboard Cite

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“…87 These premanipulative test procedures were developed in response to reports in the literature suggesting an association between cervical spine manipulation and adverse events such as stroke. Whilst pre-manipulative tests have ostensibly been used to 'screen' for the presence of vertebral artery dysfunction, there is a sound rationale to extend reasoning to consideration of the whole cervical arterial system, particularly as ICADs occur at a ratio of approximately 2:1 compared to VADs.…”

Section: The Place Of Pre-manipulative Screening Testsmentioning

confidence: 99%

Manual therapy and cervical artery dysfunction: Identification of potential risk factors in clinical encounters

Vaughan

Moran

Tehan

et al. 2016

International Journal of Osteopathic Medicine

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“…[24][25][26] It is believed that spinal manipulation can influence greatly on the answer of the peripheral nervous system tests, thus the objective of this study is to evaluate the influence of spinal manipulation on the Peripheral Nervous System Tests (PNST). 27,28 …”

Section: Introductionmentioning

confidence: 99%

Influence of Manipulation in the Peripheral Nervous System Tests: A Randomized Controlled Trial

Added¹,

Araúujo²,

Alcaide³

et al. 2015

Sport Exerc Med Open J

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Background: Chronic cervical pain is a serious public health issue that affects a large part of the world population and results in huge costs for the society. The chronic cervical pain is associated to problems in the peripheral nervous system. Clinical practice presents multiple techniques conventionally used to ameliorate chronic cervical pain. The spinal manipulation is a technique that can increase the range of motion of the peripheral nervous system. Objective: To determine the efficacy of the cervical and thoracic manipulation in the peripheral nervous system tests. Methods: The present study is a randomized controlled trial, with blinded assessor. The patient population consisted of 128 patients with chronic cervical pain and also tested positive (pain in motion) to the neural system. They were randomly divided into four groups: group A (manipulation of the sixth cervical vertebra), group B (manipulaton of the sixth thoracic vertebra), group C (manipulation of the sixth cervical and sixth thoracic vertebra) and group D (without intervention). These patients underwent an assessment before and after spinal manipulation by the blinded assessor. Results: After the manipulation, an improvement of the ragion of motion was observed on the group that the sixth cervical vertebra was handled: left median nerve range of motion (p=0.04) and right (p=0.04) and left ulnar nerve (p=0.03) and right (p=0.04). Also was observed a statistically significant result when associate manipulation of the sixth cervical vertebra and sixth thoracic vertebra: left median nerve (p=0.01) and the right side (p=0.03). Conclusion: Isolated manipulation of the sixth cervical vertebra or together with the manipulation of the sixth thoracic vertebra in individuals with chronic neck pain appears to be an effective resource in improving range of motion in patients that tested positive to the peripheral nervous system tests.

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Is there a role for premanipulative testing before cervical manipulation?

Cited by 57 publications

References 16 publications

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

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

Manual therapy and cervical artery dysfunction: Identification of potential risk factors in clinical encounters

Influence of Manipulation in the Peripheral Nervous System Tests: A Randomized Controlled Trial

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