STUDY DESIGN: Randomized Clinical Trial.
OBJECTIVE: To investigate the Short-term Effects of Thoracic Spine thrust Manipulation Combined with Cervical Spine Non-thrust Manipulation [experimental group (EG)] versus Cervical Spine Non-thrust Manipulation alone [comparison group (CG)] in Individuals with Mechanical Neck Pain.
BACKGROUND: Research has demonstrated improved outcomes with both Non-thrust Manipulation directed at the Cervical Spine and thrust Manipulation directed at the Thoracic Spine in patients with Neck Pain. Previous studies have not determined if Thoracic Spine thrust Manipulation would increase benefits beyond that provided by Cervical Non-thrust Manipulation alone.
METHODS: Sixty-four participants with Mechanical Neck Pain were Randomized into 1 of 2 groups: (EG or CG). Both groups received Cervical Spine Non-thrust Manipulation and a general active range of motion exercise, while only the EG group received Thoracic Spine thrust Manipulations. Outcome measures were collected at baseline and at the 1-week follow up and included the Numeric Pain Rating Scale (NPRS), the Neck Disability Index (NDI), and the Global Rating of Change (GROC).
RESULTS: Participants in the EG demonstrated significantly greater improvements (P < .001) for both the NPRS and NDI at the 1-week follow up, compared to participants in the CG. In addition, 31 of 33 (94%) participants in the EG, compared to 11 of 35 participants (35%) in the CG, provided a GROC score of +4 or higher at the 1-week follow up, with an associated number needed to treat of 2.
CONCLUSIONS: Individuals with Neck Pain who received a combination of Thoracic Spine thrust Manipulation and Cervical Spine Non-thrust Manipulation plus exercise demonstrated better overall Short-term outcomes on the NPRS, the NDI, and the GROC.
LEVEL OF EVIDENCE: Therapy, level 1b. J Orthop Sports Phys Ther, Epub 7 December 2012. doi:10.2519/jospt.2013.4221.