Pragmatically Applied Cervical and Thoracic Nonthrust Manipulation Versus Thrust Manipulation for Patients With Mechanical Neck Pain: A Multicenter Randomized Clinical Trial
| Autor: | Bryan O'Halloran, Joshua A. Cleland, David Griswold, Morey J. Kolber, Ken Learman |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Manipulation Spinal Comparative Effectiveness Research medicine.medical_specialty Time Factors Office Visits Clinical effectiveness Physical Therapy Sports Therapy and Rehabilitation Thoracic Vertebrae law.invention 03 medical and health sciences 0302 clinical medicine Primary outcome Randomized controlled trial law Humans Medicine 030222 orthopedics Neck pain Neck Pain business.industry General Medicine Evidence-based medicine Middle Aged Patient specific Clinical equipoise Cervical Vertebrae Physical therapy Female Manual therapy medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Orthopaedic & Sports Physical Therapy. 48:137-145 |
| ISSN: | 1938-1344 0190-6011 |
| DOI: | 10.2519/jospt.2018.7738 |
| Popis: | Study Design Randomized clinical trial. Background The comparative effectiveness between nonthrust manipulation (NTM) and thrust manipulation (TM) for mechanical neck pain has been investigated, with inconsistent results. Objective To compare the clinical effectiveness of concordant cervical and thoracic NTM and TM for patients with mechanical neck pain. Methods The Neck Disability Index (NDI) was the primary outcome. Secondary outcomes included the Patient-Specific Functional Scale (PSFS), numeric pain-rating scale (NPRS), deep cervical flexion endurance (DCF), global rating of change (GROC), number of visits, and duration of care. The covariate was clinical equipoise for intervention. Outcomes were collected at baseline, visit 2, and discharge. Patients were randomly assigned to receive either NTM or TM directed at the cervical and thoracic spines. Techniques and dosages were selected pragmatically and applied to the most symptomatic level. Two-way mixed-model analyses of covariance were used to assess clinical outcomes at 3 time points. Analyses of covariance were used to assess between-group differences for the GROC, number of visits, and duration of care at discharge. Results One hundred three patients were included in the analyses (NTM, n = 55 and TM, n = 48). The between-group analyses revealed no differences in outcomes on the NDI (P = .67), PSFS (P = .26), NPRS (P = .25), DCF (P = .98), GROC (P = .77), number of visits (P = .21), and duration of care (P = .61) for patients with mechanical neck pain who received either NTM or TM. Conclusion NTM and TM produce equivalent outcomes for patients with mechanical neck pain. The trial was registered with ClinicalTrials.gov (NCT02619500). Level of Evidence Therapy, level 1b. J Orthop Sports Phys Ther 2018;48(3):137-145. Epub 6 Feb 2018. doi:10.2519/jospt.2018.7738. |
| Databáze: | OpenAIRE |
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