Browse > Article
http://dx.doi.org/10.12674/ptk.2015.22.3.050

Comparison of Immediate Effects of Pain, Range of Motion and Treatment Satisfaction on Difference of Applying Joint Mobilization Levels in Patients With Acute Mechanical Neck Pain  

Lee, Nam-yong (Dept. of Physical Therapy, The Graduate School, Daejeon University)
Kim, Suhn-yeop (Dept. of Physical Therapy, College of Health Medical & Science, Daejeon University)
Publication Information
Physical Therapy Korea / v.22, no.3, 2015 , pp. 50-60 More about this Journal
Abstract
The purpose of this study was to apply the joint mobilization technique to the level of segments with pain and to the level of segments with hypomobility respectively and compare the immediate effects of the joint mobilization technique on the pain, the active cervical range of motion (ROM), and treatment satisfaction of patients with acute mechanical neck pain. After the baseline assessment, forty-two patients were randomized into two groups: a painful group ($n_1=21$) that received joint mobilization at the most painful cervical spine level and a hypomobile group ($n_2=21$) that received joint mobilization at the most hypomobile cervical level. The patients received an intervention that applied unilateral posterior-anterior gliding for 5 minutes and two repetitions of 10 times of active extension motion with distraction. In the Wilcoxon signed-rank test, the painful group and the hypomobile group were improved significantly in all pain variables (p<.001), while the painful group was improved significantly in the active cervical flexion (p<.001), extension (p<.001), left side-bending (p<.01), right side-bending (p=.001), left rotation (p<.001), and right rotation (p<.001). The hypomobile group was significantly improved in active cervical flexion (p=.001), extension (p<.001), left side-bending (p<.05), right side-bending (p=.001), left rotation (p=.001), and right rotation (p<.01) after intervention. In the Mann-Whitney U test, there was no significant difference in any of the dependent variables after the intervention between the two groups, but the painful group was slightly superior to the hypomobile group in all variables except for the right lateral flexion ROM and treatment satisfaction. These outcomes suggest that the cervical joint mobilization may be applied to either the level of painful segments or the hypomobile segments for the treatment of patients with acute mechanical neck pain.
Keywords
Joint mobilization; Mechanical neck pain; Range of motion;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Ahn NU, Ahn UM, Ipsen B, et al. Mechanical neck pain and cervicogenic headache. Neurosurgery. 2007;60(1 Supp1 1):S21-S27.
2 Aprill C, Bogduk N. The prevalence of cervical zygapophyseal joint pain. A first approximation. Spine (Phila Pa 1976). 1992;17(7):744-747.   DOI
3 Aquino RL, Caires PM, Furtado FC, et al. Applying joint mobilization at different cervical vertebral levels does not influence immediate pain reduction in patients with chronic neck pain: A randomized clinical trial. J Man Manip Ther. 2009; 17(2):95-100.   DOI
4 Bombardier C. Outcome assessments in the evaluation of treatment of spinal disorders: Summary and general recommendations. Spine (Phila Pa 1976). 2000;25(24):3100-3103.   DOI
5 Binder A. The diagnosis and treatment of nonspecific neck pain and whiplash. Eura Medicophys. 2007; 43(1):79-89.
6 Bronfort G, Evans R, Nelson B, et al. A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain. Spine (Phila Pa 1976). 2001;26(7):788-797; discussion 798-799.   DOI
7 Conroy DE, Hayes KW. The effect of joint mobilization as a component of comprehensive treatment for primary shoulder impingement syndrome. J Orthop Sports Phys Ther. 1998;28(1):3-14.   DOI
8 Creighton D, Kondratek M, Krauss J, et al. Ultrasound analysis of the vertebral artery during non-thrust cervical translatoric spinal manipulation. J Man Manip Ther. 2011;19(2):84-90. http://dx.doi.org/10.1179/2042618611Y.0000000005   DOI
9 Dunning JR, Cleland JA, Waldrop MA, et al. Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: A multicenter randomized clinical trial. J Orthop Sports Phys Ther. 2012;42 (1):5-18. http://dx.doi.org/10.2519/jospt.2012.3894   DOI
10 Ernst E, Canter PH. A systematic review of systematic reviews of spinal manipulation. J R Soc Med. 2006;99(4):192-196.   DOI   ScienceOn
11 Gross AR, Kay T, Hondras M, et al. Manual therapy for mechanical neck disorders: A systematic review. Man Ther. 2002;7(3):131-149.   DOI
12 Hing W, Reid DA, Monaghan M. Manipulation of the cervical spine. Man Ther. 2003;8(1):2-9.   DOI
13 Hoy DG, Protani M, De R, et al. The epidemiology of neck pain. Best Pract Res Clin Rheumatol. 2010; 24(6):783-792. http://dx.doi.org/10.1016/j.berh.2011.01.019   DOI
14 Hurwitz EL, Aker PD, Adams AH, et al. Manipulation and mobilization of the cervical spine: A systematic review of the literature. Spine (Phila Pa 1976). 1996;21(15):1746-1759; discussion 1759-1760.   DOI
15 Hurwitz EL, Morgenstern H, Harber P, et al. A randomized trial of chiropractic manipulation and mobilization for patients with neck pain: Clinical outcomes from the UCLA neck-pain study. Am J Public Health. 2002;92(10):1634-1641.   DOI
16 Jull G, Bogduk N, Marsland A. The accuracy of manual diagnosis for cervical zygapophysial joint pain syndromes. Med J Aust. 1988;148(5):233-236.
17 Katavich L. Differential effects of spinal manipulative therapy on acute and chronic muscle spasm: A proposal for mechanisms and efficacy. Man Ther. 1998;3(3):132-139.   DOI
18 Kaltenborn FM, Kaltenborn BT, Morgan D, et al. Manual Mobilization of the Joints: Joint examination and basic treatment. Vol. 2: The spine. 5th ed. Oslo, Norli, 2009:51-68.
19 Kamper SJ, Ostelo RW, Knol DL, et al. Global perceived effect scales provided reliable assessments of health transition in people with musculoskeletal disorders, but ratings are strongly influenced by current status. J Clin Epidemiol. 2010;63(7):760-766. http://dx.doi.org/10.1016/j.jclinepi.2009.09.009   DOI
20 Kanlayanaphotporn R, Chiradejnant A, Vachalathiti R. The immediate effects of mobilization technique on pain and range of motion in patients presenting with unilateral neck pain: A randomized controlled trial. Arch Phys Med Rehabil. 2009;90(2): 187-192. http://dx.doi.org/10.1016/j.apmr.2008.07.017   DOI
21 Kelly AM. The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain. Emerg Med J. 2001;18(3):205-207.   DOI
22 Kim SY. Effects of joint mobilization techniques on the joint receptors. Phys Ther Korea. 1996;3(2): 95-105.
23 Krauss JR, Evjenth O, Creighton D. Translatoric spinal manipulation for physical therapists. Rochester, Lakeview Media LLC, 2006:41-58.
24 Kulig K, Landel R, Powers CM. Assessment of lumbar spine kinematics using dynamic MRI: A proposed mechanism of sagittal plane motion induced by manual posterior-to-anterior mobilization. J Orthop Sports Phys Ther. 2004;34(2):57-64.
25 Ostelo RW, de Vet HC. Clinically important outcomes in low back pain. Best Pract Res Clin Rheumatol. 2005;19(4):593-607.   DOI
26 Kulig K, Powers CM, Landel RF, et al. Segmental lumbar mobility in individuals with low back pain: In vivo assessment during manual and self-imposed motion using dynamic MRI. BMC Musculoskelet Disord. 2007;29(8):8.
27 Maitland GD, Hengeveld E, Banks K, et al. Maitland's vertebral manipulation. 7th ed. London, Butterworth-Heinemann, 2005:61-84.
28 McNair PJ, Portero P, Chiquet C, et al. Acute neck pain: Cervical spine range of motion and position sense prior to and after joint mobilization. Man Ther. 2007;12(4):390-394.   DOI
29 Randall T, Portney L, Harris BA. Effects of joint mobilization on joint stiffness and active motion of the metacarpal-phalangeal joint. J Orthop Sports Phys Ther. 1992;16(1):30-36.   DOI
30 Sambajon VV, Cillo JE, Gassner RJ, et al. The effects of mechanical strain on synovial fibroblasts. J Oral Maxillofac Surg. 2003;61(6): 707-712.   DOI
31 Schomacher J. The effect of an analgesic mobilization technique when applied at symptomatic or asymptomatic levels of the cervical spine in subjects with neck pain: A randomized controlled trial. J Man Manip Ther. 2009;17(2): 101-108.   DOI
32 Senstad O, Leboeuf-Yde C, Borchgrevink C. Frequency and characteristics of side effects of spinal manipulative therapy. Spine (Phila Pa 1976). 1997;22(4):435-440; discussion 440-441.   DOI
33 Tousignant M, Duclos E, Lafleche S, et al. Validity study for the cervical range of motion device used for lateral flexion in patients with neck pain. Spine (Phila Pa 1976). 2002;27(8):812-817.   DOI
34 Zusman M. Central nervous system contribution to mechanically produced motor and sensory responses. Aust J Physiother. 1992;38(4):245-255. http://dx.doi.org/10.1016/S0004-9514(14)60567-5   DOI
35 Twomey LT. A rationale for the treatment of back pain and joint pain by manual therapy. Phys Ther. 1992;72(12):885-892.   DOI
36 Youdas JW, Carey JR, Garrett TR. Reliability of measurements of cervical spine range of motion-comparison of three methods. Phys Ther. 1991;71(2):98-104; discussion 105-106.   DOI