Authors: David Griswold, PT, PhD
Published: Journal of Orthopaedic & Sports Physical Therapy, 2018 Volume:0 Issue:0 Pages:1–30 DOI: 10.2519/jospt.2018.7738
Study Design
Randomized clinical trial.
Background
The comparative effectiveness between non-thrust (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), Numerical Pain Rating Scale (NPRS), deep cervical flexion endurance (DCF), Global Rating of Change (GROC), number of visits, and duration of care. Covariates were 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, repeated measures Analysis of Covariance (ANCOVA), were used to analyze clinical outcomes at three time points. ANCOVAs analyzed between-group differences for GROC, number of visits, and duration of care at discharge.
Results
One hundred and three patients were included in the analyses (N=55 NTM and N=48 TM). The between group analyses revealed no differences on the NDI (P=.67) PSFS (P=.26), NPRS (P=.25), and DCF (P=.98) or for the 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.
Level of Evidence
Level 1b. J Orthop Sports Phys Ther, Epub 6 Feb 2018. doi:10.2519/jospt.2018.7738