Immediate effects of cervical mobilisations
Cervical mobilisations are a common manual therapy technique, adopted by physiotherapists in the treatment of neck pain.
This RCT opted for a double blind placebo method to determine the immediate effects of cervical mobilisations on individuals with neck pain.
The study recruited 40 patients with neck pain and randomised them into a cervical mobilisation or a manual contact placebo group. The same treating physiotherapist conducted both interventions.
In the mobilisation group, the physiotherapist assessed the patient, and using clinical reasoning determined which joint segment(s) required mobilisations and whether they required posterior-anterior and/ or antero-posterior mobilisations.
The placebo group involved the physiotherapist placing their hands on the patient’s neck in the same position as the mobilisation group; however no accessory glide was performed.
Immediately following the intervention, all participants were asked to complete several outcome measures.
The mobilisation group demonstrated a greater magnitude in the Global Rate of Change Scale with 80% participants reporting an improvement compared to 45% of the placebo group.
Cervical range of motion (ROM) was also assessed. The mobilisation group demonstrated a significant increase in ROM of side flexion and rotation compared to the placebo group, but only if there was a restriction found pre-intervention.
No significant improvements were noted for cervical flexion or extension ROM. Finally, a significant increase in cervical movement velocity occurred after both interventions, but only in those with velocity restrictions pre-intervention.
The results of this study outline that, whilst placebo does have a role in some of the improvements noted in cervical mobilisations, the accessory glide component does also appear to have a greater measureable effect on short-term patient outcomes, specifically of their global perceived effect and cervical ROM.
> From: Lascurain-Aguirrebeña et al., Musculoskelet Sci Pract 38 (2018) 83-90. All rights reserved to Elsevier Ltd. Click here for the online summary.