Influence of Manipulation in the Peripheral Nervous System Tests: A Randomized Controlled Trial
DOI:
https://doi.org/10.17140/SEMOJ-1-112Keywords:
Chronic cervical pain, Manipulation, Peripheral nervous systemAbstract
Background: Chronic cervical pain is a serious public health issue that affects a large part of the world population and results in huge costs for the society. The chronic cervical pain is associated to problems in the peripheral nervous system. Clinical practice presents multiple techniques conventionally used to ameliorate chronic cervical pain. The spinal manipulation is a technique that can increase the range of motion of the peripheral nervous system.
Objective: To determine the efficacy of the cervical and thoracic manipulation in the peripheral nervous system tests.
Methods: The present study is a randomized controlled trial, with blinded assessor. The patient population consisted of 128 patients with chronic cervical pain and also tested positive (pain in motion) to the neural system. They were randomly divided into four groups: group A (manipulation of the sixth cervical vertebra), group B (manipulaton of the sixth thoracic vertebra), group C (manipulation of the sixth cervical and sixth thoracic vertebra) and group D (without intervention). These patients underwent an assessment before and after spinal manipulation by the blinded assessor.
Results: After the manipulation, an improvement of the ragion of motion was observed on the group that the sixth cervical vertebra was handled: left median nerve range of motion (p=0.04) and right (p=0.04) and left ulnar nerve (p=0.03) and right (p=0.04). Also was observed a statistically significant result when associate manipulation of the sixth cervical vertebra and sixth thoracic vertebra: left median nerve (p=0.01) and the right side (p=0.03).
Conclusion: Isolated manipulation of the sixth cervical vertebra or together with the manipulation of the sixth thoracic vertebra in individuals with chronic neck pain appears to be an effective resource in improving range of motion in patients that tested positive to the peripheral nervous system tests.
References
Haneline MT. Chiropractic manipulation and acute neck pain: a review of the evidence. J Manipulative Physiol Ther. 2005; 28(7): 520-525. doi: 10.1016/j.jmpt.2005.07.010
Vernon H, Humphreys K, Hagino C. Chronic mechanical neck pain in adults treated by manual therapy: a systematic review of change scores in randomized clinical trials. J Ma-nipulative Physiol Ther. 2007; 30(3): 215-226. doi: 10.1016/j. jmpt.2007.01.014
Gay RE, Madson TJ, Cieslak KR. Comparison of the neck disability index and the neck Bournemouth questionnaire in a sample of patients with chronic uncomplicated neck pain. J Ma-nipulative PhysiolTher. 2007; 30(4): 259-269. doi: 10.1016/j. jmpt.2007.03.009
Di Fabio RP. Manipulation of the cervical spine: risks and benefits. Phys Ther. 1999; 79: 1.
Di Fabio RP. Efficacy of manual therapy. Phys Ther. 1992; 72: 853- 864
Whalen WM. Resolution of cervical radiculopathy in a wom-an after chiropractic manipulation. J Chiropractic Med. 2008; 7: 17-23. doi: 10.1016/j.jcme.2007.10.002
Alcantara J, Plaugher G, Thornton RE, Salem C. Chiropractic care of a patient with vertebral subluxations and unsuccessful surgery of the cervical spine. J Manipulative Physiol Ther. 2001; 24(7): 477-482. doi: 10.1016/S0161-4754(01)40866-9
Murphy DR, Hurwitz EL, Gregory A, Clary R. A nonsurgical approach to the management of patients with cervical radiculop-athy; a prospective observational cohort study. J Manipulative Physiol Ther. 2006; 29(4): 279-287.
Murphy DR. Herniated disc with radiculopathy following cervical manipulation: nonsurgical management. Spine J. 2006; 6(4): 459-463. doi: 10.1016/j.spinee.2006.01.019
Tatarek NE. Variation in the human cervical neural canal. Spine J. 2005; 5(6): 623-631. doi: 10.1016/j.spinee.2005.07.009
BenEliyahu DJ. Magnetic resonance imaging and clinical follow-up. Study of 27 patients receiving chiropractic care for cervical and lumbar disc herniation. J Manipulative Physiol Ther. 1996; 19(9): 597-606.
Strunk RG, Hondras MA. A feasibility study assessing man-ual therapies to different regions of the spine for patients with subacute or chronic neck pain. J Chiropractic Med. 2008; 7: 1-8. doi: 10.1016/j.jcme.2007.10.004
Christensen KD, Buswell K. Chiropractic outcomes manag-ing radiculopathy in a hospital setting: a retrospective review of 162 patients. J Chiropractic Med. 2008; 7: 115-125. doi: 10.1016/j.jcm.2008.05.001
Rubenstein SM, Leboeuf-Yde C, Knol DL, Koekkoek TE, Pfeifle CE, van Tulder MW. The benefits outweigh the risks for patients undergoing chiropractic care for neck pain: a prospec-tive, multicenter, cohort study. J Manipulative Physiol Ther. 2007; 30(6): 408-418. doi: 10.1016/j.jmpt.2007.04.013
Lee KP, Carlini WG, McCormick GF, Albers GW. Neurolog-ic complications following chiropractic manipulation: a survey of California neurologists. Neurology. 2005; 45(6): 1213-1215.
Peñas CF, Joshua A, Cleland, Peter H, Cerro LP, Iglesias JG. Repeated applications of thoracic spine thrust manipulation do not lead to tolerance in patients presenting with acute mechani-cal neck pain: a secondary analysis. J Man Manip Ther. 2009; 17(3): 154-162.
Butler D. Adverse mechanical tension in the nervous sys-tem: a model for assessment and treatment. Australian J Physio. 1989; 35(4).
Coppieters M, Stappaerts K, Janssens K, Jull G. Reliability of detecting onset of pain” and “submaximal pain” during neural tissue provocation testing of the upper quadrant. Physiother Res Int. 2002; 7: 146-156.
Walsh J, Flatley M, Johnston N, Bennett K. Slump Test: Sen-sory Responses in Asymptomatic Subjects. J Man Manip Ther. 2007; 15(4): 231-238.
Scrimshaw SV, Maher CG. Randomized controlled trial of neural mobilization after spinal surgery. Spine J. 2001; 26: 2647- 2652.
Tal-Akabi A, Rushton A. An investigation to compare the ef-fectiveness of carpal bone mobilization and neurodynamic mo-bilization as methods of treatment for carpal tunnel syndrome. Man Ther. 2000; 5: 214-222. doi: 10.1054/math.2000.0355
Ellis RF, Hing WA. Neural mobilization: a systematic review of randomized controlled trials with an analysis of therapeutic efficacy. J Man Manip Ther. 2008; 16: 8-22.
Beneciuk JM, Bishop MD, George SZ. Effects of upper ex-tremity neural mobilization on thermal pain sensitivity: a sham-controlled study in asymptomatic participants. JOSPT. 2009; 39(6): 428-438. doi: 10.2519/jospt.2009.2954
Boyles RE, Walker MJ, Young BA, Strunce JB, Wainner RS. The addition of cervical thrust manipulations to a manual physi-cal therapy approach in patients treated for mechanical neck pain: a secondary analysis. JOSPT. 2010; 40 (3): 133-140. doi: 10.2519/jospt.2010.3106
Cleland JA, Whitman JM, Fritz JM, Palmer JA. Manual physical therapy, cervical traction and strengthening exercises in patients with cervical radiculopathy: a case series. JOSPT. 2005; 35 (12): 802-811.
Added MA, Costa LO, Fukuda TY, et al. Efficacy of adding the Kinesio Taping method to guideline-endorsed conventional physiotherapy in patients with chronic nonspecific low back pain: a randomized controlled trial. BMC Musculoskelet Disord. 14: 301.
Licht PB, Christensen HW, Hoilund-Carlsen PE. Is there a role for premanipulative testing before cervical manipulation? J Manipulative Physiol Ther. 2000; 23(3): 175-179. doi: 10.1016/ S0161-4754(00)90247-1
Cleland JA, Flynn TW, Childs JD, Eberhart S. The audible pop from thoracic spine thrust manipulation and its relation to short-term outcomes in patients with neck pain. J Man Manip Ther. 2007; 15(3): 143-154
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Sports and Exercise Medicine (SEM) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.