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Related Experiment Videos

Manipulation and mobilisation for mechanical neck disorders.

A R Gross, J L Hoving, T A Haines

    The Cochrane Database of Systematic Reviews
    |February 20, 2004
    PubMed
    Summary

    Multimodal care, including mobilization and exercise, offers significant short-term and long-term benefits for mechanical neck disorders (MND). Manipulation or mobilization alone showed no significant pain relief for MND.

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    Area of Science:

    • Orthopedics
    • Physical Therapy
    • Evidence-Based Medicine

    Background:

    • Mechanical neck disorders (MND) are prevalent, causing disability and significant healthcare costs.
    • The efficacy of manual therapies like manipulation and mobilization for MND remains uncertain.

    Purpose of the Study:

    • To evaluate the effectiveness of manipulation and mobilization, alone or combined with other treatments, for pain relief, functional improvement, and patient satisfaction in adults with MND.
    • To synthesize evidence from randomized controlled trials (RCTs) on manual therapies for mechanical neck disorders.

    Main Methods:

    • A systematic review and meta-analysis of randomized and quasi-randomized controlled trials were conducted.
    • Searches of multiple databases (CENTRAL, MEDLINE, EMBASE, etc.) were performed up to March 2002.

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  • Data were extracted and analyzed using random-effects models to calculate pooled effect sizes.

    • Main Results:

    • Manipulation or mobilization alone did not demonstrate significant pain relief for acute, subacute, or chronic MND.
    • Multimodal care, combining mobilization/manipulation with exercise, showed strong evidence of benefit for pain reduction and functional improvement in subacute/chronic MND.
    • Moderate evidence indicated no significant difference when multimodal care was compared to other treatments.

    Conclusions:

    • Multimodal care incorporating mobilization/manipulation and exercise provides sustained short-term and long-term benefits for subacute/chronic MND.
    • Manual therapies alone or with other physical agents were not superior to each other or other treatments.
    • Further research is needed to explore the role of exercise and identify optimal treatment characteristics for MND.