UBIC, Department of Physiotherapy, University of Valencia, Valencia, Spain.
Facultad de Ingeniería Mecánica, Escuela Politécnica Nacional, Quito, Ecuador.
J Manipulative Physiol Ther. 2023 Jan;46(1):17-26. doi: 10.1016/j.jmpt.2023.05.006. Epub 2023 Jul 7.
The aim of the present study was to assess the immediate effects of a single session of cervical spine manipulation on cervical movement patterns, disability, and the patient's perceived improvement in people with nonspecific neck pain.
A single-blinded, randomized, sham-controlled trial was carried out at a biomechanics institute. Fifty participants diagnosed with acute and chronic nonspecific neck pain (minimum duration of the symptoms being 1 month) were randomized to an experimental group (EG, n = 25) or a sham-control group (CG, n = 25, 23 of whom completed the study). EG received a single cervical spine manipulation session; CG received a single placebo intervention. Both groups received manipulation or sham from the same physiotherapist. Main outcome measures were neck kinematics (ie, range of motion and movement harmony) during cyclic movements, self-reported neck disability, and impression of change assessed before and 5 minutes after treatment.
The EG showed no significant improvements (P > .05) in any of the studied biomechanical variables, except for right-side bending and left rotation, in which we found a range of motion significant mean difference of 1.97° and 1.95°, respectively (P < .05). The CG showed enhanced harmonic motion during flexion (P < .05). Both groups showed a significant decrease in self-reported neck disability after treatment (P < .05), and EG participants perceived a significantly larger improvement after manipulation compared with the CG (P < .05).
A single session of cervical manipulation provided by a physiotherapist had no impact on cervical motion during cyclic movements, but rather induced self-reported perceived improvement in neck disability and impression of change after treatment in people with nonspecific neck pain.
本研究旨在评估单次颈椎推拿对非特异性颈痛患者颈椎运动模式、功能障碍以及患者自我感知改善的即刻影响。
一项单盲、随机、假对照试验在生物力学研究所进行。50 名被诊断为急性和慢性非特异性颈痛（症状持续至少 1 个月）的患者被随机分为实验组（EG，n=25）或假对照组（CG，n=25，其中 23 名完成了研究）。EG 接受单次颈椎推拿治疗；CG 接受单次安慰剂干预。两组均由同一位物理治疗师进行推拿或假操作。主要观察指标为循环运动期间的颈部运动学（即活动范围和运动协调性）、自我报告的颈部功能障碍以及治疗前和治疗后 5 分钟的变化印象。
实验组在任何研究的生物力学变量中均未显示出显著改善（P>.05），除了右侧弯曲和左侧旋转，其中我们发现运动范围的显著平均差异分别为 1.97°和 1.95°（P<.05）。CG 在屈伸时表现出增强的协调运动（P<.05）。两组在治疗后自我报告的颈部功能障碍均显著降低（P<.05），实验组在治疗后自我感知的改善明显大于 CG（P<.05）。
由物理治疗师进行单次颈椎推拿治疗对循环运动期间的颈椎运动没有影响，但在非特异性颈痛患者中，治疗后会引起自我报告的颈部功能障碍和变化印象的感知改善。
