Rose, dJA., Branney, J., Breen, CA. (2021) 'Association of Spinal Manipulative Therapy With Changes in Cervical Motion Segment Interactions in Patients With Neck Pain: An Observational Study With Matched Asymptomatic Controls', J Manipulative Physiol Ther.2021 Jul-Aug;44(6):475-486.
J Manipulative Physiol Ther.2021 Jul-Aug;44(6):475-486.
Association of Spinal Manipulative Therapy With Changes in Cervical Motion Segment Interactions in Patients With Neck Pain: An Observational Study With Matched Asymptomatic Controls
A J d Rose, J Branney, A C Breen
Abstract:
Objective: The objectives of this study were to determine (1) if maximal intervertebral range of motion (IV-RoMmax) and laxity interactions exist in the cervical spine during flexion, (2) if there are differences in IV-RoMmax or laxity parameters between baseline and follow-up in both patients with neck pain and asymptomatic controls, and (3) if there is an effect on IV-RoMmax/laxity relationships in patients with neck pain after spinal manipulative therapy. Methods: Twenty-nine patients with subacute or chronic neck pain and 33 asymptomatic controls were imaged during flexion and extension, pre and post a course of cervical chiropractic manipulation (patient group only), using a standardized quantitative fluoroscopy acquisition protocol. Results: Significant correlations between IV-RoMs were found in both neck pain and neck pain-free populations at baseline and follow-up. Positive relationships were found between C2-C3 and C3-C4 and C4-C5 and C5-C6 IV-RoM in both populations. A negative correlation was found in the patient group at baseline between C1-C2 and C5-C6, but not at follow-up. Significant relationships were also found for segmental laxity, with a negative correlation found at C1-C2 and C5-C6 in the patient group only and at baseline only. Conclusion: Distinct relationships were found between both intraregional IV-RoM and laxity, many of which were present in both groups at baseline and follow-up, suggestive of normal kinematic behaviors. Changes in correlations unique to the patient group may be indicative of a change in regional kinematics resulting from the manipulation intervention. Spinal manipulative therapy may have a therapeutic effect by influencing cervical kinematics at the regional level.
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