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Chiropractic Research Review

Single High-Velocity Adjustment May Benefit Neck Pain

A recent study performed in Spain has shown an immediate benefit from one adjustment in subjects with mechanical neck pain. The objective of this study was to analyze the immediate effects on neck pain and active cervical range of motion after a single cervical high-velocity, low-amplitude (HVLA) manipulation or a control mobilization procedure.

The possible correlation between neck pain and neck mobility also was investigated.

A group of 70 patients with neck pain (25 males and 45 females, ages 20-55 years) participated in this study. The lateral gliding test was used to establish an intervertebral joint dysfunction at the C3 through C4 or C4 through C5 levels. The subjects were randomly divided into either an experimental group, which received an HVLA thrust, or a control group, which received manual mobilization. The outcome measures were active cervical range of motion and neck pain at rest, assessed before the treatment and five minutes after it. Intragroup and intergroup comparisons were made with parametric tests.

The HVLA group showed a significant improvement in neck pain at rest and mobility after application of the manipulation. The control group also showed a significant improvement in neck pain at rest, flexion, extension, and both lateral flexions, but not in rotation. Pre-post effect sizes were large for all the outcomes in the experimental group, but were small to medium in the control mobilization group. The intergroup comparison showed that the experimental group obtained a greater improvement than the control group in all the outcome measures. Decreased neck pain and increased range of motion were negatively associated for all cervical motions - the greater the increase in neck mobility, the less the pain at rest.

Results suggest that a single cervical HVLA manipulation is more effective in reducing neck pain at rest, and in increasing active cervical range of motion, than a control mobilization procedure in subjects suffering from mechanical neck pain.

Martínez-Segura R, Fernandez-de-las-Penas C, Ruiz-Saez M, et al. Immediate effects on neck pain and active range of motion after a single cervical high-velocity low-amplitude manipulation in subjects presenting with mechanical neck pain: a randomized controlled trial. Journal of Manipulative and Physiological Therapeutics 2006;29(7):511-517.

Chiropractic Research Review

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