Abstract
Study designPilot randomized controlled trial.BackgroundBetter understanding of the relative effectiveness of different approaches to cervical spine mobilization has been identified as a research priority in manual therapy practice. Two distinct approaches to the practice of mobilization have emerged in recent years, based on different reasoning models for selection of mobilization techniques. The objective of this pilot study was to assess feasibility aspects for a future randomized clinical trial by exploring short-term pain and disability outcomes after a single treatment with pragmatic versus prescriptive approaches to cervical mobilization for people with recent-onset neck pain at 48-h follow-up after randomization.MethodsTwenty adults with a new episode of mechanical neck pain were randomly allocated to either pragmatic or prescriptive mobilization intervention groups. The pragmatic group received a single treatment of cervical mobilization with the technique, target segment, and grade selected by their treating therapist. The prescriptive group received a single treatment of standardized mobilization with techniques similar to a previous mobilization clinical trial. Feasibility outcomes were recruitment rates, randomization audit and completion of treatment and follow-up per protocol. The primary clinical outcome of interest was disability level measured at 48-h follow-up after randomization.ResultsRecruitment rates were approximately 2.5 participants per week and 100% of eligible participants were deemed suitable for treatment with cervical mobilization. There was sufficient variety in the range of pragmatic treatments selected and the data collection process imposed minimal burden on participants.ConclusionsOur results provide supporting evidence for the feasibility of a future larger scale randomized clinical trial.Trial registrationTrial registration: Australian New Zealand Clinical Trials Registry (ACTRN12616000446460). Registered 6th April 2016. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370448&isReview=true
Highlights
Better understanding of the relative effectiveness of different approaches to cervical spine mobilization has been identified as a research priority in manual therapy practice
Recruitment rates were approximately 2.5 participants per week and 100% of eligible participants were deemed suitable for treatment with cervical mobilization
It is distinguished from cervical manipulation in that it does not involve application of a rapid thrust or production of an audible ‘crack’ that is associated with spinal manipulation
Summary
Better understanding of the relative effectiveness of different approaches to cervical spine mobilization has been identified as a research priority in manual therapy practice. Mobilization is a manual therapy technique that involves application of low-velocity, passive inter-vertebral movements that are within the patient’s range of motion and their control [8] It is distinguished from cervical manipulation in that it does not involve application of a rapid thrust or production of an audible ‘crack’ that is associated with spinal manipulation. There is considerable diversity between and even within these disciplines and to date there have been few head-to-head clinical trials that have directly compared different mobilization techniques or approaches [8] This type of trial is important because it is not known whether certain approaches to manual therapy are more effective than others
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