No abstract

Objective: The aim is to verify whether there is difference in neck strength between healthy individuals and individuals with chronic neck pain. Methods: The PubMed, Embase, and Scopus databases were searched. Two independent reviewers selected relevant full articles comparing neck strength between healthy individuals and individuals with chronic neck pain. Two independent reviewers extracted the data from the full articles selected. A meta-analysis was used to assess standardized mean differences in neck strength based on a random-effects model (Prospero number CRD42017081502). Results: The search returned 3554 results; 15 articles were included. The chronic neck pain group showed lower neck strength compared with healthy individuals. The standardized mean difference was -0.90 (95% confidence interval [CI] ¼ -1.13 to -0.67) for flexion, -0.79 (95% CI ¼ -0.99 to -0.60) for extension, -0.74 (95% CI ¼ -1.03 to -0.45) for right lateral flexion, and -0.75 (95% CI ¼ -1.04 to -0.46) for left lateral flexion. Conclusion:Based on this meta-analysis with a 3a level of evidence, individuals with chronic neck pain have lower neck strength for flexion, extension, and the lateral flexion of the neck than healthy controls.

No abstract

Background: According to the American Physical Therapy Association, there is strong evidence to show that vertebral mobilization and manipulation procedures can be used to improve spinal and hip mobility and reduce pain and incapacity in low back pain patients that fit the clinical prediction rule. Objectives: To evaluate the immediate effects of high-velocity low-amplitude (HVLA) manipulation on pain and postural control parameters in individuals with nonspecific low back pain. Methods: This study used a participant-blinded and assessor-blinded randomized controlled clinical trial involving a single session, in which 24 participants were randomly distributed into control (simulated manipulation) and intervention (HVLA lumbar manipulation) groups. The primary (pain: subjective pain intensity and pressure pain threshold) and secondary outcomes (postural control: ellipse area, center of pressure [COP] excursion, COP RMS velocity, and differences between the COP and center of projected gravity) were evaluated before and after the session using a numerical pain scale, algometer, and a force platform. For all outcomes, multiple mixed 2 (group) × 2 (time) ANOVAs were performed. Results: For the subjective pain intensity, only time was significant as a main effect, where pre-intervention presented a greater value then post-intervention (F [1.44] = 4.377; p = 0.042; r = 0.30). For the pressure pain threshold no significant effect was found. For the postural control parameters, as a main effect, only the ellipse area was significantly greater in the control group (F [1.44] = 6.760; p = 0.013; effect size = 0.36).

Introduction: Cervical joint dysfunction may interfere with the sensorimotor afferent response, interfering with neck neck Joint Position Sense error (JPS). Objective: The aim of this study was to evaluate the influence of Cervical Spine Manipulation (CSM) on neck JPS error in patients with chronic neck pain. Method: 21 patients with chronic neck pain were divided into 2 groups: Spinal Manipulation Group (MG) or Sham Group (SG) who received 4 sessions of CSM and Sham CSM respectively. JPS was assessed in three different time frames: 1) pre-intervention; 2) Right after the first intervention (post-intervention 1); and 3) After a chronic intervention (post-intervention 2). The outcome measured in this study was the head reposition accuracy test with the Revel's Test. Results: The JPS showed no significant differences between pre-and post-intervention 1 and 2 for any of the assessed groups. Conclusion: We conclude that, for this sample, neither the CSM nor the Sham CSM statistically changed the JPS error for neither groups. We believe that the changes in JPS after CSM were concealed because the ability of other sensory system information to compensate for inadequacies in any other component. Therefore, more studies have to be done with a stronger methodological rigor, clinical prediction rule for spinal manipulation, bigger sample and a blind assessment.