Table 3 Primary outcome measures results
Study | Intervention (N) | Comparator (N) | HI scale | HI: MCID reached for Intervention group (Mean change at short term) | HI: MCID reached for Intervention group (Mean change at long term) | HF scale | HF: MCID reached for Intervention group (Mean change at short term) | HF: MCID reached for Intervention group (Mean change at long term) | P value between-groups | RoB |
|---|---|---|---|---|---|---|---|---|---|---|
Bodes-Pardo et al. [51] | Trigger point therapy + stretching (10) | Sham trigger point therapy (10) | NPRS 0–10 | MCID reached (− 5.4/10 at 1 week) |  |  |  |  | P < .001 | Unsure |
Chaibi et al. [52] | Cervical manipulation (4) | Sham manual therapy (4); Control (4) | VAS 0–10 |  | MCID unknown (− 2.3 at 3 months) | Days/month |  | − 6 at 3 months | P values not calculated due to small sample size | High |
Dunning et al. [53] | Cervical and thoracic manipulation (58) | Cervical and thoracic mobilization and cranio-cervical flexion exercises (52) | NPRS 0–10 | MCID reached (− 4.5/10 at 4 weeks) | MCID reached (− 4.3/10 at 3 months) |  |  |  | P < .001 at all time points | Low |
Esin et al. [54] | Kinesiotaping (34) | Sham taping (34); Education and autonomous rehabilitation instructions (33) | VAS 0–100 | MCID unknown (− 2.3/100 at 4 weeks, − 29.5/100 at 8 weeks) |  | Days/month | MCID reached (− 8 at 4 weeks, − 9.7 at 8 weeks) |  | P < .01 for both comparisons at long term, and for HF at short term. P > 0.05 for HI at short term | High |
Haas et al. [55] | Cervical and thoracic manipulation—8 sessions (20) | Moist heat and light massage—8 sessions (20) | MVK 0–100 | MCID unknown (− 21/100 at 12 weeks) | MCID unknown (− 18/100 at 24 weeks) | Days/4 weeks | MCID reached (− 9 at 12 weeks) | MCID reched (− 7.6 at 24 weeks) | Analysis comparing both intervention groups ot both control groups found P < .05 for all outcomes at all time points, besides P > .05 for HF at 24 weeks | Low |
Cervical and thoracic manipulation—16 sessions (20) | Moist heat and light massage—16 sessions (20) | MVK 0–100 | MCID unknown (− 21/100 at 12 weeks) | MCID unknown (− 23/100 at 24 weeks) | Days/4 weeks | MCID reached (− 9.6 at 12 weeks | MCID reched (− 9.4 at 24 weeks) | |||
Haas et al. [56] | Cervical and thoracic manipulation—6 sessions (65) | Sham massage (64) | VAS 0–10 | MCID unknown (− .5/10 at 6 weeks) | MCID unknown (− .6/10 at 24 weeks) | Days/4 weeks | MCID not reached (− 3 at 6 weeks) | MCID not reached (− 5.2 at 24 weeks) | P > .05 at all time points | Low |
Cervical and thoracic manipulation—12 sessions (64) | Sham massage (64) | VAS 0–10 | MCID unknown (− .7/10 at 6 weeks) | MCID unknown (− .7/10 at 24 weeks) | Days/4 weeks | MCID not reached (− 5 at 6 weeks) | MCID not reached (− 5.5 at 24 weeks) | P > .05 at all time points | ||
Cervical and thoracic manipulation—18 sessions (63) | Sham massage (64) | VAS 0–10 | MCID unknown (− .9/10 at 6 weeks) | MCID unknown (− .6/10 at 24 weeks) | Days/4 weeks | MCID not reached (− 7.7 at 6 weeks) | MCID not reached (− 7.2 at 24 weeks) | P < .05 at all time points for HF. P < .05 at 6 and 52 weeks for HI | ||
Hall et al. [57] | C1-2 SNAG (16) | Sham SNAG (16) | CGH index | MCID unknown (− 21/100 at 4 weeks) | MCID unknown (− 28/100 at 24 weeks) | CGH index | MCID unknown (− 21/100 at 4 weeks) | MCID unknown (− 28/100 at 12 months) | P < .001 at 4 weeks and 12 months | High |
Jafari et al. [58] | Trigger point therapy (9) | No treatment control (10) | VAS 0–10 | MCID unknown (− 2.4/10 at 3 weeks) |  | Days/2 weeks | MCID reached (− 1.8 at 3 weeks) |  | P < .05 at 3 weeks | Unsure |
Jull et al. [59] | Spinal mobilization and manipulation (51) | No treatment control (48) | VAS 0–10 | MCID unknown (− 3 at 7 weeks) | MCID unknown (− 2.3/10 at 12 months) | Days/week | MCID reached (− 2 at 7 weeks) | MCID reached (− 2.2 at 12 months) | P < .001 at 7 weeks for both outcomes, P < .05 at 12 months for HI and P < .01 for HF | High |
Low load endurance exercises for cervico-scapular muscle (52) | No treatment control (48) | VAS 0–10 | MCID unknown (− 3.3 at 7 weeks) | MCID unknown (− 2.8/10 at 12 months) | Days/week | MCID reached (− 2.4 at 7 weeks) | MCID reched (− 2.5 at 12 months) | P < .001 for HF at all time points, P < .05 at 7 weeks and P < .01 at 12 months for HI | ||
Combination of the above (49) | No treatment control (48) | VAS 0–10 | MCID unknown (− 3.4 at 7 weeks) | MCID unknown (− 2.7/10 at 12 months) | Days/week | MCID reached (− 2 at 7 weeks) | MCID reched (− 2.1 at 12 months) | P < .001 at all time points | ||
Malo-Urriès et al. [60] | Upper cervical mobilization (41) | No treatment control (41) | VAS 0–10 | MCID unknown (− .6 post TTT) |  |  |  |  | P < .05 | Low |
Nilsson et al. [61] | Cervical manipulation (28) | G2: Deep friction massage, trigger point therapy to upper back and neck, laser light therapy (26) | VAS 0–100 | MCID unknown (− 16/100 at 5 weeks) |  |  |  |  | P < .05 | Low |
Sedighi et al. [62] | Sub-occipital and trapezius dry needling (15) | Sham sub-occipital and trapezius dry needling (15) | CGH index | MCID unknown (− 8.4 At 1 week) |  | CGH index | MCID unknown (− 8.4 At 1 week) |  | P > .05 | Unsure |
Sharma et al. [63] | Multimodal therapy (spinal mobilization, low load and mobility exercise program for the cervical spine, postural correction intervention) (9) | Postural correction (9) | VAS 0–100 | MCID unknown (− 71 at 4 weeks) |  | Days/week | MCID reached (− 5.2 at 4 weeks) |  | P < .05 for both outcome measures | Unsure |
Exercise therapy (low load and mobility exercise program for the cervical spine, postural correction intervention) (9) | Postural correction (9) | VAS 0–100 | MCID unknown (− 71 at 4 weeks) |  | Days/week | MCID reached (− 5.2 at 4 weeks) |  | P < .05 for HI, P > .05 for HF | ||
von Piekartz et al. [64] | Manual therapy + exercise (TMJ manual therapy, TMJ coordination and ROM exercises) (22) | Usual care (cranio-cervical manual and exercise therapy) (21) | CAS 0–10 |  | MCID unknown (− 3,9 at 3 months, − 4.9 at 6 months) |  |  |  | P < .001 at all time points | Unsure |
Yang and Kang [65] | Hot pack and low frequency therapy on trapezius + cranio cervical flexion exercises (10) | Hot pack and low frequency therapy on trapezius (10) | VAS 0–100 | MCID unknown (unclear results at 4 weeks) |  |  |  |  | P < .05 reported despite wrong results reported at weel 4 | High |
Hot pack and low frequency therapy on trapezius + sub-occipital relaxation (10) | Hot pack and low frequency therapy on trapezius (10) | VAS 0–100 | MCID unknown (wrong 4 weeks measure |  |  |  |  | P < .05 reported despite wrong results reported at weel 4 | ||
Youssef and Shanb [66] | Cervical mobilization and exercise (20) | Massage and exercise (18) | VAS 0–10 | MCID unknown (− 4.9 at 7 weeks) |  | Days/4 weeks | MCID reached (− 4.1 at 7 weeks) |  | P < .05 for both outcome measures | Low |
Abdel et al. [67] | Exercise Therapy (stretching, isometric contractions, postural correction) + Graston technique (30) | Exercise Therapy (stretching, isometric contractions, postural correction) (30) | VAS 0–100 | MCID unknown (MD = 36.7/100 at 4 weeks) |  | Days/week | Values expressed in median, difference of median for the Intervention group reaching MCID (− 80% from baseline) |  | P = 0.0001 for HI, P = 0.001 for HF | Low |
Dunning et al. [68] | Spinal manipulation and electrical dry needling (74) | Spinal mobilization and scapular and cranio-cervical exercise (68) | NPRS 0–10 | MCID reached (MD = 3.9 at 4 weeks) | MCID reached (MD = 4.9 at 3 months) | Days/week | MCID reached (MD = 2.9 at 4 weeks) | MCID reached (MD = 3.5 at 3 months) | P < 0.001 at 4 weeks and 3 months for HI and HF | Low |
Lerner-Lentz et al. [69] | Spinal manipulation, cranio-cervical and scapular exercise (21) | Spinal mobilization and scapular and cranio-cervical exercise (24) | NPRS 0–10 | MCID reached (MD = 4.3 at 1 month) |  |  |  |  | P > 0.05 at all time points. Within-group P < 0.05 for both groups at all timepoints | Unsure |
Moustafa et al. [70] | Myofascial release, spinal mobilization, cranio-cervical and scapular exercise, Dennerol cervical extension traction (30) | Myofascial release, spinal mobilization, cranio-cervical and scapular exercise (30) |  |  |  | Days/2 weeks | MCID reached (MD = 5.5 at 10 weeks) | MCID reached (MD = 10.4 at 1 year) | P < 0.001 at all time points for HF | High |