Table 1 Summary of Included Trials
Reference | Trial Design | Jadad Score | Patients/Problems | Interventions | Main Outcome Measures | Follow-Up Period | Main Results | Comments | Conclusion of Study |
|---|---|---|---|---|---|---|---|---|---|
Vernon (1990)22 | RCT, 2 parallel groups | 1 | 9 with mechanical neck pain | A) HVLA rotational manipulation B) oscillatory mobilisation | Pressure pain threshold | None | Treatment A improved pressure pain threshold more than B | Pilot 1 treatment only | Manipulation superior to mobilisation |
Cassidy (1991)23 | RCT, 2 parallel groups | 1 | 100 with mechanical neck pain and radiation into trapezius | A) HVLA rotational manipulation B) PIR to improve cervical ROM | NRS-101 for pain Cervical ROM | None | Both treatments improved cervical ROM Treatment A superior to B in relieving pain | Pilot 1 treatment only Observer blind | Manipulation superior to mobilisation in relieving pain Both equal in improving cervical ROM |
Yurkiw (1996)24 | RCT, 2 parallel groups | 2 | 14 with unilateral mechanical neck pain | A) diversified HVLA manipulation B) Activator | Cervical lateral flexion VAS for pain | None | Both treatments improved pain and lateral flexion equally | Pilot 1 treatment only Observer blind | No difference between HVLA and Activator |
Wood (2001)25 | RCT, 2 parallel groups | 0 | 30 with mechanical neck pain and restricted ROM | A) diversified HVLA manipulation B) Activator | NRS-101 for pain McGill Neck Disability Index Cervical ROM | 1 month | Both treatments had an equal positive effect | Pilot maximum 8 treatments over 4 weeks Non-blinded examiner | No difference between HVLA and Activator |
Hurwitz (2002)26 | 2 × 2 × 2 factorial design | 3 | 336 with mechanical neck pain | A) HVLA manipulation with heat B) HVLA manipulation without heat C) HVLA manipulation with EMS D) HVLA manipulation without EMS E) Mobilisation with heat F) Mobilisation without heat G) Mobilisation with EMS H) Mobilisation without EMS | 11-point NRS Neck Disability Index SF-36 Adverse reactions Satisfaction with care Patient global assessment | 6 months | Both treatments have comparable outcomes Heat and EMS add nothing to treatment | Limited to HMO patients At least 1 treatment Examiner blinded? | Manipulation and mobilisation give comparable clinical outcomes |