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Table 4 Effects of SMT on cervical range of motion

From: The effect of spinal manipulative therapy on spinal range of motion: a systematic literature review

Author Quality score /100 Treatment and control activity (sham, other or nothing) Δ ROM pre/post treatment in degrees: flexion Δ ROM pre/post treatment in degrees: extension Δ ROM pre/post treatment in degrees: right lateral flexion Δ ROM pre/post treatment in degrees: left lateral flexion Δ ROM pre/post treatment in degrees: right rotation Δ ROM pre/post treatment in degrees: left rotation Summarized results given by authors Comments Were the differences in outcome tested between groups and were they significant?
Kanlayanaphotporn[43] 83 - Clinically determined mobilization - Random mobilization 1.9 ± 4.1 −0.7 ± 4.5 1.8 ± 6.3 0.8 ± 4.6 - 0.3 ± 6.3 1.2 ± 4.9 0.8 ± 4.8 1.3 ± 4.1 0.5 ± 5.5 0.6 ± 6.9 1.1 ± 4.2 0.8 ± 6.0 The preferred mobilization group showed an increased flexion/extension compared to random mobilization group.   Yes and yes
Whittingham[40] 83 - SMT upper cervical - Sham (deactivated instrument) - - Gr. 1=39° ± 1.1 Gr. 2=38° ± 1.4 Gr. 1=38° ± 1.3 Gr. 2=36° ± 1.2 Gr. 1=56° ± 1.4 Gr. 2=57° ± 1.5 Gr. 1=54° ± 1.6 Gr. 2=54° ± 1.6 SMT increase significantly ROM Those are given baseline values. ROM values immediately after treatment. Effect is observed on weeks 3, 6, 9 and 12. Yes and yes
Krauss[42] 77 - Thoracic SMT - Nothing - - - - 8.23 (SD=7.41) −0.1 (SD=2.33) 7.09 (SD=5.83) −0.6 (SD=3.66) Cervical rotation ROM is improved following SMT   Yes and yes
Martinez Segura[37] 77 - SMT (C3-C5) - Sham neck mobilization 7 (Cohen’s d=5) 1.5 (Cohen’s d=2.5) 8 (Cohen’s d=7) 1.4 (Cohen’s d=3.3) 5 (Cohen’s d=4) 0.8 (Cohen’s d=1.6) 5 (Cohen’s d=4) 0.8 (Cohen’s d=1.5) 10 (Cohen’s d=5) 0.4 (Cohen’s d=1.5) 9 (Cohen’s d=5) 0.3 (Cohen’s d=0.8) SMT was more effective than control mobilization on ROM. Large effect sizes.   Yes and yes
Mc Clatchie[38] 69 - Mobilization (cervical) - Sham (same mobilization position but without external force) −1.2 ± 6.5 −1.4 ± 5.3 0.8 ± 5.5 −0.5 ± 5.5 −0.7 ± 5.2 −0.1 ± 5.3 −0.4 ± 4.1 0.3 ± 4.4 1.1 ± 4.4 −0.4 ± 5.9 1.3 ± 6.6 - 0.3 ± 4.9 No significant difference   Not tested
Cassidy[36] 69 - SMT(cervical) (n=52) - Mobilization (cervical) (n=48) 5.1 (SD 8.3) 3.9 (SD 9.4) 3.1 (SD 7.8) 1.3 (SD 7.5) 3.4 (SD 7.5) 2.0 (SD 5.2) 4.3 (SD 7.0) 3.0 (SD 4.7) 5.0 (SD 9.0) 4.2 (SD 9.0) 3.6 (SD 7.0) 2.4 (SD 6.4) Both treatments increase ROM to similar degree.   Yes and no
Kanlayanaphotporn[44] 67 - Post/ant (PA) cervical mobilization - random mobilization (PA, right or left) 1.4 (SD 5.2) −0.4 (SD 7.6) 1.8 (SD 5.4) −0.4 (SD 5.9) −0.2 (SD 4.0) 0.6 (SD 4.1) 0.9 (SD 4.2) 1.5 (SD 7.8) 1.2 (SD 5.9) 1.2 (SD 6.1) 2.7 (SD 5.3) 2.0 (SD 5.8) No significant effect on ROM   Yes and no
Tuttle[41] 67 - PA cervical mobilization at symptomatic level - Placebo (PA mobilization but asymptomatic side)          
- Nothing (lying down) * initial values flexion/extension ROM =119° (SD-17) * initial values flexion/extension ROM=119° (SD-17) * initial values lateral flexion ROM=93° (SD-12) * initial values lateral flexion ROM=93° (SD-12) * initial values rotation ROM=93° (SD-12) * initial values rotation ROM=93° (SD-12) No significant ROM increase * No differences. pre/post treatment values are given but only shown in a graph. Not tested   
Passmore[39] 50 - SMT(C1-C2) - Nothing (wait 5’) No difference No difference No difference No difference No difference No difference No difference No difference 3.75 No difference - SMT increases cervical active ROM   Not tested