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. | Â | 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) | Â | Â | Â | Â | Â | Â | Â | Â | Â |
- 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 |