Table 5 RCTs including manual therapy in the treatment of patients with CR

Howe, [20]; n = 52

I: Manipulation and /or injection + NSAID (n = 26) C: NSAID (n = 26)

Manual therapy provided immediate significant pain reduction, but at the 1 week follow up there was no between-group difference anymore.

Brodin, [38]; n = 63

I 1: Mobilisation (n = 21) I 2: Electrotherapy en massage (n = 21) C: Wait & see (n = 21)

Segmental mobilisation was more effective than a placebo or a wait & see policy on the level of pain and range of motion.

Allison, [30]; n = 30

I 1: Thoracic & articular mobilisation (n = 10) I 2: Neurodynamic mobilisation (n = 10) C : Wait & see (n = 10)

Manual therapy combined with neurodynamic mobilisation is effective in improving pain intensity, pain quality scores and functional disability levels

Coppieters, [39]; n = 20

I: Cervical mobilisation with neurodynamic intent (n = 10) C: Therapeutic ultrasound (n = 10)

When a cervical dysfunction could be regarded as a cause of the neurogenic disorder or as a contributing factor that impedes natural recovery, a cervical lateral glide mobilisation has positive immediate effects in patients with subacute CR.

Shin, [29]; n = 26

I: Chuna Manual Therapy (CMT, n = 13) C: Cervical Traction (CT, n = 13)

Both CT and CMT reduce the level of pain, but CMT was found to be more effective than CT.

Ragonese, [18]; n = 30

I 1: manual therapy (n = 10) I 2: exercise (n = 10) I 3: combination (n = 10)

A combination of segmental spinal mobilisation and specific motor control exercises is more effective on pain and activity limitations than separate interventions of manual therapy or exercises alone.

Young, [19]; n = 81

I: Traction & manual therapy & exercise (n = 45) C: Placebo traction & manual therapy & exercise (n = 36)

At the 2 and 4 week follow up there was so significant difference between groups on pain and activity limitations.

Note: manual therapy consisted of thoracic manipulation and thoracic & cervical mobilisation

Nee, [42]; n = 60

I: Cervical mobilisation with neurodynamic intent & peripheral neurodynamic mobilisations (n = 40) C : Wait & see (n = 20)

At the 2 week follow up the intervention group reported substantial reductions in neck pain, arm pain, and activity limitations.

Langevin, [41]; n = 36

I : Cervical mobilisation + specific exercises, both aimed at opening IVF (n = 18) C: General mobilisation and exercises NOT aimed at opening IVF (n = 18)

Preliminary results based on the size of the treatment effect, suggest that at the 4 & 8 week follow up, a combination of manual therapy and motor control exercises is more effective on pain and activity limitations than a wait-and-see policy. There is no difference between general mobilisation or mobilisation aimed at opening the IVF.