Dose optimization for spinal treatment effectiveness: a randomized controlled trial investigating the effects of high and low mobilization forces in patients with neck pain
Passive joint mobilisations are commonly used by physiotherapists to treat neck pain. However, the optimal dose of force required to treat patients with neck pain remains elusive. The aim of the current study was to determine if patient outcomes following posterior-to-anterior mobilisation is influenced by the magnitude of force applied.
64 patients were randomised to receive a single treatment of PA mobilisations applied at either 30N or 90N, whilst the remaining received a placebo. A range of outcome measures were performed prior, immediately after, and a mean 4 days post treatment.
The patients who received 90N of force experienced less pain than the 30N group, and were less stiff than the placebo group. No significant between-group differences were reported in pressure pain threshold or range-of-motion.
These findings suggest the specificity of force applied during mobilisation treatment may influence outcomes. However, as changes were not observed immediately post-treatment, effects may not be directly mechanical.> From: Snodgrass et al., J Orthop Sports Phys Ther 44 (2014). All rights reserved to the Journal of Orthopaedic & Sports Physical Therapy.
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