Cervical Manipulation Research for Chiropractors

Cervical Manipulation Effects

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The Study:

The effects of cervical joint manipulation on cervical lordosis, forward head posture, and cervical range of motion.

The Facts:

a. The authors compared general mobilization to “cervical posture manipulation based on passive motion analysis (MBPMA).”

b. They looked at 40 university students who had chronic cervical pain and divided them into two groups with one group receiving general mobilization and the other receiving MBPMA.

c. Both the general mobilization and the MBPMA group received three manipulations a week for four weeks.

d. The patients were X-rayed but the manipulations administered to the MBPMA group were based on passive motion analysis of the joints of the cervical spine.

e. The joints that were restricted were manipulated “while movement in the surrounding joints was prevented.”

f. They looked at cervical extension range of motion, ranges of flexion and extension motion, absolute rotation angle, anterior weight bearing and cervical flexion range of motion

g. “CER [Cervical Extension Range of Motion] and RFEM [Ranges of flexion and extension motion] were significantly higher in the MBPMA group than in the mobilization group after the experiment,” according to the researchers.

h. Overall changes in the MBPMA group were higher than the general mobilization group.

i. Absolute rotation angles (the cervical lordosis) and Forward Head Posture were both significantly more improved in the MBPMA group as opposed to the group that received a more generalized manipulation.

Take-Home:

Manipulations based on locating restricted joints showed a greater increase in motion than general mobilization.

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Reviewer’s Comments:

Although we might expect that care based on motion analysis would improve motion, it might not have turned out that way. It appears that directing the forces toward the restricted joints as opposed to a general manipulation does improve motion more. It reinforces the idea that quality care is more than just “pop and pray.” The direction of the forces does make a difference. Oh, if you don’t believe me see how well you do playing pool and directing the forces from your cue stick in random directions.

Reviewer:  Roger Coleman, DC

Editor’s Comments:  In terms of the lordosis, the MBPMA group showed an average correction of 5.2 degrees compared to the mobilization group which only improved 2.6 degrees…twice as much improvement.. While this obviously isn’t nearly what we would expect were we to add extension traction to the therapeutic  mix, it’s still a sizeable difference. Correcting spines isn’t about home runs, it’s about base hits. It’s important to get whatever correction you can, where you can, in whatever way you can.  This study gives us some insight on how we might possibly modify our manipulation/adjustment methods in order to improve our both our functional and structural care outcomes.

Editor: Mark R. Payne, DC

Reference: Gong W. The effects of cervical joint manipulation, based on passive motion analysis, on cervical lordosis, forward head posture, and cervical ROM in university students with abnormal posture of the cervical spine. J Phys Ther Sci. 2015 May;27(5):1609-11. doi: 10.1589/jpts.27.1609. Epub 2015 May 26.

Link to abstract: http://www.ncbi.nlm.nih.gov/pubmed/26157273

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