Paradigm Shift in Manual Therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation

Schmid, Annina, Brunner, Florian, Wright , Anthony and Bachmann, Lucas M. (2008) Paradigm Shift in Manual Therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation. Manual Therapy, 13 5: 387-396. doi:10.1016/j.math.2007.12.007


Author Schmid, Annina
Brunner, Florian
Wright , Anthony
Bachmann, Lucas M.
Title Paradigm Shift in Manual Therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation
Journal name Manual Therapy   Check publisher's open access policy
ISSN 1356-689X
1532-2769
Publication date 2008-10-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.math.2007.12.007
Open Access Status DOI
Volume 13
Issue 5
Start page 387
End page 396
Total pages 10
Place of publication Kidlington, Dorset, U.K.
Publisher Churchill Livingstone
Language eng
Formatted abstract
Segmental neurological modulation, neural hysteresis and biomechanical effects have been proposed as mechanisms underpinning the effects of manual therapy. An increasing number of studies hypothesise activation of the central nervous system resulting in a non-segmental hypoalgesic effect with concurrent activation of other neural pathways as a potential mechanism of action. Whether this model is consistent with the current literature is unknown. This systematic review aims to assess the consistency of evidence supporting an involvement of supraspinal systems in mediating the effects of passive cervical joint mobilisation. We searched randomised trials in three electronic databases from inception to November 2007, without language restriction, and checked reference lists of included studies. We assessed study validity and extracted salient features in duplicate. Fifteen studies met our inclusion criteria. The overall quality was high. We found consistency for concurrent hypoalgesia, sympathetic nervous system excitation and changes in motor function. Pooling of data suggested that joint mobilisation improved outcomes by approximately 20% relative to controls. This specific pattern suggests that descending pathways might play a key role in manual therapy induced hypoalgesia. Our review supports the existence of an alternative neurophysiological model, in which passive joint mobilisation stimulates areas within the central nervous system
Keyword Cervical pain
Joint mobilisation techniques
Manipulation spinal
Neck
Physical therapy (speciality
Treatment outcome
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: ERA 2012 Admin Only
School of Health and Rehabilitation Sciences Publications
 
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Created: Mon, 20 Feb 2012, 23:22:26 EST by Ms Annina Barbara Schmid on behalf of School of Health & Rehabilitation Sciences