Neural tissue management provides immediate clinically relevant benefits without harmful effects for patients with nerve-related neck and arm pain: A randomised trial

Nee, Robert J., Vicenzino, Bill, Jull, Gwendolen A., Cleland, Joshua A. and Coppieters, Michel W. (2012) Neural tissue management provides immediate clinically relevant benefits without harmful effects for patients with nerve-related neck and arm pain: A randomised trial. Journal of Physiotherapy, 58 1: 23-31. doi:10.1016/S1836-9553(12)70069-3


Author Nee, Robert J.
Vicenzino, Bill
Jull, Gwendolen A.
Cleland, Joshua A.
Coppieters, Michel W.
Title Neural tissue management provides immediate clinically relevant benefits without harmful effects for patients with nerve-related neck and arm pain: A randomised trial
Journal name Journal of Physiotherapy   Check publisher's open access policy
ISSN 1836-9553
1836-9561
Publication date 2012-01-01
Year available 2012
Sub-type Article (original research)
DOI 10.1016/S1836-9553(12)70069-3
Open Access Status DOI
Volume 58
Issue 1
Start page 23
End page 31
Total pages 9
Place of publication Chatswood, NSW, Australia
Publisher Elsevier
Language eng
Formatted abstract
Question: What are the benefits and harms of neural tissue management in the short term for treating nerve-related neck and arm pain?
Design: Randomised controlled trial.
Participants: Sixty participants with non-traumatic nerve-related neck and unilateral arm pain were randomised to experimental (n = 40) or control (n = 20) groups.
Intervention: Both groups were advised to continue usual activities. The experimental group also received education, manual therapy, and nerve gliding exercises in 4 treatments over 2 weeks.
Outcome measures: Primary outcomes were participant-reported improvement and worsening on a Global Rating of Change scale. Secondary outcomes were neck pain, arm pain, the Neck Disability Index, the Patient-Specific Functional Scale, and adverse events related to treatment. Follow-up occurred 3–4 weeks after baseline.
Results: Numbers needed to treat favoured the experimental intervention for participant-reported improvement (2.7, 95% CI 1.7 to 6.5), neck pain (3.6, 95% CI 2.1 to 10), arm pain (3.6, 95% CI 2.1 to 10), Neck Disability Index (4.3, 95% CI 2.4 to 18.2), and Patient-Specific Functional Scale (3.0, 95% CI 1.9 to 6.7). The prevalence of worsening in the experimental (13%) and control (20%) groups were not different (RD –7%, 95% CI –28 to 13). Adverse events had minimal impact on daily activities and did not reduce the chance of improving with the experimental intervention (RR = 1.03, 95% CI 0.58 to 1.84).
Conclusion: These results enable physiotherapists to inform patients that neural tissue management provides immediate clinically relevant benefits beyond advice to remain active with no evidence of harmful effects.
Keyword Spinal nerves
Upper limb neurodynamic test
Manual therapy
Nerve gliding
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Health and Rehabilitation Sciences Publications
 
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