Cheung Lau 2011.
| Methods | Type of trial: RCT
Number analysed/randomly assigned: 60/60
Intention‐to‐treat analysis: calculated Location of study: Hong Kong |
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| Participants | Chronic (> 3 months) mechanical neck pain | |
| Interventions | INDEX TREATMENT
Manipulation group (manipulation plus cntl): technique: supine technique performed anterior‐posterior, high‐velocity low‐amplitude thoracic manipulation plus infrared radiation therapy and educational materials (pathology, advice, exercise) provided; frequency: 2 sessions per week for 4 weeks, 8 sessions total; dose: 1 to 2 manipulations per segment; duration: infrared radiation therapy applied for 15 minutes; route: thoracic spine manipulation to identified restricted segment, infrared radiation therapy applied over painful site COMPARISON TREATMENT Control group (cntl): Infrared radiation therapy group received the same educational materials as were given to the manipulation group (CG): technique: infrared radiation therapy; frequency: 2 sessions per week for 4 weeks, 8 sessions total; dose: 15 minutes per session; route: applied over painful site CO‐INTERVENTION: NR Duration of therapy period: 4 weeks Duration of follow‐up: immediately post treatment, 3 months, 6 months |
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| Outcomes | PAIN (NPRS, 0 to 10) Baseline mean: manip plus cntl 5.02, cntl 5.05 End of study mean: manip plus cntl 2.98, cntl 4.24 Absolute benefit: manip plus cntl 2.04, cntl 0.81 Reported results: significant favouring manipulation SMD (6 months): ‐0.64 (95% CI ‐1.04 to ‐0.25); NNTB 4 FUNCTION: NPQ, 0 to 100% Baseline mean: manip plus cntl 39.15, cntl 41.86 End of study mean: manip plus cntl 28.77, cntl 34.80 Absolute benefit: manip plus cntl 10.38, cntl 7.06 Reported results: significant favouring manipulation SMD: ‐0.38 (95% CI ‐0.77 to 0.01); NNTB 5 PARTICIPANT SATISFACTION: NR GPE: NR QoL: SF‐36 PCS and MCS PCS Baseline mean: manip plus cntl 38.35, cntl 35.35 End of study mean: manip plus cntl 41.24, cntl 35.67 Absolute benefit: manip plus cntl 2.89, cntl 0.32 Reported results: significant favouring manipulation SMD: ‐0.64 (95% CI ‐1.02 to ‐0.26) SIDE EFFECTS: none COST OF CARE: NR |
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| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Page 142, left column, paragraphs 3 and 4 |
| Allocation concealment (selection bias) | Low risk | Page 142, left column, paragraphs 3 and 4 |
| Blinding of Participants (performance bias) | High risk | Not possible owing to intervention |
| Blinding of Personal (performance bias) | High risk | Not possible owing to intervention |
| Blinding of the Outcome assessor (detection bias) | High risk | Not possible owing to intervention |
| Incomplete outcome data (attrition bias) | Low risk | Figure 1 |
| Randomized Participants analysed were allocated (attrition bias) | Low risk | Figure 1 |
| Selective outcome (reporting bias) | Unclear risk | No protocol |
| Similar groups at baseline? | Low risk | Table 1 |
| co‐interventions avoided or similar? | Unclear risk | Not described |
| Compliance acceptable? | Unclear risk | Home exercise compliance not reported |
| Similar timing of outcome assessment? | Low risk | Baseline, immediate, 3 months, 6 months. Figure 1; page 142, right column, paragraph 4 |