Saavedra‐Hernandez 2012CR.
| Methods | Type of trial: RCT Number analysed/randomly assigned: 81/82 Intention‐to‐treat analysis: calculated | |
| Participants | Chronic mechanical neck pain | |
| Interventions | INDEX TREATMENT Full manipulation group (A): technique: high‐velocity low‐amplitude thrust, (1) cervical spine: manipulation directed upward and medially in the direction of the participant's contralateral eye, participant in supine position with the cervical spine in a neutral position, (2) cervicothoracic junction: thrust applied toward the participant's right or left side, thrust applied bilaterally, participant prone with head and neck rotated, (3) upper thoracic spine: distraction thrust manipulation directed in an upward direction, participant in supine position with arms crossed; timing: at baseline; frequency: 1 session; dose: 1 to 2 thrusts per area; route: cervical spine, cervicothoracic junction, upper thoracic spine, symptomatic level COMPARISON TREATMENT Cervical manipulation group (B): technique: high‐velocity low‐amplitude thrust manipulation directed upward and medially in the direction of the participant's contralateral eye, participant in supine position with the cervical spine in a neutral position; timing: at baseline; frequency: 1 treatment session; dose: 1 to 2 thrusts; route: cervical spine, symptomatic level CO‐INTERVENTION: N/A Duration of treatment: 1 day, 1 session Duration of follow‐up: 1 week post treatment |
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| Outcomes | PAIN (NPRS, 0 to 10)
Baseline mean: A 4.9, B 4.8
End of study mean: A 2.7, B 2.7
Absolute benefit: A 2.2, B 2.1
Reported results: equally effective, no significant differences between groups SMD: 0.08 (95% CI ‐0.36 to 0.51) FUNCTION (NDI, 0 to 50) Baseline mean: A 22.2, B 23.7 End of study mean: A 11.6, B 16.8 Absolute benefit: A 10.6, B 6.9 Reported results: statistically significant favouring A SMD: ‐0.17 (95% CI ‐0.61 to 0.27) GPE: NR PATIENT SATISFACTION: NR QoL: NR SIDE EFFECTS: reported Minor increase in neck pain or fatigue after manipulation(s): A 1/41, B 1/40 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 3, column 2, paragraph 1 |
| Allocation concealment (selection bias) | Low risk | Page 3, column 2, paragraph 1 |
| Blinding of Participants (performance bias) | High risk | Not possible owing to design |
| Blinding of Personal (performance bias) | High risk | Not possible owing to design |
| Blinding of the Outcome assessor (detection bias) | High risk | Not possible owing to design |
| Incomplete outcome data (attrition bias) | Low risk | Figure 4, page 4 |
| Randomized Participants analysed were allocated (attrition bias) | Low risk | Figure 4, page 4 |
| Selective outcome (reporting bias) | Unclear risk | Not reported |
| Similar groups at baseline? | Low risk | Table 1, page 5 |
| co‐interventions avoided or similar? | Unclear risk | Not reported |
| Compliance acceptable? | Low risk | Short‐term follow‐up |
| Similar timing of outcome assessment? | Low risk | Baseline, 7‐day follow‐up |