Table 4.
Effects of SMT on cervical range of motion
| Author | Quality score /100 | Treatment and control activity (sham, other or nothing) | Δ ROM pre/post treatment in degrees: flexion | Δ ROM pre/post treatment in degrees: extension | Δ ROM pre/post treatment in degrees: right lateral flexion | Δ ROM pre/post treatment in degrees: left lateral flexion | Δ ROM pre/post treatment in degrees: right rotation | Δ ROM pre/post treatment in degrees: left rotation | Summarized results given by authors | Comments | Were the differences in outcome tested between groups and were they significant? |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Kanlayanaphotporn
[43] |
83 |
- Clinically determined mobilization - Random mobilization |
1.9 ± 4.1 −0.7 ± 4.5 |
1.8 ± 6.3 0.8 ± 4.6 |
- 0.3 ± 6.3 1.2 ± 4.9 |
0.8 ± 4.8 1.3 ± 4.1 |
0.5 ± 5.5 0.6 ± 6.9 |
1.1 ± 4.2 0.8 ± 6.0 |
The preferred mobilization group showed an increased flexion/extension compared to random mobilization group. |
|
Yes and yes |
| Whittingham
[40] |
83 |
- SMT upper cervical - Sham (deactivated instrument) |
- |
- |
Gr. 1=39° ± 1.1 Gr. 2=38° ± 1.4 |
Gr. 1=38° ± 1.3 Gr. 2=36° ± 1.2 |
Gr. 1=56° ± 1.4 Gr. 2=57° ± 1.5 |
Gr. 1=54° ± 1.6 Gr. 2=54° ± 1.6 |
SMT increase significantly ROM |
Those are given baseline values. ROM values immediately after treatment. Effect is observed on weeks 3, 6, 9 and 12. |
Yes and yes |
| Krauss
[42] |
77 |
- Thoracic SMT - Nothing |
- |
- |
- |
- |
8.23 (SD=7.41) −0.1 (SD=2.33) |
7.09 (SD=5.83) −0.6 (SD=3.66) |
Cervical rotation ROM is improved following SMT |
|
Yes and yes |
| Martinez Segura
[37] |
77 |
- SMT (C3-C5) - Sham neck mobilization |
7 (Cohen’s d=5) 1.5 (Cohen’s d=2.5) |
8 (Cohen’s d=7) 1.4 (Cohen’s d=3.3) |
5 (Cohen’s d=4) 0.8 (Cohen’s d=1.6) |
5 (Cohen’s d=4) 0.8 (Cohen’s d=1.5) |
10 (Cohen’s d=5) 0.4 (Cohen’s d=1.5) |
9 (Cohen’s d=5) 0.3 (Cohen’s d=0.8) |
SMT was more effective than control mobilization on ROM. Large effect sizes. |
|
Yes and yes |
| Mc Clatchie
[38] |
69 |
- Mobilization (cervical) - Sham (same mobilization position but without external force) |
−1.2 ± 6.5 −1.4 ± 5.3 |
0.8 ± 5.5 −0.5 ± 5.5 |
−0.7 ± 5.2 −0.1 ± 5.3 |
−0.4 ± 4.1 0.3 ± 4.4 |
1.1 ± 4.4 −0.4 ± 5.9 |
1.3 ± 6.6 - 0.3 ± 4.9 |
No significant difference |
|
Not tested |
| Cassidy
[36] |
69 |
- SMT(cervical) (n=52) - Mobilization (cervical) (n=48) |
5.1 (SD 8.3) 3.9 (SD 9.4) |
3.1 (SD 7.8) 1.3 (SD 7.5) |
3.4 (SD 7.5) 2.0 (SD 5.2) |
4.3 (SD 7.0) 3.0 (SD 4.7) |
5.0 (SD 9.0) 4.2 (SD 9.0) |
3.6 (SD 7.0) 2.4 (SD 6.4) |
Both treatments increase ROM to similar degree. |
|
Yes and no |
| Kanlayanaphotporn
[44] |
67 |
- Post/ant (PA) cervical mobilization - random mobilization (PA, right or left) |
1.4 (SD 5.2) −0.4 (SD 7.6) |
1.8 (SD 5.4) −0.4 (SD 5.9) |
−0.2 (SD 4.0) 0.6 (SD 4.1) |
0.9 (SD 4.2) 1.5 (SD 7.8) |
1.2 (SD 5.9) 1.2 (SD 6.1) |
2.7 (SD 5.3) 2.0 (SD 5.8) |
No significant effect on ROM |
|
Yes and no |
| Tuttle
[41] |
67 |
- PA cervical mobilization at symptomatic level - Placebo (PA mobilization but asymptomatic side) |
|
|
|
|
|
|
|
|
|
| - Nothing (lying down) |
* initial values flexion/extension ROM =119° (SD-17) |
* initial values flexion/extension ROM=119° (SD-17) |
* initial values lateral flexion ROM=93° (SD-12) |
* initial values lateral flexion ROM=93° (SD-12) |
* initial values rotation ROM=93° (SD-12) |
* initial values rotation ROM=93° (SD-12) |
No significant ROM increase |
* No differences. pre/post treatment values are given but only shown in a graph. |
Not tested |
|
|
| Passmore [39] | 50 | - SMT(C1-C2) - Nothing (wait 5’) | No difference No difference | No difference No difference | No difference No difference | No difference No difference | 3.75 No difference | - | SMT increases cervical active ROM | Not tested |