SMT-3 (Part 1)

Question 1

Dunning et al. 2012 Mechanical Neck Pain and Single Upper Cervical and thoracic spine HVLAT showed:

Answer 1

• N: 107 patients with mechanical neck pain of any duration
• Treatment:
  1. Upper CS (c1-c) & upper thoracic HVLAT

2.Upper CS (c1-c) & upper thoracic grade IV Mobilization

*Outcomes:
1. NDI
2. FRT (asses c1-2 ROM R/L side)
3. CCFT (assess DNF motor performance)
4. GRC (Global Rating of Change)

Results:
1. Following treatment, HVLAT experienced a significantly greater reduction in disability (505) and pain (58%) than the non-thrust mobilization group (12 %).

2. HVLAT had treated passive C1-2 Right rotation (8.4 degrees) & left (5.9 degrees)compared to (3.5 degrees on the right) and (2.5 degrees on the left) for none HVLAT
3. Improve motor performance (3.4 mmHg) vs (1.2 mmHg)

Question 2

Changes in the LM, TrA & IO muscle thickness patients with LBP after Lumbar SMT.

Koppenhaver et al 2011 show:

Answer 2

N: 81 Subjects (students)

*TrA, IO, LM muscle thickness assessed at L4-5 & L5-s1 using ultrasound of the muscle rest and during submaximal contraction (contralateral arm lift with small weight)

*Technique performed: Lumbopelvic HVLAT “Chicago Roll” day 1, day 3, or day 4 -post the Ultra Sound done immediately after

Question 3

Savolainen et al 2004 conclusion comparing the effectiveness of thoracic HVLAT manipulation with PT exercise instructed by PT:

Answer 3

• No significant differences between the two groups were found at 6 and 12 months follow-up for “mean” pain (VAS) scores.

*However, subjects in the thoracic HVLAT group reported significantly lower levels of perceived “worst” pain at 12-month follow-up

Question 4

Cleland et al. 2007 conclusion comparing the effectiveness of Non-thrust mobilization (one -30 sec bouts of central glide grade 3-4 level of the T2-T6 spine vs upper and middle thoracic thrust manipulation in supine:

Answer 4

Thoracic HVLAT had a greater short-term reduction in disability and pain.

• NDI 10.3% (MCID for the NDI is 7 points)

*NPRS 2.03 points (MCID for the NPRS is 1.3 points

Question 5

Krauss et al (2008) Conclusion comparing subjects with non-traumatic posterior mid-cervical pain of an insidious onset that is aggravated with neck rotation.

Answer 5

*Neck pain of unknown duration.
N: 22 experimental/ N:10 control

*Immediate outcome only.
-Neck pain R/L cervical rotation with CROM

Neck pain at rest, but rated at the end or right and left CS rotation in sitting FPS.

Results:
-No statistically significant within-group or between-group differences were found in pain for subjects experiencing pain with Right rotation.

-No statistically significant within-group or between-group differences were found in pain for subjects experiencing pain with left rotation.

Question 6

Gonzales-Iglesias et al (2009a) Conclusion