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Effects of the Manual Therapy Approach of Segments C0-1 and C2-3 in the Flexion-Rotation Test in Patients with Chronic Neck Pain: A Randomized Controlled Trial

Effects of the Manual Therapy Approach of Segments C0-1 and C2-3 in the Flexion-Rotation Test in Patients with Chronic Neck Pain: A Randomized Controlled Trial

Jacobo Rodríguez-Sanz , Miguel Malo-Urriés , María Orosia Lucha-López , Albert Pérez-Bellmunt ,Andoni Carrasco-Uribarren , Pablo Fanlo-Mazas , Jaime Corral-de-Toro  and César Hidalgo-García 

Abstract: Background: Flexion-rotation test predominantly measures rotation in C1-2 segment. Restriction
in flexion-rotation may be due to direct limitation in C1-2, but also to a premature tightening
of the alar ligament as a result of lack of movement in C0-1 or C2-3. The aim of this study was
to compare the effect of a 20-min single cervical exercise session, with or without manual therapy
of C0-1 and C2-3 segment in flexion-rotation test, in patients with chronic neck pain and positive
flexion-rotation test. Methods: Randomized controlled clinical trial in 48 subjects (24 manual therapy+
exercise/24 exercise). Range of motion and pain during flexion-rotation test, neck pain intensity
and active cervical range of motion were measured before and after the intervention. Results: Significant
differences were found in favour of the manual therapy group in the flexion-rotation test:
right (p < 0.001) and left rotation (p < 0.001); pain during the flexion-rotation test: right (p < 0.001)
and left rotation (p < 0.001); neck pain intensity: (p < 0.001); cervical flexion (p < 0.038), extension (p
< 0.010), right side-bending (p < 0.035), left side-bending (p < 0.002), right rotation (p < 0.001), and
left rotation (p < 0.006). Conclusions: Addition of one C0-C1 and C2-C3 manual therapy session to
cervical exercise can immediately improve flexion-rotation test and cervical range of motion and
reduce pain intensity.

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Heimo Just, MSc,
19.01.2021, 22:38
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