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Paradigm shift in manual therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation
- Source :
- Manual therapy. 13(5)
- Publication Year :
- 2007
-
Abstract
- Segmental neurological modulation, neural hysteresis and biomechanical effects have been proposed as mechanisms underpinning the effects of manual therapy. An increasing number of studies hypothesise activation of the central nervous system resulting in a non-segmental hypoalgesic effect with concurrent activation of other neural pathways as a potential mechanism of action. Whether this model is consistent with the current literature is unknown. This systematic review aims to assess the consistency of evidence supporting an involvement of supraspinal systems in mediating the effects of passive cervical joint mobilisation. We searched randomised trials in three electronic databases from inception to November 2007, without language restriction, and checked reference lists of included studies. We assessed study validity and extracted salient features in duplicate. Fifteen studies met our inclusion criteria. The overall quality was high. We found consistency for concurrent hypoalgesia, sympathetic nervous system excitation and changes in motor function. Pooling of data suggested that joint mobilisation improved outcomes by approximately 20% relative to controls. This specific pattern suggests that descending pathways might play a key role in manual therapy induced hypoalgesia. Our review supports the existence of an alternative neurophysiological model, in which passive joint mobilisation stimulates areas within the central nervous system.
- Subjects :
- Manipulation, Spinal
Sympathetic nervous system
medicine.medical_specialty
Sympathetic Nervous System
Central nervous system
610 Medicine & health
Physical Therapy, Sports Therapy and Rehabilitation
Motor Activity
Physical medicine and rehabilitation
Double-Blind Method
Component (UML)
Neural Pathways
medicine
Humans
3612 Physical Therapy, Sports Therapy and Rehabilitation
Pain Measurement
Randomized Controlled Trials as Topic
Afferent Pathways
Hypoalgesia
Evidence-Based Medicine
Neck Pain
business.industry
General Medicine
Evidence-based medicine
Neurophysiology
Biomechanical Phenomena
medicine.anatomical_structure
Treatment Outcome
Research Design
Meta-analysis
10046 Balgrist University Hospital, Swiss Spinal Cord Injury Center
10029 Clinic and Policlinic for Internal Medicine
Manual therapy
business
Subjects
Details
- ISSN :
- 15322769
- Volume :
- 13
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Manual therapy
- Accession number :
- edsair.doi.dedup.....3e2db32181428d0c1a93f3753d6db980