Effectiveness of a specific manual approach to the suboccipital region in patients with chronic mechanical neck pain and rotation deficit in the upper cervical spine: study protocol for a randomized controlled trial
Resumen: Background
Mechanical neck pain is a highly prevalent problem in primary healthcare settings. Many of these patients have restricted mobility of the cervical spine. Several manual techniques have been recommended for restoring cervical mobility, but their effectiveness in these patients is unknown. The aim of the present study is to compare the effectiveness of two types of specific techniques of the upper neck region: the pressure maintained suboccipital inhibition technique (PMSIT) and the translatory dorsal glide mobilization (TDGM) C0-C1 technique, as adjuncts to a protocolized physiotherapy treatment of the neck region in subjects with chronic mechanical neck pain and rotation deficit in the upper cervical spine.
Methods
A randomized, prospective, double-blind (patient and evaluator) clinical trial. The participants (n = 78) will be randomly distributed into three groups. The Control Group will receive a protocolized treatment for 3 weeks, the Mobilization Group will receive the same protocolized treatment and 6 sessions (2 per week) of the TDGM C0-C1 technique, and the Pressure Group will receive the same protocolized treatment and 6 sessions (2 per week) of the PMSIT technique. The intensity of pain (VAS), neck disability (NDI), the cervical range of motion (CROM), headache intensity (HIT-6) and the rating of clinical change (GROC scale) will be measured. The measurements will be performed at baseline, post-treatment and 3 months after the end of treatment, by the same physiotherapist blinded to the group assigned to the subject.

Discussion
We believe that an approach including manual treatment to upper cervical dysfunction will be more effective in these patients. Furthermore, the PMSIT technique acts mostly on the musculature, while the TDGM technique acts on the joint. We expect to clarify which component is more effective in improving the upper cervical mobility.

Idioma: Inglés
DOI: 10.1186/s12891-017-1744-5
Año: 2017
Publicado en: BMC MUSCULOSKELETAL DISORDERS 18 (2017), [8 pp.]
ISSN: 1471-2474

Factor impacto JCR: 1.998 (2017)
Categ. JCR: ORTHOPEDICS rank: 34 / 77 = 0.442 (2017) - Q2 - T2
Categ. JCR: RHEUMATOLOGY rank: 22 / 31 = 0.71 (2017) - Q3 - T3

Factor impacto SCIMAGO: 0.951 - Orthopedics and Sports Medicine (Q1) - Rheumatology (Q2)

Tipo y forma: Artículo (Versión definitiva)
Área (Departamento): Área Fisioterapia (Dpto. Fisiatría y Enfermería)

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