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Is manipulative therapy clinically necessary for relief of neck pain? A systematic review and meta-analysis
- Chinese Journal of Integrative Medicine Vol. 23, Issue 7, Pages: 543-554(2017)
- Affiliations：
1. Institute of Spine Disease, Longhua Hospital, Shanghai University of Traditional Chinese Medicine,Shanghai,China
2. Yueyang College of Clinical Medicine, Shanghai University of Traditional Chinese Medicine,Shanghai,China
3. Shuguang College of Clinical Medicine, Shanghai University of Traditional Chinese Medicine,Shanghai,China
4. Longhua College of Clinical Medicine, Shanghai University of Traditional Chinese Medicine,Shanghai,China
- Author bio：
- Funds：Supported by the National Natural Science Foundation of China (No. 81373666), Municipal Hospitals Cutting-Edge Technologies Emerging Joint Project (No. SHDC12013113), Municipal Science and Technology Commission of Shanghai Chinese Medicine Key Project (No.14401970400), National Research Projects of the State Administration of Traditional Chinese Medicine (No. 201407001-2), Traditional Chinese Medicine Research Foundation (No. 2012L032A), and Special Project of Scientific Research Base by State Administration of Traditional Chinese Medicine (No. JDZX2012118), China
DOI：10.1007/s11655-016-2506-1
CLC：Published：2017，
Published Online：2 August 2016，
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Yao, M., Sun, Yl., Dun, Rl. et al. Is manipulative therapy clinically necessary for relief of neck pain? A systematic review and meta-analysis., Chin. J. Integr. Med. 23, 543–554 (2017). https://doi.org/10.1007/s11655-016-2506-1
Min Yao, Yue-li Sun, Rong-liang Dun, et al. Is manipulative therapy clinically necessary for relief of neck pain? A systematic review and meta-analysis. [J]. Chinese Journal of Integrative Medicine 23(7):543-554(2017)
Yao, M., Sun, Yl., Dun, Rl. et al. Is manipulative therapy clinically necessary for relief of neck pain? A systematic review and meta-analysis., Chin. J. Integr. Med. 23, 543–554 (2017). https://doi.org/10.1007/s11655-016-2506-1 DOI：
Min Yao, Yue-li Sun, Rong-liang Dun, et al. Is manipulative therapy clinically necessary for relief of neck pain? A systematic review and meta-analysis. [J]. Chinese Journal of Integrative Medicine 23(7):543-554(2017) DOI： 10.1007/s11655-016-2506-1.
摘要
To summarize and critically assess the effificacy of Eastern and Western manipulative therapies for the treatment of neck pain in adults. A search of PubMed/MEDLINE
the Cochrane Central Register of Controlled Trials
ClinicalTrials.gov
EMBASE
etc. from their inception date to January 2014 with Chinese
Japanese
and Korean databases. Two reviewers independently selected randomized controlled trials (RCTs) with negative control or blank control
extracted data and assessed methodological quality. Meta-analysis and levels of evidence were performed by Revman5.1 and Grades of Recommendations Assessment
Development and Evaluation (GRADE) approach. Nineteen clinical trials with adequate randomization were included in this review
11 of them had a low risk of bias. The primary outcome for short-term pain had no significant differences
however
the secondary outcome
only the Numerical Pain Rating Scale (NPRS) score of intermediate-term [n=916
pooled mean differences (MD) =–0.29
P=0.02]
the Neck Disability Index (NDI) score of short-term (n=1
145
pooled MD=–2.10
P<0.01)
and intermediate-term (n=987
pooled MD=–1.45
P=0.01) were signifificantly reduced with moderate quality evidence. However
it supported the minimally clinically important difference (MCID) of the Visual Analogue Scale and NPRS pain score to be 13 mm
while NDI was 3.5 points. The meta-analysis only suggested a trend in favor of manipulative therapy rather than clinical signifificance. The results do not support the existing evidences for the clinical value of Eastern or Western manipulative therapy for neck pain of short-term follow-up according to MCIDs. The limitations of our review related to blinding
allocation concealment and small sample size.
Abstract
To summarize and critically assess the effificacy of Eastern and Western manipulative therapies for the treatment of neck pain in adults. A search of PubMed/MEDLINE
the Cochrane Central Register of Controlled Trials
ClinicalTrials.gov
EMBASE
etc. from their inception date to January 2014 with Chinese
Japanese
and Korean databases. Two reviewers independently selected randomized controlled trials (RCTs) with negative control or blank control
extracted data and assessed methodological quality. Meta-analysis and levels of evidence were performed by Revman5.1 and Grades of Recommendations Assessment
Development and Evaluation (GRADE) approach. Nineteen clinical trials with adequate randomization were included in this review
11 of them had a low risk of bias. The primary outcome for short-term pain had no significant differences
however
the secondary outcome
only the Numerical Pain Rating Scale (NPRS) score of intermediate-term [n=916
pooled mean differences (MD) =–0.29
P=0.02]
the Neck Disability Index (NDI) score of short-term (n=1
145
pooled MD=–2.10
P<0.01)
and intermediate-term (n=987
pooled MD=–1.45
P=0.01) were signifificantly reduced with moderate quality evidence. However
it supported the minimally clinically important difference (MCID) of the Visual Analogue Scale and NPRS pain score to be 13 mm
while NDI was 3.5 points. The meta-analysis only suggested a trend in favor of manipulative therapy rather than clinical signifificance. The results do not support the existing evidences for the clinical value of Eastern or Western manipulative therapy for neck pain of short-term follow-up according to MCIDs. The limitations of our review related to blinding
allocation concealment and small sample size.
关键词
systematic reviewmeta-analysismanipulative therapyneck painminimally clinically important difference
Keywords
systematic reviewmeta-analysismanipulative therapyneck painminimally clinically important difference
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