Thoracic Manipulation for Neck Pain
Clinical Prediction Rule
Variables Present
Liklihood Ratio
Probability of Success
0+
Variables PresentProbability of Success
0+
Variables PresentProbability of Success
0+
Variables PresentProbability of Success
Cleland JA, Childs JD, Fritz JM, Whitman JM, Eberhart SL. Development of a clinical prediction rule for guiding treatment of a subgroup of patients with neck pain: use of thoracic spine manipulation, exercise, and patient education. Phys Ther. 2007 Jan;87(1):9-23. Epub 2006 Dec 1.
“We successfully achieved the purpose of developing a [clinical prediction rule (CPR)] that identifies patients with neck pain who are likely to exhibit early success after thoracic spine thrust manipulation. However, this is only the first step in the process of developing and testing a CPR.”Cleland JA, Childs JD, Fritz JM, Whitman JM, Eberhart SL.
Cleland et al. Development of a clinical prediction rule for guiding treatment of a subgroup of patients with neck pain: use of thoracic spine manipulation, exercise, and patient education. Phys Ther. 2010 Sep;90(9):1239-50. Epub 2010 Jul 15.
“The results of the current study did not support the validity of the previously developed [clinical prediction rule]. However, the 2-way interaction between group and time suggests that patients with mechanical neck pain who do not exhibit any contraindications to manipulation exhibit statistically significant improvements in disability in both the short- and long-term follow-up periods.”Cleland et al.
Puentedura et al. Thoracic spine thrust manipulation versus cervical spine thrust manipulation in patients with acute neck pain: a randomized clinical trial. J Orthop Sports Phys Ther. 2011 Apr;41(4):208-20. Epub 2011 Feb 18.
“This study tested 2 different forms of [thrust joint manipulation (TJM)] in a select group of patients with mechanical neck pain who met a previously derived and recently questioned [clinical prediction rule]. We found that patients who were treated with a combination of cervical spine TJM and exercises showed significantly greater improvement in pain and disability compared to those treated with thoracic spine TJM and exercises. Our results suggest that patients with neck pain of less than 30 days in duration, who meet 4 out of the 6 CPR criteria for thoracic spine TJM, may benefit more from cervical than thoracic spine TJM.”Puentedura et al.
No impact analysis study currently published regarding this clinical prediction rule.
