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Title:	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
Author:	Rodríguez-Sanz, Jacobo; Malo-Urriés, Miguel; Lucha-López, María Orosia; Pérez Bellmunt, Albert; Carrasco Uribarren, Andoni; Fanlo-Mazas, Pablo; Corral-de-Toro, Jaime; Hidalgo-García, César
Notes:	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.
Subject(s):	-Dolor crònic -Coll -Fisioteràpia -Dolor crónico -Cuello -Fisioterapia -Chronic pain -Neck -Physiotherapy -61
Rights:	© 2021 by the authors.Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). https://creativecommons.org/licenses/by/4.0/
Document type:	Article Article - Published version
Published by:	MDPI
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