concealment Study
Howe 1983
Methods
Type of Trial: RCTNumberAnalysed/Randomised: 44/52Intention-to-treat Analysis: conductedPower Analysis: NR
Participants
Subacute, chronic mechanical neck disorder with radicular findings and headache
Interventions
INDEX TREATMENTManipulation Group: up to 3 manipulation in 1 session, azapropazoneCOMPARISON TREATMENTSControl Group: azapropazone; dose unknownCO-INTERVENTION: 2 subjects had lignocaine-hydrocortisone injections in manipulation groupDuration of Treatment: 1 sessionDuration of Follow-up: 3 weeks
Outcomes
PAIN (count, neck/shoulder/arm/hand pain and headache present)Baseline Mean: NRReported Results: significant favouring manipulationRR: 0.56(95%CI: 0.19 to 1.68) [power 18%]FUNCTION: NRPATIENT SATISFACTION: NRSIDE EFFECT: NRCOST OF CARE: NR
Notes Allocation concealment
B - Unclear
Study
Hurwitz 2002
Methods
Type of Trial: RCT (2x2x2 factorial design)Number Analysed/Randomised: 269/336Intention-to-treat Analysis: done by designPower Analysis: NR
Participants
Subacute and chronic mechanical neck disorder with or without radicular symptoms and headache
Interventions
INDEX TREATMENTSManipulation (Manip): at least 1 controlled, dynamic thrust applied with high velocity low amplitude force with minimal extension and rotation, directed at 1 or more restricted upper thoracic or cervical spine joint segmentsManipulation with heat (Manip/Heat): 10-minute moist heat application before manipulationManipulation with electrical muscle stimulation (Manip/EMS): 10-minute application of this modality before manipulation; parameters NRMobilisation (Mob): 1 or more low velocity, variable amplitude movements applied within the patient's passive range of motion directed to 1 or more restricted upper thoracic or cervical spine joint segmentsMobilisation with heat (Mob/Heat): 10-minute moist heat application before mobilisationMobilisation with EMS (Mob/EMS): 10-minute application of this modality before mobilisation; parameters NRCOMPARISON TREATMENTSAny of the above noted treatment combinationsCO-INTERVENTION: All participants received information on posture and body mechanics and one or more of the following: stretching, flexibility, or strengthening exercises and advice about ergonomic and workplace modificationsDuration of Therapy Period: NR (?6 weeks)Duration of Follow-up: 6 months
Outcomes
PAIN INTENSITY (average pain during previous week, most severe pain, NRS 0 to10)Baseline Mean: NR for each subgroupEnd of Study Mean: NR for each subgroupReported Results: no significant difference, heat therapies condition improved slightly more; the differences were clinically negligibleSMD(manip v mob): 0.15(95%CI:-0.32 to 0.61)SMD(manip+heat+EMS v mob):-0.28(95%CI:-0.77 to 0.21)SMD(mod+heat+EMS v manip): 0.24(95%CI:-0.24 to 0.71)RR(heat v no heat): 1.14(95%CI Mixed: 0.95 to 1.37)RR(EMS v no EMS): 0.90(95%CI Mixed: 0.73 to 1.13)FUNCTION (Neck Disability Index, 0 to 50)Baseline Mean: NR for each subgroupEnd of Study Mean: NR for each subgroupReported Results: no significant differenceSMD(manip v mob): 0.07(95%CI:-0.40 to 0.54)SMD(manip+heat+EMS v mob):-0.08(95%CI:-0.56 to 0.41)SMD(mod+heat+EMS v manip): 0.14(95%CI:-0.33 to 0.62)RR(heat v no heat) 1.14 (95%CI Mixed: 0.94 to 1.38)RR(EMS v no EMS) 0.87 (95%CI Mixed: 0.69 to 1.10)SATISFACTION (10-50 scale; at 4w of care)SMD(manip v mob): 0.11(95%CI:-0.35 to 0.58)SMD(manip+heat+EMS v mob): 0.14(95%CI:-0.35 to 0.62)SMD(mod+heat+EMS v manip): -0.12(95%CI:-0.59 to 0.36)SIDE EFFECTS: interviewed at 4 weeks of care, no known study related adverse events; manipulation group had statistically significant more transient minor discomfort (16%) v mobilisation group (8.7%)COST OF CARE: number of disability days were not significantly different between groups
Notes