Computerized mobilization eases chronic neck pain

By Lucy Piper

Computerized mobilization of the cervical spine appears to be a viable treatment option for patients with chronic neck pain, a proof-of-concept trial shows.

The researchers explain in the Clinical Journal of Pain that computerized mobilization provides "an extremely slow, precise, and consistent mobilization."

This novel treatment could therefore help overcome some of the limitations associated with manual therapy including inconsistency, therapist fatigue, and potential for adverse effects, they say.

The team investigated the safety and efficacy of a computerized cradle capable of 3D neck mobilization of the cervical spine in the sagittal plane in 10 patients who had suffered with chronic neck pain for a median of 6.5 years.

The treatment sessions lasted 20 minutes and patients attended every 2 weeks for 6 weeks.

None of the patients reported serious adverse effects as a result of the treatment, and minor side effects relating to the treatment appeared in only six of 120 sessions.

Pain significantly decreased over the course of treatment, from an average numerical rating scale score of 6 out of 10 before treatment to 4 out of 10.

There was also a significant 2-point improvement in overall disability as early as the third week, and an improvement in Cervical Range of Motion (CROM) was realized in the fourth week of treatment.

The most notable changes occurred in the neck extension movement, which improved from an average 47.8° in the first week to 59.3° in the sixth week, and rotation to the left side, which improved from 59.8° to 68.3°, respectively.

While the total CROM improvement was significant, the change in range of each movement was not significant.

Other improvements, albeit not significant, were seen for the average sum of pressure pain threshold, the Neck Disability Index score, the 36-item Short Form Health Survey questionnaire, and headache severity.

Yaron River, from Hillel Yaffe Medical Center in Hadera, Israel, and colleagues say that computerized mobilization allows the continuous lengthening of the extensor neck muscles in a precise and slow manner for a prolonged period of time.

This could "reverse the constant contraction, reduce peripheral sensitization, reduce the number of trigger points, and increase mechanical pressure pain threshold," they suggest.

"The results support previous studies in the area of mobilization and neck pain and give further impetus to continued research," the team concludes.

"Clearly, a larger controlled trial of computerized mobilization in a 3-dimensional space is warranted."

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