Abstract
M.Tech. (Chiropractic)
Purpose: The aim of this study was to compare the effects of chiropractic adjustment versus mobilization to the cervical spine in participants with chronic cervical facet syndrome with regards to neck pain, cervical spine range of motion and position sense.
Method: Thirty participants, male or female between the ages of 18 and 45 years, diagnosed with cervical facet syndrome were used in the study. The thirty participants were divided into two groups consisting of fifteen individuals each, ensuring equal male to female and age ratios. Group 1 received chiropractic adjustments over the restricted joints to the cervical spine. Group 2 received mobilization over the restricted joints to the cervical spine. The trial consisted of seven visits over a treatment period of three weeks, of which the first six visits the participants received treatment and the seventh visit served the purpose of obtaining the final data. The data was gathered on the first, fourth and seventh visits. Subjective data was obtained by using the Vernon-Mior Neck Pain and Disability Index and the Visual Analogue Scale for pain intensity. Objective data consisted of measuring cervical spine range of motion with a CROM instrument and Laser Pointer Device to measure head repositioning accuracy (position sense).
Results: Subjective results indicated that group 1 (chiropractic adjustment) proved to be the most effective treatment protocol in decreasing neck pain intensity by 92%, and neck pain disability index by 65.7%. Group 2 (mobilization), also showed good results with a decrease in neck pain intensity by 53.9%,and neck pain disability index by 23.8%. Subjective results produced statistically significant results with VAS score (p= 0.000) for both groups and NDI score (p=0.000) for group 1 and (p=0.002) for group 2. Objective results also proved that chiropractic treatment was most effective in increasing cervical spine range of motion by 21.9% (right rotation) and 21.07% (left rotation). In group 2 by 9.93% (right rotation) and 12.72% (left rotation). Results were statistically significant for both groups with CROM score (p=0.002) for group 1 (right rotation) and (p= 0.000) (left rotation). Group 2 CROM score (p=0.040) (right rotation) and (p= 0.007) (left rotation). Objective results also proved that chiropractic adjustment was most effective in improving position sense by 76.54% (right rotation) and 72.06% (left rotation). In group 2 by 38.01% (right rotation) and 13.03% (left rotation). Results were statistically significant for group 1 with Kinesthetic Sensibility Test score (p=0.000) (right rotation) and (p=0.002) (left rotation). In group 2, the result for right rotation was statistically significant with (p=0.019) and not statistically significant for left rotation with (p=0.167).
Both subjective and objective results showed that although group 2 produced statistically significant results, group 1 showed the best clinical results overall. Thus it was noted that in order to obtain a
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lasting increase in range of motion of the cervical spine, a decrease in neck pain and disability and an improvement in position sense, the treatment protocol used for group 1 should be the treatment of choice.
Conclusion: Based on the results of the study, it was concluded that chiropractic adjustment was more effective than mobilization in the treatment of cervical facet syndrome. This conclusion is based on the results that chiropractic adjustment was more effective in all the objective and all the subjective measurements. However, this does not rule out mobilization as a treatment for neck pain, because mobilization treatment did show improvement in cervical spine ROM, a decrease in pain and slight improvement in position sense although not as efficiently as chiropractic treatment.