Effectiveness of Thoracic Spine Manipulation for Upper Quadrant Musculoskeletal Disorders: A Systematic Review.

Thoracic high-velocity low-amplitude thrust (Tx-HVLAT) manipulation is a form of conservative management recommended as an effective treatment option for patients with upper quadrant musculoskeletal disorders (UQMD). This systematic review aimed to update the current evidence on the effectiveness of...

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Publicado en:Journal of Manipulative & Physiological Therapeutics Vol. 48; no. 1-5; pp. 422 - 435
Autores principales: Thoomes, Erik J., Tilborghs, Gus, Heneghan, Nicola R., Falla, Deborah, De Graaf, Marloes
Formato: research systematic review Journal Article
Publicado: Elsevier B.V. Jan2025
Acceso en línea:Ver este registro en EBSCOhost
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      issn: 01614754
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      dt: Jan2025
      vid: 48
      iid: 1-5
      pid: 1265
      pub: Elsevier B.V.
      place: Philadelphia, Pennsylvania
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        190204732
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        10.1016/j.jmpt.2025.10.040
        190204732
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        atl: Effectiveness of Thoracic Spine Manipulation for Upper Quadrant Musculoskeletal Disorders: A Systematic Review.
      aug:
        au:
          Thoomes, Erik J.
          Tilborghs, Gus
          Heneghan, Nicola R.
          Falla, Deborah
          De Graaf, Marloes
        affil: Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham. United Kingdom
      sug:
        subj:
          Manipulation, Orthopedic
          Thoracic Vertebrae Physiology
          Musculoskeletal Diseases
          Treatment Outcomes
          Human
          Medline
          Embase
          CINAHL Database
          Physiotherapy Evidence Database
          Confidence Intervals
          Models, Statistical
          Manipulation, Chiropractic
      ab: Thoracic high-velocity low-amplitude thrust (Tx-HVLAT) manipulation is a form of conservative management recommended as an effective treatment option for patients with upper quadrant musculoskeletal disorders (UQMD). This systematic review aimed to update the current evidence on the effectiveness of Tx-HVLAT for patients with UQMD on pain, disability, and performance outcome measures. Electronic libraries of the Cochrane Controlled Trials Register, MEDLINE, EMBASE, CINAHL, PEDro, and Index to Chiropractic Literature were searched from inception. Two review authors independently assessed the risk of bias using the Cochrane Back Review Group's recommended RoB2 tool, extracted data, and evaluated the quality of the evidence using the GRADE method. For continuous data, standardized mean differences with 95% CI were calculated. For pooling, a random-effects model was used. Eighteen of the 26 included studies were of low RoB. The effectiveness of TxHVLAT on pain and disability for patients with neck pain, shoulder pain, cervical radiculopathy, cervicogenic headache, and temporomandibular disorders was compared to sham manipulation, thoracic mobilization, cervical HVLAT, deep neck flexor training or general conservative therapy at different follow-up times. Methodological similarities between several studies allowed meta-analysis, but statistical heterogeneity was high. There is very low to low quality evidence that TxHVLAT manipulation is more effective than sham TxHVLAT, thoracic mobilization, general conservative therapy or deep neck flexor training on pain and disability in patients with neck pain, cervical radiculopathy, cervicogenic headache, and temporomandibular disorders. TxHVLAT was also more effective than general conservative therapy in patients with shoulder pain, but not more effective than sham manipulation.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        Journal Article
      ougenre: Article
    language: English
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