In 2008, the feasibility study conducted by Strunk, et. al., investigated the effectiveness of manual therapies in treating patients with subacute or chronic neck pain. The study aimed to develop and test protocols for a randomized clinical trial that combined high-velocity, low-amplitude spinal manipulation (HVLA SM) on the thoracic spine and sacroiliac joint, along with cervical spine postisometric relaxation. Additionally, the study examined the outcomes of patients receiving cervical spine HVLA SM alone.

The study recruited patients from the Quad Cities region in Iowa and Illinois. After an initial baseline assessment, eligible patients were randomly assigned to receive either cervical spine HVLA SM or the combined therapeutic approach. The treatment consisted of four visits over a two-week period. The researchers utilized several outcome assessments, including the Neck Disability Index, a visual analog scale, and a post-treatment response questionnaire. Patient outcomes were not directly compared between the two treatment groups.

The feasibility study involved eight months of planning, which included the development and pretesting of forms and protocols, as well as training staff and clinicians to ensure standardized procedures. From the initial screening, twelve participants were evaluated, and six patients were enrolled and randomly assigned to receive care over a six-week period. All patients completed five visits as part of the study. Notably, five out of six patients showed improvement in their Neck Disability Index scores. However, on the visual analog scale, only two patients demonstrated improvement at the two-week mark, while the remaining four experienced worsening symptoms. Five patients completed the post-treatment response questionnaire, with two indicating discomfort or an unpleasant reaction to the study treatments.

This feasibility study highlights the importance of careful planning and meticulous protocol development when designing a successful randomized clinical trial. The researchers found that patients were willing to be randomized, adhered to the treatment protocols, completed the necessary assessments, and provided follow-up data, with an 83% response rate for the questionnaires. Although the results indicated some positive outcomes in terms of the Neck Disability Index, further investigation is warranted to better understand the effects of the combined therapeutic approach and cervical spine HVLA SM on subacute and chronic neck pain. These findings lay the foundation for future research in this area, which may help optimize treatment strategies for patients suffering from neck pain.

Reference: Strunk, R. G., & Hondras, M. A. (2008). A feasibility study assessing manual therapies to different regions of the spine for patients with subacute or chronic neck pain. Journal of Chiropractic Medicine, 7(1), 1-8.