A randomized, comparative clinical trial conducted by R. van Schalkwyk and G. F. Parkin-Smith (2000) aimed to assess the potential therapeutic effects of supine cervical rotary manipulation and supine lateral break manipulation in treating mechanical neck pain. The study involved two groups of 15 subjects each diagnosed with mechanical neck pain, with interventions performed over a 4-week period.

The primary objective was to evaluate the effectiveness of the two manipulative techniques in addressing mechanical neck pain based on subjective and objective clinical findings.

Concerns about delivering supine lateral break manipulation to inflamed facet joints led to the exploration of alternatives, including supine cervical rotary manipulation on the ipsilateral side or supine lateral break manipulation on the contralateral side of relevant joints.

Subjects were diagnosed using conventional clinical evaluation, including motion palpation. Group A received cervical rotary manipulation on the ipsilateral side of lateral flexion fixations, while group B received supine lateral break manipulation on the contralateral side. Subjects received a maximum of 10 treatments, and assessments were conducted at the initial, final, and 1-month follow-up consultations.

Subjective assessments included the Numerical Pain Rating Scale 101, McGill Short-Form Pain Questionnaire, and the Canadian Memorial Chiropractic College Neck Disability Index. Objective measurements involved cervical range of motion goniometer and algometer readings.

Intragroup analysis showed a significant difference in subjective data between the initial and final consultations, suggesting an effect in both groups. However, no significant difference was found in objective data. Intergroup analysis revealed no significant difference between the two treatments, indicating similar efficacy. Power analysis suggested potential Type II errors, highlighting the study’s limitations.

Statistically, both treatments demonstrated effectiveness without one being superior. However, due to the study’s limited power, caution is advised in drawing conclusions. Clinical significance supported statistical outcomes, emphasizing the need for a larger sample size and a placebo group to uncover true treatment outcomes and trends.

Reference: van Schalkwyk, R., & Parkin-Smith, G. F. (2000). A clinical trial investigating the possible effect of the supine cervical rotatory manipulation and the supine lateral break manipulation in the treatment of mechanical neck pain: a pilot study. Journal of Manipulative and Physiological Therapeutics, 23(5), 324-331.