Randomised Controlled Trial for the Efficacy of Cervical Lateral Glide Mobilisation in the Management of Cervicobrachial Pain

Abstract

Objectives: To investigate the longterm efficacy of lateral glide mobilisation for patients with chronic Cervicobrachial Pain (CP). Methods: A randomised controlled trial which involved ninetynine participants with chronic CP. Participants were randomised to receive either the lateral glide with selfmanagement (n = 49) or selfmanagement alone (n = 50). Four assessments were made (at baseline and 6, 26 and 52 weeks post intervention). The primary outcome measure was the Visual Analogue Scale (VAS) for pain. Patient perceived recovery used the Global Rating of Change score (GROC). Functional outcomes included the Neck and Upper Limb Index score (NULI) and the ShortFrom 36 (SF36). Costs and reported number of harmful effects in response to intervention were evaluated. An intention to treat approach was followed for data analysis. Results: No statistically significant betweengroup differences were found for pain (using VAS) in the shortterm at six weeks (p = 0.52; 95% CI −14.72 to 7.44) or longterm at one year (p = 0.37; 95% CI −17.76 to 6.61) postintervention. The VAS outcomes correlated well with GROC scores (p < 0.001). There was a statistically significant difference in NULI scores favouring selfmanagement alone (p = 0.03), but no betweengroup differences for SF36 (p = 0.07). The cost of providing lateral glide and selfmanagement was twice that of providing selfmanagement alone. Minor harm was reported in both groups, with 11% more harm being associated with the lateral glide. Conclusion: In patients with chronic CP, the addition of a lateralglide mobilization to a selfmanagement program did not produce improved outcomes and resulted in higher healthcare costs.