A Paradigm Shift in Manual Therapy

Paradigm shift in manual therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilization. Systematic Review
Schmid, A et al. Manual Therapy 2008

  • A growing number of studies indicate that joint mobilization might activate areas within the CNS to produce a multisystem response that extends beyond the targeted joints.

  • Reviewers found consistency among selected studies for hypoalgesia, sympathetic nervous system excitation (bp, HR, RR, skin-conductance) and changes in motor function suggesting involvement of the CNS in response to MT

  • The findings demonstrate that MT is capable of inducing changes in indicators of sympathetic nervous system function and pain-related measure that are approximately 20% great than control conditions

  • The authors believe that the evidence is compelling enough to suggest that in addition to existing paradigms, the central nervous system is involved in mediating responses to passive cervical mobilization. They encourage future studies investigating the efficacy of MT to include outcome measures designed to evaluate the mutlisystem effects of treatment.