The effect of cervical spine manipulation on the postural sway of patients with non-specific neck pain

Abstract

OBJECTIVE: Neck pain has been associated with impaired proprioceptive performance which may be improved by cervical manipulation. This crossover study aimed to determine whether a high velocity, low amplitude manipulation affected postural sway in adults with nonspecific neck pain.METHODS: Ten participants received, in random order, 7-days apart, a high velocity, low amplitude manipulation applied to a dysfunctional spinal segment and a passive head-movement control. Four parameters of postural sway were measured before, immediately following, and at 5 and 10 minutes after each procedure. RESULTS: Results showed no differences between interventions in change in any of the parameters. When changes before and immediately following each procedure were analysed separately, only the control showed a significant change in the length of centre of pressure path (an increase from median = 118 mm; IQR = 93 – 137 mm to an increase to 132 mm; 112 – 147; p = 0.02).CONCLUSION: This study failed to show any evidence that manipulation of a dysfunctional cervical segment influences postural sway. Given the ability of the postural control system to reweight the hierarchy of sensory information in order to compensate for inadequacies in any one component, it is possible that any improvements in the mechanisms controlling postural sway elicited by the manipulative intervention may have been concealed.