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Open Access 01-12-2015 | Systematic review

The effectiveness of manual therapy for the management of musculoskeletal disorders of the upper and lower extremities: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration

Authors: Danielle Southerst, Hainan Yu, Kristi Randhawa, Pierre Côté, Kevin D’Angelo, Heather M. Shearer, Jessica J. Wong, Deborah Sutton, Sharanya Varatharajan, Rachel Goldgrub, Sarah Dion, Jocelyn Cox, Roger Menta, Courtney K. Brown, Paula J. Stern, Maja Stupar, Linda J. Carroll, Anne Taylor-Vaisey

Published in: Chiropractic & Manual Therapies | Issue 1/2015

Abstract

Background

Musculoskeletal disorders (MSDs) of the upper and lower extremities are common in the general population and place a significant burden on the health care system. Manual therapy is recommended by clinical practice guidelines for the management of these injuries; however, there is limited evidence to support its effectiveness. The purpose of our review was to investigate the effectiveness of manual therapy in adults or children with MSDs of the upper or lower extremity.

Methods

Randomized controlled trials (RCTs), cohort studies, and case–control studies evaluating the effectiveness of manual therapy were eligible. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials from 1990 to 2015. Paired reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with low risk of bias were synthesized following best-evidence synthesis principles. Where available, we computed mean changes between groups, relative risks and 95 % CI.

Results

We screened 6047 articles. Seven RCTs were critically appraised and three had low risk of bias. For adults with nonspecific shoulder pain of variable duration, cervicothoracic spinal manipulation and mobilization in addition to usual care may improve self-perceived recovery compared to usual care alone. For adults with subacromial impingement syndrome of variable duration, neck mobilization in addition to a multimodal shoulder program of care provides no added benefit. Finally, for adults with grade I-II ankle sprains of variable duration, lower extremity mobilization in addition to home exercise and advice provides greater short-term improvements in activities and function over home exercise and advice alone. No studies were included that evaluated the effectiveness of manual therapy in children or for the management of other extremity injuries in adults.

Conclusions

The current evidence on the effectiveness of manual therapy for MSDs of the upper and lower extremities is limited. The available evidence supports the use of manual therapy for non-specific shoulder pain and ankle sprains, but not for subacromial impingement syndrome in adults. Future research is needed to determine the effectiveness of manual therapy and guide clinical practice.

Systematic review registration number

CRD42014009899

Available only for authorised users

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Title: The effectiveness of manual therapy for the management of musculoskeletal disorders of the upper and lower extremities: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration
Authors: Danielle Southerst
Hainan Yu
Kristi Randhawa
Pierre Côté
Kevin D’Angelo
Heather M. Shearer
Jessica J. Wong
Deborah Sutton
Sharanya Varatharajan
Rachel Goldgrub
Sarah Dion
Jocelyn Cox
Roger Menta
Courtney K. Brown
Paula J. Stern
Maja Stupar
Linda J. Carroll
Anne Taylor-Vaisey
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Chiropractic & Manual Therapies / Issue 1/2015
Electronic ISSN: 2045-709X
DOI: https://doi.org/10.1186/s12998-015-0075-6

At a glance: The STEP trials

Springer Medicine

The effectiveness of manual therapy for the management of musculoskeletal disorders of the upper and lower extremities: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration

Abstract

Background

Methods

Results

Conclusions

Systematic review registration number

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Systematic review registration number

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