Annina Schmid, Florian Brunner, Anthony Wright and Lucas M. Bachmann
This systematic review aims to assess the consistency of evidence supporting an involvement of supraspinal systems in mediating the effects of passive cervical joint mobilisation. Fifteen studies met the inclusion criteria. The overall quality was high. Consistency was found for concurrent hypoalgesia, sympathetic nervous system excitation and changes in motor function. Pooling of data suggested that joint mobilisation improved outcomes by approximately 20% relative to controls. This specific pattern suggests that descending pathways might play a key role in manual therapy induced hypoalgesia.
This review supports the existence of an alternative neurophysiological model, in which passive joint mobilisation stimulates areas within the central nervous system.
Manual Therapy, 3 March 2008, online article ahead of press