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Joint mobilizations for the cervical and thoracic spine. Types of mobilizations, self-administered mobilizations, and interventions for the neck and thoracic spine. Optimal intervention for upper body dysfunction (UBD), shoulders elevate, head forward, and arms fall. The risk of adverse events, validity, efficacy, screening, and reliability of cervical spine and thoracic spine joint mobs.

Joint Mobilization: Cervical and Thoracic Spine

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Integrated Manual Therapist

This course describes joint mobilizations for the cervical spine and thoracic spine. Several terms and definitions have been used to describe the "mobilizations" (e.g. mobilisations) that are taught in this course. The Brookbush Institute uses a conventional definition of "mobilization" that includes low amplitude, low-velocity, oscillatory techniques intended to reduce the stiffness of joints exhibiting a decrease in passive accessory range of motion (a.k.a. arthrokinematic motion and specifically glide or slide). Note, the term "manipulation" is reserved for high-velocity techniques taught in a separate set of courses. Further, the types of mobilizations taught in this course are posterior to anterior (PA) and include both unilateral posterior to anterior (UPA) mobilizations directing force over facet joints, and central posterior to anterior (CPA) mobilizations directing force over the spinous process. These mobilization techniques likely represent the most commonly recommended techniques due in part to their relatively high reliability and efficacy.

This course includes mobilization techniques that intend to improve excessive stiffness of the cervical spine and thoracic spine, improve restrictions in spine range of motion (ROM), and reduce cervicothoracic and upper extremity dysfunction. For example, cervical dysfunction has been correlated with lateral epicondylitis, and mobilizations of the cervical spine have been correlated with a reduction in pain and improvements in function, such as increased grip strength. These techniques may also be used in an integrated approach for cervicothoracic dysfunction, and 

 including cervicogenic headache, shoulder impingement syndrome (SIS), lateral epicondylitis (tennis elbow), chronic thoracic pain, chronic neck pain, and acromioclavicular dysfunction, and postural dysfunctions including rounded shoulder posture, forward head posture, thoracic kyphosis, or an anterior pelvic tilt. Some evidence and clinical outcomes even suggest that addressing cervical dysfunction and forward head posture can improve long-term outcomes for low back pain patients.

The techniques in this course are recommended for all clinical human movement professionals (physical therapists, physical therapy assistants, athletic trainers, massage therapists, chiropractors, occupational therapists, etc.) with the intent of developing an evidence-based, systematic, integrated, patient-centered, and outcome-driven approach.

Sample Intervention (Cervicothoracic Junction Pain/Stiffness)

Joint Mobilizations: Ankle and Tibiofibular Joints

Joint Mobilizations: Lumbar Spine and Sacroiliac Joints

Joint Mobilizations: Cervical and Thoracic Spine

Joint Mobilizations: Shoulder, Sternoclavicular, and Acromioclavicular Joints

Joint Mobilizations: Elbow and Proximal Radioulnar Joints

For an introduction to joint mobilizations and manipulations:

Joint Mobilization and Manipulation: Introduction

Joint Mobilization and Manipulation: Reliability

Joint Mobilizations and Manipulations: Effects

Joint Mobilization and Manipulation: Risk of Adverse Effects

Joint Mobilizations and Manipulations: Evidence-based Teaching and Learning

Course Description: Cervical Spine and Thoracic Spine Joint Mobilizations

Introduction

Note: Gross movement exams may be beneficial for identifying asymmetry, significant restriction, and pain with movement; however, cervical rotation, flexion, and extension are not reliable goniometric assessments.

Although shoulder flexion and external rotation are not a measure of cervical/thoracic spine motion, optimal thoracic mobility is needed to achieve optimal 

 motion, which is necessary to achieve optimal 

 mobility - assuming the patient/client does not exhibit signs of shoulder hyper-mobility. Although measuring 

 ROM is not a direct measure of thoracic mobility, goniometry of the cervical spine, thoracic spine and scapula are not reliable.

: Weak or With Compensation (cervical protraction)

: Weak or With Compensation (scapular protraction or elevation)

Sample Intervention (Cervicothoracic Junction Pain)

Research Corner Summary

 Cervical mobilizations implemented to address specific movement impairments, may improve functional outcomes, range of motion, joint position sense, general cervical pain, mechanical pain, radiculopathy/cervicobrachial pain.

 The addition of both cervical and thoracic mobilization to exercise and conventional therapy improves outcomes associated with forward head posture resulting in larger improvements in craniovertebral angle, cervical lordosis angle, range of motion, 

 activity, functional disability index scores, and potentially respiratory function.

 Cervical mobilization may decrease headache frequency, duration, and/or intensity, but are more likely to improve symptoms when headaches are correlated with cervical muscle trigger points and cervical spine stiffness.

 The addition of cervical mobilization to a shoulder, elbow, forearm, or jaw rehabilitation programs may improve pain, swelling, recovery time, disability, and strength.

 Thoracic mobilizations have demonstrated efficacy for improving outcomes associated with cervical, thoracic, low back, and shoulder pain.

 Thoracic mobilizations have demonstrated efficacy for improving respiratory function associated with cervical, thoracic or lumbar dysfunction; however, thoracic mobilizations are not effective for respiratory dysfunction not associated with these impairments.

 Cervical and thoracic mobilizations result in neuromuscular and sympathoexcitatory responses including increased skin conductance, respiratory rate, heart rate, systolic blood pressure, analgesia, increased levels of cortisol, increased 

 activity, in conjunction with mechanical effects such as increased range of motion, decreased stiffness and optimization of joint alignment. No correlation was found between the level of patient stress, pain perception, and sympathoexcitatory response resulting from mobilizations; however, catastrophizing by the patient resulted in a decrease in the efficacy of high-velocity manipulations.

 Comparing cervical and thoracic mobilizations to exercise, stretching, neurodynamics, taping and ischemic compression does not imply that any single technique or modality is superior for addressing dysfunction; however, studies near ubiquitously demonstrate that the combination of mobilization with other techniques is superior to these techniques technique alone.

 The comparison of various cervical and thoracic mobilization techniques implies they should be oscillatory, Maitland mobilizations, in conjunction with exercise, performed faster, up to 2 oscillations/second, in a posterior to anterior direction (or anterior to posterior in special cases of cervical dysfunction)

Cervical Mobilization and Cervical Spine Dysfunction

Cervical Spine Mobilization and Distal Joints

Cervical Spine Mobilization and Effects on Muscle Activity

Systemic Response to Cervical Mobilization

Comparing and Combining Cervical Mobilizations with Other Techniques

Research Corner: Cervical Spine

Research Corner: Thoracic Spine

There are far fewer studies on thoracic mobilization than cervical mobilization, likely due to the preference of many professionals to manipulate (high-velocity thrust) the thoracic spine. Manipulation techniques for the thoracic spine will be covered in a separate course.

Thoracic mobilizations, posture, and cervical pain:

Similar to research on cervical mobilizations, thoracic spine mobilizations have demonstrated efficacy for various dysfunctions, including cervical pain and cervicothoracic posture. Kim et al. demonstrated that the addition of thoracic mobilization was more effective than adding stretching to a conventional therapy program at 4 and 8-week follow-ups, including larger reductions in cervical pain and larger increases in cervical ROM (57). Several studies discussed under "Cervical Mobilization and Posture" also demonstrated the efficacy of thoracic mobilizations. The RCT by Cho et al. demonstrated that upper thoracic mobilization and mobility exercise resulted in larger improvements than cervical mobilizations and stability exercise for forward head posture (13). Lee et al. demonstrated that the combination of cervical and thoracic mobilizations was more effective than cervical mobilizations alone for improving cervical alignment (14). And, an RCT by Cho et al. demonstrated that upper cervical and upper thoracic spine mobilizations improved forward head posture more than 

 (59). Additionally, an RCT by Nakamaru et al. demonstrated that self-administered mobilization of the thoracic spine increases active cervical flexion and extension range of motion in individuals with mechanical neck pain (76). And, Hwangbo et al. demonstrated that self-administered thoracic mobilization and stretching were more effective than either technique alone for reducing cervical pain and improving respiratory function (FVC, FEV1, and PEF) (58). These studies suggest that adding thoracic mobilizations (both manual and self-administered) to conventional therapy improves outcomes for cervicothoracic posture and pain.

Thoracic mobilizations, thoracic and low back pain, and respiratory function.

Thoracic mobilization may have a positive effect on the thoracic spine and low back pain, as well as respiratory function for some individuals. A study by Jeong et al demonstrated that thoracic mobilizations performed once a week for 3 weeks resulted in improvements in thoracic kyphosis angle (posture), and also improved balance during follow-up at 6 weeks (59). Kirshner et al. demonstrated significant improvements in thoracic spine segmental mobility and thoracic mobility during respiration after just two treatments of Kaltenborn mobilizations (60). Park et al. demonstrated that thoracic spine posterior to anterior mobilizations decreased pain in low back patients, as well as improved respiratory function including FVC, FEV1, PEF, FEF25~75%, and chest wall expansion (61). An RCT by Babina et al. demonstrated similar findings combining thoracic mobilization and breathing exercises, resulting in improvements in low back pain, respiratory function, and disability (62). However, the ability to improve respiratory function appears to be limited to regaining lost respiratory function due to cervical, thoracic, and/or lumbar spine dysfunction. Jung et al. demonstrated that self-administered thoracic mobilization was effective for increasing chest expansion but not respiratory function in asymptomatic healthy adults (63). Further, Wang et al. reported rather unfortunate findings for COPD patients, demonstrating that although thoracic mobilization improved kyphosis angle and mobility, there was little effect on respiratory function (64). It is interesting that many of the studies investigating the efficacy of thoracic mobilizations on cervical, thoracic, and low back pain are paired with respiratory function; however, it is important not to separate and generalize these findings. Thoracic mobilizations are effective for improving thoracic spine and low back pain, and respiratory function associated with cervical, thoracic or lumbar dysfunction; however, thoracic mobilizations are not effective for respiratory dysfunction not associated with these impairments.

Thoracic mobilizations in combination with other techniques

Similar to cervical mobilizations several studies have demonstrated that the addition of thoracic mobilizations improves outcomes. Mentioned several times in this course, Lee et al. demonstrated that the combination of cervical and thoracic mobilizations was more effective than cervical mobilizations alone for improving cervical alignment (14). In another study by Lee et al., adding cervical and thoracic mobilizations to 2 weeks of therapeutic intervention including hot packs, neck strengthening, 

 stretching and thoracic extensions resulted in similar results with the additional benefit of improved cervical range of motion (65). Yang et al. demonstrated that low back pain patients benefited from the addition of thoracic mobilization to stabilization exercises, demonstrating significantly better strength and range of motion at 12 weeks (66). Further, Mohanty et al demonstrated that mobilization of the thoracic spine in addition to therapeutic exercise and stretching resulted in a significant reduction in lumbar spondylolisthesis "slip" (67). These studies demonstrate that the addition of thoracic mobilization to conventional therapy results in better outcomes than individual interventions.

Thoracic mobilizations, muscle activity, and systemic changes:

Several studies have demonstrated that thoracic mobilizations also have effects on the muscular and sympathetic nervous systems. In a preliminary RCT by Pecos-Martín et al., findings indicate that grade III, central posterior to anterior mobilizations, over the most symptomatic thoracic segment, reduced thoracic 

 activity during extension of the trunk in people with non-specific thoracic spine pain (68). Leibler et al. demonstrated that grade IV thoracic mobilization resulted in an immediate increase in 

 activity in asymptomatic individuals (77). An RCT mentioned above by Cho et al., demonstrated that cervical and thoracic mobilizations had a positive effect on 

 activity (15). In an RCT by Jowsey et al., grade III, central, posterior to anterior mobilizations to T4 resulted in skin conductance changes in the hand, suggesting "sympathoexcitatory" changes (69). Ghaffer et al. tracked additional sympathetic associated variables, demonstrating that thoracic mobilization resulted in a sudden elevation in heart rate, respiratory rate, and blood pressure without any major change in blood oxygen saturation (70). Conversely, two studies by Araujo et al demonstrated that pain pressure threshold and heart rate variability did not change following mobilization of thoracic spine regardless of mobilization speed (71, 72). The studies by Jowsey et al., Ghaffer et al., and Araujo et al. were performed on healthy asymptomatic individuals which may account for some of the variances in effect; however, the studies may also demonstrate that heart rate variability is simply not a reliable indicator of sympathoexcitatory effects. Further research is needed comparing the neuromuscular and sympathoexcitatory effects of cervical, thoracic, and/or lumbar mobilization techniques, and studies are needed correlating these effects with the positive outcomes. These studies are evidence that thoracic mobilization has neuromuscular and sympathoexcitatory effects in addition to the mechanical effects expected.

Only one study was located comparing thoracic spine mobilizations. Shukla et al. compared posterior to anterior and transverse mobilizations, demonstrating that only small differences between the two techniques were apparent, and both techniques were effective for reducing pain and increasing range of motion for mechanical neck pain (73).

Techniques and Ending Info

Cervical Mobilizations

Thoracic Spine Mobilizations

Video Demonstration

Choi, W., & Heo, S. (2019). Short-term Benefits of Mobilization for Patients with Non-Specific Neck Pains: Executive Function and Neck Pain Intensity. 

Journal of International Academy of Physical Therapy Research

Shah, S., Shakil-ur-Rehman, S., & Ahmad, S. (2015). The effects of spinal mobilization with and without manual traction in patients with cervical radiculopathy. 

Rodríguez-Sanz, D., Calvo-Lobo, C., Unda-Solano, F., Sanz-Corbalán, I., Romero-Morales, C., & López-López, D. (2017). Cervical Lateral Glide Neural Mobilization Is Effective in Treating Cervicobrachial Pain: A Randomized Waiting List Controlled Clinical Trial. 

Hayat, A. S. K. F. U. (2017, April). Effectiveness of Maitland’s Mobilization vs. Mulligan Mobilization in Patients with Cervical Radiculopathy. In 

Ranganath, P. N., Dowle, P., & Chandrasekhar, P. (2018). Effectiveness of MWM, Neurodynamics and Conventional Therapy Versus Neurodynamics and Conventional Therapy in Unilateral Cervical Radiculopathy: A Randomized Control Trial. 

Indian Journal of Physiotherapy & Occupational Therapy

Oh, H. T., & Hwangbo, G. (2018). The effect of short-term upper thoracic self-mobilization using a Kaltenborn wedge on pain and cervical dysfunction in patients with neck pain. 

Said, S. M., Ali, O. I., Abo Elazm, S. N., & Abdelraoof, N. A. (2017). Mulligan self mobilization versus Mulligan snags on cervical position sense.

Sönmezer, E., Tüzün, E. H., Eker, L., & Yüksel, İ. (2018). Effectiveness of mobilization therapy for treating cervical myofascial pain syndrome. 

Journal of Exercise Therapy and Rehabilitation

Lascurain-Aguirrebeña, I., Newham, D. J., Casado-Zumeta, X., Lertxundi, A., & Critchley, D. J. (2018). Immediate effects of cervical mobilisations on global perceived effect, movement associated pain and neck kinematics in patients with non-specific neck pain. A double blind placebo randomised controlled trial. 

Gong, W. (2015). The effects of cervical joint manipulation, based on passive motion analysis, on cervical lordosis, forward head posture, and cervical ROM in university students with abnormal posture of the cervical spine. 

Kim, S. Y., Kim, N. S., & Kim, L. J. (2015). Effects of cervical sustained natural apophyseal glide on forward head posture and respiratory function. 

Lee, K. J., Roh, J. S., Choi, H. S., Cynn, H. S., Choi, K. H., & Kim, T. H. (2015). Effect of active intervention after Kaltenborn's cervical joint mobilization on the cervical spine alignment and muscle activity in patients with forward head posture. 

Journal of the Korean Society of Physical Medicine

Cho, J., Lee, E., & Lee, S. (2017). Upper thoracic spine mobilization and mobility exercise versus upper cervical spine mobilization and stabilization exercise in individuals with forward head posture: a randomized clinical trial. 

Lee, J., Lee, Y., Kim, H., & Lee, J. (2013). The effects of cervical mobilization combined with thoracic mobilization on forward head posture of neck pain patients. 

Cho, J., Lee, E., & Lee, S. (2018). Upper cervical and upper thoracic spine mobilization versus deep cervical flexors exercise in individuals with forward head posture: A randomized clinical trial investigating their effectiveness. 

Journal of back and musculoskeletal rehabilitation

Schoensee, S. K., Jensen, G., Nicholson, G., Gossman, M., & Katholi, C. (1995). The effect of mobilization on cervical headaches. 

Journal of Orthopaedic & Sports Physical Therapy

Pilling, M., Davidson, I., Todd, C., Crooks, K., & Newington, L. (2018). A pre-test, post-test intervention study (with embedded waiting list control) to assess the feasibility (efficacy; acceptability; and methodology) of mobilization of C0-C3 cervical segments to reduce headache in migaineurs.

Mohamed, A. A., Shendy, W. S., Semary, M., Mourad, H. S., Battecha, K. H., Soliman, E. S., … & Mohamed, G. I. (2019). Combined use of cervical headache snag and cervical snag half rotation techniques in the treatment of cervicogenic headache. 

Hall, T., Chan, H. T., Christensen, L., Odenthal, B., Wells, C., & Robinson, K. (2007). Efficacy of a C1-C2 self-sustained natural apophyseal glide (SNAG) in the management of cervicogenic headache. 

journal of orthopaedic & sports physical therapy

La Touche, R., París-Alemany, A., Mannheimer, J. S., Angulo-Díaz-Parreño, S., Bishop, M. D., Lopéz-Valverde-Centeno, A., … & Fernández-Carnero, J. (2013). Does mobilization of the upper cervical spine affect pain sensitivity and autonomic nervous system function in patients with cervico-craniofacial pain?: A randomized-controlled trial. 

Borusiak, P., Biedermann, H., Boßerhoff, S., & Opp, J. (2010). Lack of efficacy of manual therapy in children and adolescents with suspected cervicogenic headache: Results of a prospective, randomized, placebo‐controlled, and blinded trial. 

Headache: The Journal of Head and Face Pain

Fernández‐de‐las‐Peñas, C., Cleland, J. A., Palomeque‐del‐Cerro, L., Caminero, A. B., Guillem‐Mesado, A., & Jiménez‐García, R. (2011). Development of a Clinical Prediction Rule for Identifying Women With Tension‐Type Headache Who Are Likely to Achieve Short‐Term Success With Joint Mobilization and Muscle Trigger Point Therapy. 

Huang, S. J., Wei, M. J., & Wang, T. J. (2018). Effectiveness of Cervical Mobilization in Patients With Non-Specific Shoulder/Arm Pain: A Preliminary Study. 

Wang, S. S., & Meadows, J. (2010). Immediate and carryover changes of C5-6 joint mobilization on shoulder external rotator muscle strength. 

Journal of manipulative and physiological therapeutics

Seo, Y., Lee, J., & Han, D. (2015). The effects of spinal mobilization with arm movements on shoulder muscle strengthening. 

Chaudhery, J. K., & Dabholkar, A. (2017). Efficacy of spinal mobilization with arm movements (SMWAMS) in mechanical neck pain patients: Case-controlled trial. 

International Journal of Therapies and Rehabilitation Research

Cleland, J. A., Flynn, T. W., & Palmer, J. A. (2005). Incorporation of manual therapy directed at the cervicothoracic spine in patients with lateral epicondylalgia: a pilot clinical trial. 

Mohanty, P. P., Arora, J., & Pattnaik, M. (2016). Effect of Cervicothoracic Mobilization in Distal Radius Fractures after Plaster Removal. 

Botelho, M. B., & Andrade, B. B. (2012). Effect of cervical spine manipulative therapy on judo athletes' grip strength. 

Pedroni, C. R., Oliveira, A. S., & Bérzin, F. (2005). Immediate effect of cervical mobilization in temporomandibular disorder patients. 

Calixtre, L. B., Grüninger, B. L. D. S., Haik, M. N., Alburquerque-Sendín, F., & Oliveira, A. B. (2016). Effects of cervical mobilization and exercise on pain, movement and function in subjects with temporomandibular disorders: a single group pre-post test. 

Effects on Muscle Activity (12, 14, 28, 29)

Sterling, M., Jull, G., & Wright, A. (2001). Cervical mobilisation: concurrent effects on pain, sympathetic nervous system activity and motor activity. 

Jesus-Moraleida, F. R., Ferreira, P. H., Pereira, L. S., Vasconcelos, C. M., & Ferreira, M. L. (2011). Ultrasonographic analysis of the neck flexor muscles in patients with chronic neck pain and changes after cervical spine mobilization. 

Valera-Calero, A., Lluch, E., Gallego-Izquierdo, T., Malfliet, A., & Pecos-Martín, D. (2019). Endocrine response after cervical manipulation and mobilization in people with chronic mechanical neck pain: a randomized controlled trial. 

European journal of physical and rehabilitation medicine

Yung, E. Y., Oh, C., Wong, M. S., Grimes, J. K., Barton, E. M., Ali, M. I., & Cameron, D. (2017). The immediate cardiovascular response to joint mobilization of the neck-a randomized, placebo-controlled trial in pain-free adults. 

Vicenzino, B., Cartwright, T., Collins, D., & Wright, A. (1998). Cardiovascular and respiratory changes produced by lateral glide mobilization of the cervical spine. 

McGuiness, J., Vicenzino, B., & Wright, A. (1997). Influence of a cervical mobilization technique on respiratory and cardiovascular function. 

Moulson, A., & Watson, T. (2006). A preliminary investigation into the relationship between cervical snags and sympathetic nervous system activity in the upper limbs of an asymptomatic population. 

Chiu, T. W., & Wright, A. (1996). To compare the effects of different rates of application of a cervical mobilisation technique on sympathetic outflow to the upper limb in normal subjects. 

Vicenzino, B., Cartwright, T., Collins, D., & Wright, A. (1999). An investigation of stress and pain perception during manual therapy in asymptomatic subjects. 

Alonso-Perez, J. L., Lopez-Lopez, A., La Touche, R., Lerma-Lara, S., Suarez, E., Rojas, J., … & Fernández-Carnero, J. (2017). Hypoalgesic effects of three different manual therapy techniques on cervical spine and psychological interaction: A randomized clinical trial. 

Journal of bodywork and movement therapies

Mobilizations compared to other interventions

Ganesh, G. S., Mohanty, P., Pattnaik, M., & Mishra, C. (2015). Effectiveness of mobilization therapy and exercises in mechanical neck pain. 

Vinodkumar, A., & Desai, P. (2016). Efficacy of Mobilization versus Strength Training in Patients with Chronic Cervicogenic Headache. 

Indian Journal of Physiotherapy and Occupational Therapy-An International Journal

Kim, S. H., Choi, J. H., & Lee, K. W. (2016). Immediate effects of active stretching versus passive mobilization of the upper cervical spine on patients with neck pain and ROM. 

Riaz, F., Haider, R., Qamar, M. M., Basharat, A., Manzoor, A., Rasul, A., … & Ahmad, W. (2018). Effects of static stretching in comparison with Kaltenborn mobilization technique in nonspecific neck pain. 

BLDE University Journal of Health Sciences

Ganesh, G. S., Singh, H., Mushtaq, S., Mohanty, P., & Pattnaik, M. (2016). Effect of cervical mobilization and ischemic compression therapy on contralateral cervical side flexion and pressure pain threshold in latent upper trapezius trigger points. 

Khan, M. R., Shafi, H., Amjad, I., & Siddiqui, F. A. (2015). Efficacy of Cervical Spine Mobilization Versus Peripheral Nerve Slider Techniques (Neurodynamics) in Cervicobrachial Pain Syndrome. 

Journal of International Inovative Medical Council

Copurgensli, C., Gur, G., & Tunay, V. B. (2017). A comparison of the effects of Mulligan's mobilization and Kinesio taping on pain, range of motion, muscle strength, and neck disability in patients with cervical spondylosis: a randomized controlled study. 

Mobilizations in combination with other interventions

Buyukturan, O., Buyukturan, B., Sas, S., Karartı, C., & Ceylan, I. (2018). The Effect of Mulligan Mobilization Technique in Older Adults with Neck Pain: A Randomized Controlled, Double-Blind Study. 

Farooq, M. N., Mohseni-Bandpei, M. A., Gilani, S. A., Ashfaq, M., & Mahmood, Q. (2018). The effects of neck mobilization in patients with chronic neck pain: A randomized controlled trial. 

Ko, T., Jeong, U., & Lee, K. (2010). Effects of the inclusion thoracic mobilization into cranio-cervical flexor exercise in patients with chronic neck pain. 

Gong, W. T., Cheun, H. J., & Lee, K. M. (2010). The effect of cervical stabilized exercise and joint mobilization on maximum muscle strength and static muscle endurance of cervical region. 

Journal of the Korean Data and Information Science Society

Aquaroli, R. S., Camacho, E. S., Marchi, L., & Pimenta, L. (2016). Manual therapy and segmental stabilization in the treatment of cervical radiculopathy. 

Comparing cervical mobilization techniques (4, 39)

Hassan, F., Osama, M., Ghafoor, A., & Yaqoob, M. F. (2019). Effects of oscillatory mobilization as compared to sustained stretch mobilization in the management of cervical radiculopathy: A randomized controlled trial. 

Al Shehri, A., Khan, S., Shamsi, S., & Almureef, S. S. (2018). COMPARATIVE STUDY OF MULLIGAN (SNAGS) AND MAITLAND MOBILIZATION IN NECK PAIN. 

European Journal of Physical Education and Sport Science

Egwu, M. O. (2008). Relative therapeutic efficacy of some vertebral mobilization techniques in the management of unilateral cervical spondylosis: a comparative study. 

Kim, G., Lee, S., & Jeong, H. (2011). Effects of upper thoracic joint mobilization on dynamic stability of patients with chronic neck pain. 

Hwangbo, P. N., Hwangbo, G., Park, J., & Lee, S. (2014). The effect of thoracic joint mobilization and self-stretching exercise on pulmonary functions of patients with chronic neck pain. 

Jeong, H. J., & Kim, B. J. (2019). The Effect of Thoracic Joint Mobilization on the Changes of the Thoracic Kyphosis Angle and Static and Dynamic Balance. 

Kirschner, J., Vorwerg, S., Michel, S., Braun, A., Martin, T., & Prill, R. (2017). Effect of a manual-therapeutic segmental mobilization on the mobility of the thoracic spine.

Park, J. J., & Chon, S. C. (2018). Effect of Posterior-Anterior Mobilization of the Thoracic Spine on Pain, Respiratory Function, and Thoracic Circumference in Patients With Chronic Low Back Pain. 

Babina, R., Mohanty, P. P., & Pattnaik, M. (2016). Effect of thoracic mobilization on respiratory parameters in chronic non-specific low back pain: A randomized controlled trial. 

Jung, J. H., & Moon, D. C. (2015). The effect of thoracic region self-mobilization on chest expansion and pulmonary function. 

Wang, J. S. (2015). Effect of joint mobilization and stretching on respiratory function and spinal movement in very severe COPD with thoracic kyphosis. 

Thoracic mobilization in combination with other techniques

Lee, K. S., & Lee, J. H. (2017). Effect of maitland mobilization in cervical and thoracic spine and therapeutic exercise on functional impairment in individuals with chronic neck pain. 

Yang, S. R., Kim, K., & Park, S. J. (2015). The effect of thoracic spine mobilization and stabilization exercise on the muscular strength and flexibility of the trunk of chronic low back pain patients. 

Mohanty, P. P., & Pattnaik, M. (2016). Mobilisation of the thoracic spine in the management of spondylolisthesis. 

Thoracic mobilization effect on muscle activity and systemic response

Pecos-Martín, D., de Melo Aroeira, A. E., Silva, R. V., de Tejada Pozo, G. M., Solano, L. R., Plaza-Manzano, G., … & Falla, D. (2017). Immediate effects of thoracic spinal mobilisation on erector spinae muscle activity and pain in patients with thoracic spine pain: a preliminary randomised controlled trial. 

Jowsey, P., & Perry, J. (2010). Sympathetic nervous system effects in the hands following a grade III postero-anterior rotatory mobilisation technique applied to T4: a randomised, placebo-controlled trial. 

Ghaffar, T., Sajjad, A., & Rasul, A. (2016). Effects of thoracic spine mobilization on vitals and blood oxygen level in healthy individuals. 

Journal of Islamic International Medical College

Araujo, F. X., Schell, M. S., Ferreira, G. E., Pessoa, M. D., Pinho, A. S., Plentz, R. D., & Silva, M. F. (2019). Short-Term Effects of Different Rates of Thoracic Mobilization on Pressure Pain Thresholds in Asymptomatic Individuals: A Randomized Crossover Trial. 

Araujo, F. X., Schell, M. S., Ferreira, G. E., Pessoa, M. D. V., de Oliveira, L. R., Borges, B. G., … & Silva, M. F. (2018). Autonomic function and pressure pain threshold following thoracic mobilization in asymptomatic subjects: A randomized controlled trial. 

Shukla, R., Sahay, P., Sharma, R., Sarkar, B., & Biswas, A. (2018). Immediate Effects of Unilateral Thoracic Postero-Anterior Pressure Versus Transverse Pressure in Chronic Mechanical Neck Pain: A Comparative Study. 

Muhsen, A., Moss, P., Gibson, W., Walker, B., Jacques, A., Schug, S., & Wright, A. (2019). The Association Between Conditioned Pain Modulation and Manipulation-induced Analgesia in People With Lateral Epicondylalgia. 

Yung, E., Oh, C., Wong, M., Grimes, J. K., Barton, E. M., Ali, M. I., & Breakey, A. (2019). Non-thrust cervical manipulations reduce short-term pain and decrease systolic blood pressure during intervention in mechanical neck pain: a randomized clinical trial. 

Nakamaru, K., Aizawa, J., Kawarada, K., Uemura, Y., Koyama, T., & Nitta, O. (2019). Immediate effects of thoracic spine self-mobilization in patients with mechanical neck pain: A randomized controlled trial. 

Liebler, E. J., Tufano-Coors, L., Douris, P., Makofsky, H. W., McKenna, R., Michels, C., & Rattray, S. (2001). The effect of thoracic spine mobilization on lower trapezius strength testing. 

McClatchie, L., Laprade, J., Martin, S., Jaglal, S. B., Richardson, D., & Agur, A. (2009). Mobilizations of the asymptomatic cervical spine can reduce signs of shoulder dysfunction in adults. 

Joint Mobilization: Cervical and Thoracic Spine

Related Courses:

Course Description: Cervical Spine and Thoracic Spine Joint Mobilizations

Introduction

Research Corner Summary

Research Corner: Cervical Spine
5 Sub Sections

Research Corner: Thoracic Spine

Video Demonstration
2 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Joint Mobilization: Cervical and Thoracic Spine

Related Courses:

Course Description: Cervical Spine and Thoracic Spine Joint Mobilizations

Introduction

Research Corner Summary

Research Corner: Cervical Spine5 Sub Sections

Research Corner: Thoracic Spine

Video Demonstration2 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Research Corner: Cervical Spine
5 Sub Sections

Video Demonstration
2 Sub Sections