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Official websites use. Share sensitive information only on official, secure websites. However, this classification does not encompass upper cervical spine dysfunction. The aim is to compare the short- and mid-term effectiveness of adding a manual therapy approach to a cervical exercise protocol in patients with chronic neck pain and upper cervical spine dysfunction.
Each group received four min sessions, one per week during four consecutive weeks, and a home exercise regime. Upper flexion and flexion-rotation test range of motion, neck disability index, craniocervical flexion test, visual analogue scale, pressure pain threshold, global rating of change scale, and adherence to self-treatment were assessed at the beginning, end of the intervention and at 3- and 6-month follow-ups. Chronic neck pain is one of the most prevalent pathologies nowadays, accounting for Cervical exercise has been shown to be an effective treatment for neck pain [ 3 , 4 ].
A recent systematic review in patients with chronic neck pain concluded that multimodal training exercises involving deep and superficial cervical muscles is necessary to have beneficial effects on function and symptoms [ 5 ].
Some studies have considered if a manual therapy approach should be added or not to the cervical exercise protocol for neck pain [ 4 , 6 ].
However, there is a lack of clinical trials evaluating the effectiveness of the manual therapy approach on neck pain samples with upper cervical joint dysfunctions. Lack of mobility and symptoms arising from upper cervical joints are considered to be the main indication for upper cervical manual therapy approach. In addition, upper cervical dysfunction could limit the efficacy of cervical exercise in this sample of chronic neck pain patients.