Aim: An observational cohort study to determine whether localised manual therapy results in a preferential increase in mobility of the targeted motion segment.

Method: Eighteen participants with mechanical neck pain had three MRIs of their cervical spine. The first two were taken prior to treatment in neutral and at the end of active rotation in their more limited rotation. Participants received localised manual therapy targeting a motion segment deemed to be relevant to their presentation until either their range increased by > 10° or 8 min, whichever came first. A third MRI was performed immediately after treatment with their head in the same rotated position as pre-treatment. In the images, each vertebra was segmented using a semi-automated process. Movement between neutral and rotated positions was calculated as Euler angles and distance of facet translations for each motion segment.

Results: Rotation and lateral flexion at the targeted location increased by 40% (mean 0.86° (CI: 0.24–1.48) and 15% (mean 0.52° (CI: 0.17–1.21) respectively with only the CIs for rotation not containing zero. The mean changes for the non-targeted locations were less than 0.1° for each axis and all CIs contained zero. Facet translations at the targeted location increased by 25% (0.419 mm) and decreased by >4% (>0.01 mm) at the untreated locations but the wide CIs both contained zero.

Conclusion: Localised manual therapy seems to have a preferential effect on mobility of the targeted motion segment. The findings support considering segmental dysfunction in clinical reasoning and the use of specifically targeted manual therapy interventions.

目的：一项观察性队列研究，以确定局部手法治疗是否会优先增加目标运动段的活动度。

方法：18 名患有机械性颈部疼痛的参与者对他们的颈椎进行了 3 次 MRI 检查。前两个是在中立治疗之前和在更有限的旋转中主动旋转结束时拍摄的。参与者接受了针对与他们的表现相关的运动段的局部手动治疗，直到他们的范围增加 > 10° 或 8 分钟，以先到者为准。第三次 MRI 在治疗后立即进行，他们的头部处于与治疗前相同的旋转位置。在图像中，每个椎骨都使用半自动过程进行分割。中性位置和旋转位置之间的运动计算为欧拉角和每个运动段的小平面平移距离。

结果：目标位置的旋转和侧屈分别增加了 40%（平均 0.86°（CI：0.24-1.48）和 15%（平均 0.52°（CI：0.17-1.21）），只有旋转的 CI 不包含零。每个轴的非目标位置的平均变化小于 0.1°，所有 CI 均为零。目标位置的小平面平移增加了 25% (0.419 mm) 并在目标位置减少了 >4% (>0.01 mm)未处理的位置，但宽 CI 均包含零。

结论：局部手法治疗似乎对目标运动段的活动性有优先影响。研究结果支持在临床推理中考虑节段性功能障碍以及使用专门针对手动治疗的干预措施。