Is It Necessary to Select Target Techniques in Manual Therapy?

Summary

For the optimization of results in manual therapy it is recommended to applied target therapy in certain segments of the spine. In this article the authors attempted to find out whether:

1. Is the posterior-anterior mobilization of the segment specific?

2. Is the specific mobilization better that that which is generally used?

3. Is there evidence supporting reliability of identification of specific problems?

4. Is there evidence supporting validity of specific problems?

From the Medline Data-base the author selected over relevant studies to answer these questions. It has become obvious that posterior-anterior mobilization does not influence one segment only, but it exerts effect on the whole region of the spine. There is no evidence confirming that specific manual therapy is superior to the non-specific one, in other words that which is commonly used. It was not confirmed that a specific damage was be determined on the basis of comparison of the levels of segments or tightness of the segments, nor can it be used to get a concordance of opinions in a group of therapists. The evidence confirming relationship between disorders between segments and back pain proved to be contradictory. In conclusion, the evidence confirms that manual therapy targeted to specific segments is not necessary to reach optimization of the results of treatment.

Key words:
posterior-anterior mobilization, specific manual therapy, spine segments, therapeutic techniques