{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T20:00:29Z","timestamp":1766088029597,"version":"build-2065373602"},"reference-count":42,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T00:00:00Z","timestamp":1676937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia (FCT) through R&amp;D Units","award":["UIDB\/05210\/2020"],"award-info":[{"award-number":["UIDB\/05210\/2020"]}]},{"name":"Portuguese Foundation for Science and Technology","award":["UIDB\/05210\/2020"],"award-info":[{"award-number":["UIDB\/05210\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Applied Sciences"],"abstract":"<jats:p>There is limited evidence comparing the effects of manual and instrumented-assisted manipulations among adults with neck pain. Our purpose was to determine the effects of a multisession regime of manual and instrument-assisted cervical manipulation on pain, disability, perception of change, and muscle properties in subjects with nonspecific neck pain. We conducted a double-blind, randomized, placebo-controlled study in 32 subjects with nonspecific neck pain. Two groups received three sessions of cervical (C3\/C4) manipulation, one group manual and the other instrument-assisted, a third group received three sessions of sham manipulation, and a fourth group served as a control. Self-reported pain, pressure pain thresholds, neck disability, patient perception of change, and properties (tonus, stiffness, and elasticity) of the upper trapezius and biceps brachii were assessed at baseline, immediately after the first session and 15 days after the end of the intervention. After the end of the intervention, the percentage of changes in the visual analogue scale score, Neck Disability Index, and Patient Global Perception of Change score were significantly higher in the manual group in comparison with the other groups (p &lt; 0.05). No between-group differences were observed in the percentage of changes in tonus, stiffness, and elasticity of the four muscles at the end of the intervention. We concluded that three sessions of C3\/C4 manual manipulation improved pain and disability in subjects with nonspecific neck pain.<\/jats:p>","DOI":"10.3390\/app13052770","type":"journal-article","created":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T02:31:55Z","timestamp":1677033115000},"page":"2770","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Manual but Not Instrument-Assisted Cervical Manipulation Reduces Pain and Disability in Subjects with Nonspecific Neck Pain: Double-Blinded, Randomized Clinical Trial"],"prefix":"10.3390","volume":"13","author":[{"given":"Nuno","family":"Nogueira","sequence":"first","affiliation":[{"name":"Vale do Sousa Higher School of Health, Polytechnic Health School of the North, CESPU, 4585-116 Gandra, PRD, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7432-912X","authenticated-orcid":false,"given":"Nat\u00e1lia","family":"Oliveira-Campelo","sequence":"additional","affiliation":[{"name":"Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, Rua Dr. Ant\u00f3nio Bernardino de Almeida, 400, 4200-072 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4041-270X","authenticated-orcid":false,"given":"Rui","family":"Torres","sequence":"additional","affiliation":[{"name":"Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, Rua Dr. Ant\u00f3nio Bernardino de Almeida, 400, 4200-072 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9528-1463","authenticated-orcid":false,"given":"Andreia","family":"Sousa","sequence":"additional","affiliation":[{"name":"Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, Rua Dr. Ant\u00f3nio Bernardino de Almeida, 400, 4200-072 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9094-1493","authenticated-orcid":false,"given":"Fernando","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Institute of Biomedicine\u2014iBiMED and School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/00007632-200101150-00015","article-title":"A Critical Appraisal of Review Articles on the Effectiveness of Conservative Treatment for Neck Pain","volume":"26","author":"Hoving","year":"2001","journal-title":"Spine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1136\/annrheumdis-2013-204431","article-title":"The global burden of neck pain: Estimates from the Global Burden of Disease 2010 study","volume":"73","author":"Hoy","year":"2014","journal-title":"Ann. 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