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Effective Cervical Jm Dosage Is A Common Condition, Ranking As The Fifth Most Burdensome Disease Worldwide Essay

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1. INTRODUCTION
Neck pain is a common condition, ranking as the fourth most burdensome disease worldwide. Evidence suggests that rates of recurrence and chronicity are high (Borghouts et al., 1998; Hoving et al., 2001), which results in considerable functional and economic implications (Vos et al., 2012). Joint mobilization (JM) is widely acknowledged as an effective intervention (Childs et al., 2008). However, a Cochrane review indicated that the most effective cervical JM dosage has yet to be determined (Gross et al., 2010). Multiple studies have established a sympatho-excitatory effect resulting from cervical JM (McGuiness et al., 1997; Vicenzino et al., 1998; La Touche et al., 2013). On the contrary, Yung et al. (2014) developed a distinctive dose using anterior-to-posterior pressures (AP) of the cervical spine that resulted in a reduction in systolic blood pressure (SBP) and heart rate (HR), suggesting a sympatho-inhibitory effect. Therefore, it is indeterminate whether cervical JM results in sympatho-excitatory or sympatho-inhibitory effect if the dosage (Yung et al., 2015) is different from the traditional 3 sets of continuous 30-90 second regimen.
Maitland’s (Maitland et al., 2005) unilateral posterior-to-anterior glide (PA) is an entry-level form of JM commonly used by physiotherapists worldwide; and it appears to be more efficacious for pain relief and outcomes in patients with unilateral neck pain compared to other JM techniques such as transverse pressures and

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