Joint Mobilization : A Common Condition, Ranking As The Third Most Burdensome Disease Worldwide

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BACKGROUND
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., 2010). Joint mobilization (JM) is widely acknowledged as an effective intervention (Childs et al., 2008); and the UPA is an entry-level form of JM commonly used by physiotherapists globally. However, a Cochrane review indicated that the most effective cervical JM dosage has yet to be determined (Gross et al., 2010). Unilateral anterior glide (UPA) appears to be more efficacious for pain relief and outcomes in patients with unilateral neck pain compared to other JM techniques (Egwu, 2008). The rationale behind the pain modulation attained with JM has been suggested to be as a result of neurophysiologic mechanisms (Bialosky et al., 2008). For example, spinal manipulative therapy has been associated with increased afferent discharge (Colloca et al., 2003), motoneuron pool depression (Dishman et al., 2005), changes in motor activity (Herzog, 1999; DeVocht, 2005) and reduction of pain perception in response to a standard stimulus (George, 2006; Vicenzino, 1996). The neurophysiologic system that alters pain overlaps with blood pressure (BP) as observed in BP-related hypoalgesia (Vincenzino, 1998; Sterling, 2001). Therefore, BP is a pertinent and easily quantified variable to examine to ensure

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