Mechanical Diagnosis and Therapy Has a Clinically Meaningful Effect on Neck Derangement Syndrome With a Directional Preference for Cervical Retraction or Extension in Comparison to a Wait-and-See Approach: An Assessor-Blinded Randomized Controlled Trial for 6 Weeks

Abstract

OBJECTIVES: This study aimed to estimate the short-term therapeutic effect of Mechanical Diagnosis and Therapy (MDT) on the subgroup of the cervical derangement syndrome with a directional preference (DP) for cervical retraction or extension in comparison with the wait-and-see approach. DESIGN: Assessor-blinded 2-arm randomized controlled trial: the MDT and a wait-and-see approach. METHODS: Participants were university students with neck symptoms lasting for ≥1 week, neck disability index of ≥16%, and derangement syndrome with a DP for cervical retraction or extension. In the wait-and-see group, participants were instructed to perform their usual activities. In the MDT group, participants undertook 6-week MDT interventions. The primary outcome was the global rating of change scale at 3 and 6 weeks after randomization. Effect estimation was conducted using the 95% confidence interval method with pre-established clinically meaningful important differences. RESULTS: Twenty participants in each group completed the study. The effect of MDT in comparison with the wait-and-see approach was large enough to be meaningful at 6 weeks after randomization. CONCLUSIONS: Compared with the wait-and-see approach, the 6-week MDT intervention was effective in young individuals with a DP for cervical retraction or extension. JOSPT Open 2024;2(2):106-114. Epub 8 March 2024. doi:10.2519/josptopen.2024.0810