Comparative effectiveness of manipulation, mobilisation and the Activator instrument in treatment of non-specific neck pain: A systematic review

Background: Neck pain is a common problem and different forms of manual therapy are used in its treatment. The purpose of this systematic review was to critically appraise the literature that directly compared manipulation, mobilisation and the Activator instrument for non-specific neck pain. Methods: Electronic databases (MEDLINE, MANTIS and CINAHL) were searched from their inception to October 2005 for all English language randomised clinical trials that directly compared manipulation, mobilisation and the Activator instrument. Inclusion and exclusion criteria were applied to select the studies and these studies were then evaluated using validated criteria. Results: Five such studies were identified. The methodological quality was mostly poor. Findings from the studies were mixed and no one therapy was shown to be more effective than the others. Conclusion: Further high quality research has to be done before a recommendation can be made as to the most effective manual method for non-specific neck pain. © 2006 Gemmell and Miller; licensee BioMed Central Ltd.