Endocrine response after cervical manipulation and mobilization in people with chronic mechanical neck pain: a randomized controlled trial
BACKGROUND: Most of the research on the effects of spinal manipulation on endocrine function has been done on healthy subjects and has yielded contradictory results. The potential role of cervical manual therapy intervention in order to induce changes in the endocrine system has not yet been investigated. AIM: The aim of this trial is to compare the effects on salivary cortisol levels and clinical outcomes of cervical manipulation versus cervical mobilization or sham manipulation in patients with chronic mechanical neck pain. DESIGN: Randomized controlled trial. SETTING: University of Alcala de Henares: outpatient (referrals from office workers). POPULATION: A total of 83 patients with chro…
The Influence of Treatment Expectations on Clinical Outcomes and Cortisol Levels in Patients With Chronic Neck Pain: An Experimental Study
Background The role of contextual factors like pre‐existing treatment expectations has been established. However, the effect of verbally delivered treatment expectations in patient–therapist communication has not been considered, nor has the role of cortisol changes within the placebo/nocebo response in people with chronic neck pain. Objective To examine the effect of verbally delivered treatment expectations on clinical outcomes in physical therapy practice and to determine if changes in cortisol levels are associated with changes in neck pain and disability. Methods Eighty‐three patients with chronic neck pain were randomly allocated to 3 different verbally delivered expectations (positiv…