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NAGS involves a mid to end-range facet joint mobilisation applied anterocranially along the plane of treatment within the desired joint, combined with a small amount of manual traction. The purpose of this treatment is to increase movement within the spine, and decrease symptomatic pain.
The McKenzie method is a technique primarily used in physical therapy.It was developed in the late 1950s by New Zealand physiotherapist Robin McKenzie. [1] [2] [3] In 1981 he launched the concept which he called "Mechanical Diagnosis and Therapy (MDT)" – a system encompassing assessment, diagnosis and treatment for the spine and extremities.
Spinal mobilization is a type of passive movement of a spinal segment or region. It is usually performed with the aim of achieving a therapeutic effect. Spinal mobilization has been described as "a gentle, often oscillatory, passive movement applied to a spinal region or segment so as gently to increase the passive range of motion of that segment or region."
Passive accessory intervertebral movements (PAIVM) refers to a spinal physical therapy assessment and treatment technique developed by Geoff Maitland. The purpose of PAIVM is to assess the amount and quality of movement at various intervertebral levels, and to treat pain and stiffness of the cervical and lumbar spine. [1]
The International Federation of Orthopaedic Manipulative Physical Therapists defines joint mobilization as "a manual therapy technique comprising a continuum of skilled passive movements that are applied at varying speeds and amplitudes to joints, muscles or nerves with the intent to restore optimal motion, function, and/or to reduce pain." [1]
Movement of facet joints; Expansion of intervertebral foramen; Stretch of soft tissues; When mechanical traction is combined with other physical therapy modalities such as passive mobilization, massage, stretching and active exercises, it is an effective treatment for pain reduction in cervical or lumbar spine disorders. [5]
Many definitions of joint manipulation have been proposed. [1] The most rigorous definition, based on available empirical research is that of Evans and Lucas: [2] "Separation (gapping) of opposing articular surfaces of a synovial joint, caused by a force applied perpendicularly to those articular surfaces, that results in cavitation within the synovial fluid of that joint."
For neck pain, manipulation and mobilization produce similar changes, and manual therapy and exercise are more effective than other strategies. [12] A 2015 Cochrane systematic review found that there is no high-quality evidence assessing the effectiveness of spinal manipulation for treating neck pain. [13]