Cervical ROM

Manual Therapy Techniques Improve Cervical Range Of Motion In the Case of a Grade 4 WAD

By: Megan Moore



To determine if manual therapy increases cervical ROM in the case of a grade 4 Whiplash Associated Disorder.

ummary and background:

Whiplash occurring after a motor vehicle accident affects at least a million Americans each year. Sixty percent of those diagnosed are still symptomatic three months post injury, and exhibit three consistent clinical features: neck pain, reduced cervical ROM, and myofascial-entheseal dysfunction.


The patient was admitted to the study 8 months post injury. Manual therapies including cranial balancing, cervical mobilizations, and massage were applied for 1-2 hours twice per week for ten consecutive treatments. ROM of the 6 neck movements including left and right rotation, left and right lateral flexion, anterior flexion, and posterior extension, were measured both before and after treatment.


The patient’s ROM drastically improved in each of the 6 neck movements measured, and he experienced a reduction in pain, as recorded by a Visual Analogue scale, and the Bournemouth Neck questionnaire.


Manual therapy techniques can improve cervical ROM and decrease pain in the case of a Grade 4 Whiplash Associated Disorder.

Key Words:

Proprioception, vector, thixotropy, lordotic curve, goniometer, anterior flexion, posterior extension, lateral flexion, sheer

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