Milton Yeong Hao Yu
Singapore Institute of Technology
Abstract Title: Comparing the Effectiveness of Cervical Manipulation Versus Exercise for Adults with Neck Pain: A Systematic Review
Biography: Milton Yeong Hao Yu is a recent graduate from the Bachelor of Science (Honours) in Physiotherapy program from the Singapore Institute of Technology. He is also the recipient of the esteemed MOHH Healthcare Merit Award which recognizes his strong academic performance and commitment to pursue a career in public healthcare. Given his strong interest in sports and musculoskeletal rehabilitation, Milton is focused on staying up to date with new innovations and approaches to rehabilitation. He is particularly interested in translating research into clinical practice so he can deliver evidence-based care and optimize patient outcomes.
Research Interest: Background: Neck pain is a significant health burden. Exercise and Cervical Spinal Manipulation (CSM) are widely used interventions, yet their comparative effectiveness remains unclear. Objective: This systematic review aims to investigate the effectiveness of exercise therapy compared to CSM in reducing pain, improving disability and increasing cervical Range of Motion (ROM) in adults with neck pain. Data Sources: A systematic review was conducted using three electronic databases, PubMed, CINAHL and Cochrane, from 31st December 2014 to 31st December 2024 Methods: A systematic review was conducted in accordance with PRISMA guidelines. Eligible Randomized Controlled Trials (RCT) included (a) Adults aged 18-65 years old with neck pain, (b) study intervention was CSM or CSM combined with exercise, (c) the intervention was compared to exercise, (d) the study measured at least one of the following outcome measures – 1) Pain Visual Analog Scale (VAS), 2) Numerical Pain Rating Scale (NPRS), 3) Neck Disability Index (NDI) and 4) Cervical ROM, and (e) published in English. Methodological quality was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Results: Eleven RCTs (PEDro scores ranged from fair to excellent) were included. Both exercise and CSM produced significant within-group improvements in pain and disability. Neither intervention outperformed the other when they were delivered independently. However, when the two interventions were combined, greater and more sustained results were achieved in improving pain, reducing disability and increasing cervical ROM. Several studies recorded statistically significant between-group differences at long-term follow-up periods of up to six months. Conclusion: Both exercise and CSM are effective interventions for managing neck pain. However, combining the two interventions yields superior and more sustained clinical outcomes compared to either intervention delivered alone. Future trials should investigate the optimal dosing parameters for multimodal treatment strategies and expending research to acute neck pain populations. Keywords: Neck Pain; Cervical Manipulation; Exercise Therapy; Physiotherapy; Rehabilitation