Study designs of evaluations included in the review
Prospective controlled studies and before-and-after studies. Five of the eight studies included in the review were randomised controlled trials and three were uncontrolled trials.
Specific interventions included in the review
Physical therapy interventions or programmes that were within the scope of physical therapy practice in Canada.
The physical therapy interventions covered by the included studies were varied. The therapies were hospital- or clinic-based or home programmes. The time between the accident and the intervention varied from 24 hours to over 5 years. In the majority of the studies, it was not specifically stated whether a physical therapist or another individual provided the intervention.
The controlled studies all involved different interventions: mobilisation; home exercise or physiotherapy; electromagnetic therapy collar; multi-modal; or soft collar. The uncontrolled studies investigated the effects of acupuncture, transcutaneous electrical neurostimulation, and spinal manipulative therapy.
Participants included in the review
Both male and female participants with sufficient soft tissue trauma to the cervical spine had to be included. Patients with chronic conditions (e.g. rheumatoid arthritis), more severe injuries indicated by a neurological deficit or with acute severe injuries (e.g. fractures) were excluded because these factors might have confounded the treatment. The authors were primarily concerned with soft tissue trauma to muscles, ligaments and connective tissue.
Outcomes assessed in the review
At least one of the following three outcomes had to be measured: range of motion, pain, and/or patient satisfaction or outcome.
The range of motion was usually assessed using a goniometer, but the final range of motion values were measured or compiled differently in each study. For example, range of motion was noted as individual measurements (e.g. flexion, extension, side flexion or rotation); the sum of all of the movements; normative values converted to ordinal scores; or using one movement as a criterion for limitation of the other movements.
Pain was measured using a visual analogue scale in all of the studies.
For patient satisfaction or outcome, a visual analogue scale was the most common measurement tool used.
How were decisions on the relevance of primary studies made?
All titles obtained from the computer searches and their reference lists were assessed by two independent assessors. The authors stated that the level of agreement between the two assessors was high. Where discrepancies existed, the two reviewers met to discuss the differences and reach a consensus. It is not stated whether the reviewers were blinded to the results or source.