Short-term changes in median nerve neural tension after a suboccipital muscle inhibition technique in subjects with cervical whiplash: A randomised controlled trial.

Objectives To assess the immediate effect of a suboccipital muscle inhibition (SMI) technique on: (a) neck pain, (b) elbow extension rangeof motion during the upper limb neurodynamic test of the median nerve (ULNT-1), and (c) grip strength in subjects with cervical whiplash;and determine the relationships between key variables.Design Randomised, single-blind, controlled clinical trial.Setting Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Spain.Participants Forty subjects {mean age 34 years [standard deviation (SD) 3.6]} with Grade I or II cervical whiplash and a positive responseto the ULNT-1 were recruited and distributed into two study groups: intervention group (IG) (n = 20) and control group (CG) (n = 20).Interventions The IG underwent the SMI technique for 4 minutes and the CG received a sham (placebo) intervention. Measures were collectedimmediately after the intervention.Main outcome measures The primary outcome was elbow range of motion during the ULNT-1, measured with a goniometer. The secondaryoutcomes were self-perceived neck pain (visual analogue scale) and free-pain grip strength, measured with a digital dynamometer.Results The mean baseline elbow range of motion was 116.0◦(SD 10.2) for the CG and 130.1◦(SD 7.8) for the IG. The within-groupcomparison found a significant difference in elbow range of motion for the IG [mean difference −15.4◦, 95% confidence interval (CI) −20.1to −10.6; P = 0.01], but not for the CG (mean difference −4.9◦, 95% CI −11.8 to 2.0; P = 0.15). In the between-group comparison, thedifference in elbow range of motion was significant (mean difference −10.5◦, 95% CI −18.6 to −2.3; P = 0.013), but the differences in gripstrength (P = 0.06) and neck pain (P = 0.38) were not significant.Conclusion The SMI technique has an immediate positive effect on elbow extension in the ULNT-1. No immediate effects on self-perceivedcervical pain or grip strength were observed.