Evidence-Based Practice: Chronic Neck Pain and Manipulative Therapy Essay

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Table of Contents

CINAHL Database Search
Article Critique (CINAHL)
JBI Database Search
Article Critique (JBI)
Reference List

Clinical Question: In patients with chronic neck pain, what is the dosage effect of spinal manipulative therapy on pain relief compared with a home exercise program within a specific duration?

The PICO (T) (Boswell & Cannon, 2014) elements are:

Population (P) = patients with chronic neck pain
Intervention (I) = spinal manipulative therapy
Comparison (C) = home exercise program
Outcome (O) = pain relief

CINAHL Database Search

Search Number	P	I	C	O	T	# of Results	Notes
1	Patients chronic neck pain					9,592	I searched the database by typing “Patients chronic neck pain ” into the basic search field and clicking “Search.” The conjunction was omitted, as the use of conjunctions and prepositions often messes the search results.
2		Spinal manipulative therapy				26,261	I cleared the “search” field and typed in “Spinal manipulative therapy.” Afterward, I clicked “Search” again.
3			Home exercise program			23,243	I clicked “Clear” and typed “relaxation” in the search field. CINAHL suggested “relaxation techniques” so I chose to search on this.
4				Pain relief		25,803	I clicked “Clear” and typed “pain relief” in the search field and clicked “Search.”
5	Patients chronic neck pain	Spinal manipulative therapy				1,231	I clicked on “advanced search” and combined Search #1 with Search #2 with the help of the Boolean operator “AND”. After I clicked “Search,” the database returned 1,231 results.
	Patients chronic neck pain	Spinal manipulative therapy	Home exercise program				To narrow down the number of results, I combined the “P,” “I” and “C” elements of the PICO search. As a result, I retrieved 463 results.
6	Patients chronic neck pain	Spinal manipulative therapy	Home exercise program	Pain relief		273	I incorporated the “O” element into the search as well by clicking the plus button to select one more field.
7	Patients chronic neck pain	Spinal manipulative therapy	Home exercise program	Pain relief			I incorporated the “T” element into the search as well by clicking the plus button to select one more field.
8	Patients chronic neck pain	Spinal manipulative therapy	Home exercise program	Pain relief		273	I chose all elements of the PICO, narrowed the number of search items to full-text papers and clicked “Search.”
9	Patients chronic neck pain	Spinal manipulative therapy	Home exercise program	Pain relief	2011–2014	22	I moved the slider on the publication date scale to limit the search results to 2011–2014 articles. Since the rest of the limitations might have jeopardized the objectivity of the information (i.e., geographical location of the authors), it was decided to stop at this point.

*This table reports the history of an actual search of this clinical question in CINAHL

Article Critique (CINAHL)

In a study by Jonali and Scalzitti (2014), the article retrieved in the course of the search appeared to be rather peculiar in terms of its content. The research can be considered rather impressive in terms of the conciseness of the results layout. However, the study could use a better description of the key limitations. Detailed and embracing every major aspect of manipulation for neck pain, the study can be credited for its accuracy and depth.

JBI Database Search

Search Number	P	I	C	O	T	# of Results	Notes
1	Patients with chronic neck pain					5	I searched the JBI database for “Patients with chronic neck pain” by typing the above-mentioned phrase in the search field. Because of an extremely small number of research results, it was decided to use the phrase “neck pain” as “P” instead.
2	Neck pain					36	I searched on the P, “neck pain” by typing it into the search field and clicking “Search.”
3		Spinal manipulative therapy				22	I cleared the search field and typed “spinal manipulative therapy” in it, clicking “Search.”
4			Home exercise program			16	I cleared the search field once again and typed the “C” element (Home exercise program) in it.
				Pain relief		288	I cleared the search filed and typed “pain relief” (the “O” element of PICO) in it.
	Neck pain	Spinal manipulative therapy				0	I typed “neck pain in the search field” and “spinal manipulative therapy” in the second field choosing the “AND” operator. However, instead, the search did not return any results, so it was decided to use “spinal therapy” instead.
5	Neck pain	Spinal therapy				0	I clicked on “multi-field search” and combined “neck pain” with “spinal therapy” using the Boolean operator “AND”. I clicked “Search.” The search did not return any results, though. It was decided to modify the “I” element and use “therapy” instead of “spinal therapy”.
6	Neck pain	Therapy				24	I cleared the search field, typed in “neck pain,” chose the AND Boolean operator and added another search field with the word “therapy” in it.
7	Neck pain	Therapy			2010–2015	24	I used the “P” and “I” elements in the search fields, reducing the amount of search results by choosing the “past five years” filter.

It was decided to stop at the given stage, as any further modification of the search (adding or removing at least one word) resulted in retrieving either 0 results (was too narrow), or more than 30 results (turned too broad).

Article Critique (JBI)

Chu’s article on the topic of neck pain and the methods of diagnosing neck disorders (Chu, 2014) is quite profound and very detailed, which is obviously its key strength. However, the article suffers from the lack of information on the tools for fighting neck disorders. Consequently, the research seems somewhat narrow. The use of credible resource, however, makes the research quite trustworthy.

Reference List

Boswell, C. & Cannon, S. (2014). Introduction to nursing research: incorporating evidence-based practice. Hoboken: Jones & Bartlett Publishers.

Jonali, H. & Scalzitti, D. A. (2014). In a 36-year-old woman with neck pain, will manipulation and mobilization be beneficial for reducing her reports of neck pain? LEAP, 94(2), 179–84.

Chu, V. (2014). Neck disorders: Stretching and strengthening exercises. Adelaide, SA: Joanne Briggs Institute. Web.

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