scholarly journals Does TENS Reduce the Intensity of Acute and Chronic Pain? A Comprehensive Appraisal of the Characteristics and Outcomes of 169 Reviews and 49 Meta-Analyses

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1060
Author(s):  
Carole Paley ◽  
Priscilla Wittkopf ◽  
Gareth Jones ◽  
Mark Johnson
Keyword(s):  
Chronic Pain ◽  
Clinical Efficacy ◽  
Systematic Reviews ◽  
Effect Size ◽  
Entire Body ◽  
Sufficient Data ◽  
Transcutaneous Electric Nerve Stimulation ◽  
Eligibility Criteria ◽  
Post Surgery ◽  
Meta Analyses

Background and Objectives: Uncertainty about the clinical efficacy of transcutaneous electric nerve stimulation (TENS) to alleviate pain spans half a century. There has been no attempt to synthesise the entire body of systematic review evidence. The aim of this comprehensive review was to critically appraise the characteristics and outcomes of systematic reviews evaluating the clinical efficacy of TENS for any type of acute and chronic pain in adults. Materials and Methods: We searched electronic databases for full reports of systematic reviews of studies, overviews of systematic reviews, and hybrid reviews that evaluated the efficacy of TENS for any type of clinical pain in adults. We screened reports against eligibility criteria and extracted data related to the characteristics and outcomes of the review, including effect size estimates. We conducted a descriptive analysis of extracted data. Results: We included 169 reviews consisting of eight overviews, seven hybrid reviews and 154 systematic reviews with 49 meta-analyses. A tally of authors’ conclusions found a tendency toward benefits from TENS in 69/169 reviews, no benefits in 13/169 reviews, and inconclusive evidence in 87/169 reviews. Only three meta-analyses pooled sufficient data to have confidence in the effect size estimate (i.e., pooled analysis of >500 events). Lower pain intensity was found during TENS compared with control for chronic musculoskeletal pain and labour pain, and lower analgesic consumption was found post-surgery during TENS. The appraisal revealed repeated shortcomings in RCTs that have hindered confident judgements about efficacy, resulting in stagnation of evidence. Conclusions: Our appraisal reveals examples of meta-analyses with ‘sufficient data’ demonstrating benefit. There were no examples of meta-analyses with ‘sufficient data’ demonstrating no benefit. Therefore, we recommend that TENS should be considered as a treatment option. The considerable quantity of reviews with ‘insufficient data’ and meaningless findings have clouded the issue of efficacy. We offer solutions to these issues going forward.

scholarly journals Acupuncture for the Relief of Chronic Pain: A Synthesis of Systematic Reviews

Medicina ◽  
2019 ◽  
Vol 56 (1) ◽  
pp. 6
Author(s):  
Carole A. Paley ◽  
Mark I. Johnson
Keyword(s):  
Chronic Pain ◽  
Systematic Reviews ◽  
Statistical Power ◽  
English Language ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Supporting Evidence ◽  
Pharmacological Interventions ◽  
Eligibility Criteria ◽  
Meta Analyses

Background and Objectives: It is estimated that 28 million people in the UK live with chronic pain. A biopsychosocial approach to chronic pain is recommended which combines pharmacological interventions with behavioural and non-pharmacological treatments. Acupuncture represents one of a number of non-pharmacological interventions for pain. In the current climate of difficult commissioning decisions and constantly changing national guidance, the quest for strong supporting evidence has never been more important. Although hundreds of systematic reviews (SRs) and meta-analyses have been conducted, most have been inconclusive, and this has created uncertainty in clinical policy and practice. There is a need to bring all the evidence together for different pain conditions. The aim of this review is to synthesise SRs of RCTs evaluating the clinical efficacy of acupuncture to alleviate chronic pain and to consider the quality and adequacy of the evidence, including RCT design. Materials and Methods: Electronic databases were searched for English language SRs and meta-analyses on acupuncture for chronic pain. The SRs were scrutinised for methodology, risk of bias and judgement of efficacy. Results: A total of 177 reviews of acupuncture from 1989 to 2019 met our eligibility criteria. The majority of SRs found that RCTs of acupuncture had methodological shortcomings, including inadequate statistical power with a high risk of bias. Heterogeneity between RCTs was such that meta-analysis was often inappropriate. Conclusions: The large quantity of RCTs on acupuncture for chronic pain contained within systematic reviews provide evidence that is conflicting and inconclusive, due in part to recurring methodological shortcomings of RCTs. We suggest that an enriched enrolment with randomised withdrawal design may overcome some of these methodological shortcomings. It is essential that the quality of evidence is improved so that healthcare providers and commissioners can make informed choices on the interventions which can legitimately be provided to patients living with chronic pain.

scholarly journals Efficacy and safety of instantaneous wave-free ratio in patients undergoing coronary revascularisation: protocol for a systematic review

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017868
Author(s):  
Joey S.W. Kwong ◽  
Sheyu Li ◽  
Wan-Jie Gu ◽  
Hao Chen ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Coronary Revascularisation ◽  
Eligibility Criteria ◽  
Registration Number ◽  
Collection Form ◽  
Randomised Controlled ◽  
Meta Analyses

IntroductionEffective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous ‘wave-free’ ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted.Methods and analysisThis is a protocol for a systematic review of randomised controlled trials and controlled observational studies. Electronic sources including MEDLINE via Ovid, Embase, Cochrane databases and ClinicalTrials.gov will be searched for potentially eligible studies investigating the effects of iFR-guided strategy in patients undergoing coronary revascularisation. Studies will be selected against transparent eligibility criteria and data will be extracted using a prestandardised data collection form by two independent authors. Risk of bias in included studies and overall quality of evidence will be assessed using validated methodological tools. Meta-analysis will be performed using the Review Manager software. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationEthics approval is not required. Results of the systematic review will be disseminated as conference proceedings and peer-reviewed journal publication.Trial registration numberThis protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017065460.

scholarly journals Programme frequency, type, time and duration do not explain the effects of balance exercise in older adults: a systematic review with a meta-regression analysis

2018 ◽  
Vol 53 (16) ◽  
pp. 996-1002 ◽  
Author(s):  
Melanie K Farlie ◽  
Lauren Robins ◽  
Romi Haas ◽  
Jennifer L Keating ◽  
Elizabeth Molloy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Systematic Reviews ◽  
Centre Of Mass ◽  
Randomised Trials ◽  
Eligibility Criteria ◽  
Exercise Interventions ◽  
Balance Exercise ◽  
Control Centre ◽  
Meta Analyses

ObjectiveThe objective of this systematic review was to examine the effects of different balance exercise interventions compared with non-balance exercise controls on balance task performance in older adults.DesignSystematic review.Data sourcesMedline, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Scopus and Cochrane Database of Systematic Reviews were searched until July 2017.Eligibility criteria for selecting studiesSystematic reviews and meta-analyses of randomised trials of balance exercise interventions for older adults were identified for extraction of eligible randomised trials. Eligibility criteria for inclusion of randomised trials in meta-analyses were comparison of a balance exercise intervention with a control group that did not perform balance exercises, report of at least one end-intervention balance outcome measurement that was consistent with the five subgroups of balance exercise identified, and full-text article available in English.ResultsNinety-five trials were included in meta-analyses and 80 in meta-regressions. For four balance exercise types (control centre of mass, multidimensional, mobility and reaching), significant effects for balance exercise interventions were found in meta-analyses (standardised mean difference (SMD) 0.31–0.50), however with considerable heterogeneity in observed effects (I2: 50.4%–80.6%). Risk of bias assessments (Physiotherapy Evidence Database score and funnel plots) did not explain heterogeneity. One significant relationship identified in the meta-regressions of SMD and balance exercise frequency, time and duration explained 2.1% of variance for the control centre of mass subgroup.ConclusionLimitations to this study included the variability in design of balance interventions, incomplete reporting of data and statistical heterogeneity. The design of balance exercise programmes provides inadequate explanation of the observed benefits of these interventions.

scholarly journals Systematic Reviews and Meta-Analysis in Spine Surgery—How Good Are They in Methodological Quality? A Systematic Review

2020 ◽  
pp. 219256822090681 ◽  
Author(s):  
Muthu Sathish ◽  
Ramakrishnan Eswar
Keyword(s):  
Systematic Review ◽  
Spine Surgery ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Cochrane Database ◽  
Critical Flaw ◽  
Meta Analyses

Study Design: Systematic review. Objectives: To assess the methodological quality of systematic reviews and meta-analyses in spine surgery over the past 2 decades. Materials and Methods: We conducted independent and in duplicate systematic review of the published systematic reviews and meta-analyses between 2000 and 2019 from PubMed Central and Cochrane Database pertaining to spine surgery involving surgical intervention. We searched bibliographies to identify additional relevant studies. Methodological quality was evaluated with AMSTAR score and graded with AMSTAR 2 criteria. Results: A total of 96 reviews met the eligibility criteria, with mean AMSTAR score of 7.51 (SD = 1.98). Based on AMSTAR 2 criteria, 13.5% (n = 13) and 18.7% (n = 18) of the studies had high and moderate level of confidence of results, respectively, without any critical flaws. A total of 29.1% (n = 28) of the studies had at least 1 critical flaw and 38.5% (n = 37) of the studies had more than 1 critical flaw, so that their results have low and critically low confidence, respectively. Failure to analyze the conflict of interest of authors of primary studies included in review and lack of list of excluded studies with justification were the most common critical flaw. Regression analysis demonstrated that studies with funding and studies published in recent years were significantly associated with higher methodological quality. Conclusion: Despite improvement in methodological quality of systematic reviews and meta-analyses in spine surgery in current decade, a substantial proportion continue to show critical flaws. With increasing number of review articles in spine surgery, stringent measures must be taken to adhere to methodological quality by following PRISMA and AMSTAR guidelines to attain higher standards of evidence in published literature.

scholarly journals Impact of heterogeneity and effect size on the estimation of the optimal information size: analysis of recently published meta-analyses

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e015888 ◽  
Author(s):  
Josep M Garcia-Alamino ◽  
Clare Bankhead ◽  
Carl Heneghan ◽  
Nicola Pidduck ◽  
Rafael Perera
Keyword(s):  
Systematic Reviews ◽  
Effect Size ◽  
Sequential Analysis ◽  
Trial Sequential Analysis ◽  
Size Analysis ◽  
Cochrane Reviews ◽  
Number Of Patients ◽  
Optimal Information ◽  
Meta Analyses ◽  
The Impact

ObjectiveTo estimate the proportion of systematic reviews that meet the optimal information size (OIS) and assess the impact heterogeneity and effect size have on the OIS estimate by type of outcome (eg, mortality, semiobjective or subjective).MethodsWe carried out searches of Medline and Cochrane to retrieve meta-analyses published in systematic reviews from 2010 to 2012. We estimated the OIS usingTrial Sequential Analysissoftware (TSA V.0.9) and based on several heterogeneity and effect size scenarios, stratifying by type of outcome (mortality/semiobjective/subjective) and by Cochrane/non-Cochrane reviews.ResultsWe included 137 meta-analyses out of 218 (63%) potential systematic reviews (one meta-analysis from each systematic review). Of these reviews, 83 (61%) were Cochrane and 54 (39%) non-Cochrane. The Cochrane reviews included a mean of 6.5 (SD 6.1) studies and the non-Cochrane included a mean of 13.2 (SD 10.2) studies. The mean number of patients was 2619.1 (SD 6245.8 or median 586.0) for the Cochrane and 19 888.5 (SD 32 925.7 or median 6566.5) patients for the non-Cochrane reviews. The percentage of systematic reviews that achieved the OIS for all-cause mortality outcome were 0% Cochrane and 25% for non-Cochrane reviews; for semiobjective outcome 17% for Cochrane and 46% for non-Cochrane reviews and for subjective outcome 45% for Cochrane and 72% for non-Cochrane reviews.ConclusionsThe number of systematic reviews that meet an optimal information size is low and varies depending on the type of outcome and the type of publication. Less than half of primary outcomes synthesised in systematic reviews achieve the OIS, and therefore the conclusions are subject to substantial uncertainty.

scholarly journals Mapping the Evidence on the Effectiveness of Telemedicine Interventions in Diabetes, Dyslipidemia, and Hypertension: An Umbrella Review of Systematic Reviews and Meta-Analyses

10.2196/16791 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e16791 ◽  
Author(s):  
Patrick Timpel ◽  
Sarah Oswald ◽  
Peter E H Schwarz ◽  
Lorenz Harst
Keyword(s):  
Clinical Outcomes ◽  
Systematic Reviews ◽  
Population Characteristics ◽  
Cochrane Library ◽  
Low Grade ◽  
Umbrella Review ◽  
Eligibility Criteria ◽  
Patients With Diabetes ◽  
Meta Analyses

Background Telemedicine is defined by three characteristics: (1) using information and communication technologies, (2) covering a geographical distance, and (3) involving professionals who deliver care directly to a patient or a group of patients. It is said to improve chronic care management and self-management in patients with chronic diseases. However, currently available guidelines for the care of patients with diabetes, hypertension, or dyslipidemia do not include evidence-based guidance on which components of telemedicine are most effective for which patient populations. Objective The primary aim of this study was to identify, synthesize, and critically appraise evidence on the effectiveness of telemedicine solutions and their components on clinical outcomes in patients with diabetes, hypertension, or dyslipidemia. Methods We conducted an umbrella review of high-level evidence, including systematic reviews and meta-analyses of randomized controlled trials. On the basis of predefined eligibility criteria, extensive automated and manual searches of the databases PubMed, EMBASE, and Cochrane Library were conducted. Two authors independently screened the studies, extracted data, and carried out the quality assessments. Extracted data were presented according to intervention components and patient characteristics using defined thresholds of clinical relevance. Overall certainty of outcomes was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. Results Overall, 3564 references were identified, of which 46 records were included after applying eligibility criteria. The majority of included studies were published after 2015. Significant and clinically relevant reduction rates for glycated hemoglobin (HbA1c; ≤−0.5%) were found in patients with diabetes. Higher reduction rates were found for recently diagnosed patients and those with higher baseline HbA1c (>8%). Telemedicine was not found to have a significant and clinically meaningful impact on blood pressure. Only reviews or meta-analyses reporting lipid outcomes in patients with diabetes were found. GRADE assessment revealed that the overall quality of the evidence was low to very low. Conclusions The results of this umbrella review indicate that telemedicine has the potential to improve clinical outcomes in patients with diabetes. Although subgroup-specific effectiveness rates favoring certain intervention and population characteristics were found, the low GRADE ratings indicate that evidence can be considered as limited. Future updates of clinical care and practice guidelines should carefully assess the methodological quality of studies and the overall certainty of subgroup-specific outcomes before recommending telemedicine interventions for certain patient populations.

scholarly journals Improving the usefulness of evidence concerning the effectiveness of implementation strategies for knowledge products in primary healthcare: Protocol for a series of systematic reviews

2020 ◽  
Author(s):  
Hervé Tchala Vignon Zomahoun ◽  
José Massougbodji ◽  
André Bussières ◽  
Aliki Thomas ◽  
Dahlia Kairy ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Primary Healthcare ◽  
Data Extraction ◽  
Healthcare Delivery ◽  
Implementation Strategies ◽  
Psychosocial Health ◽  
Performance Outcomes ◽  
Eligibility Criteria ◽  
Support Tool ◽  
Meta Analyses

Abstract Background : The literature on the implementation of knowledge products is extensive. However, this literature is still difficult to interpret for policymakers and other stakeholders when faced with choosing implementation strategies likely to bring about successful change in their health systems. This work has the particularity to examine the scope of this literature, and to clarify the effectiveness of implementation strategies for different knowledge products. Consequently, we aim to: 1) determine the strengths and weaknesses of existing literature overviews; 2) produce a detailed portrait of the literature on implementation strategies for various knowledge products; and 3) assess the effectiveness of implementation strategies for each knowledge product identified and classify them. Methods : We will use a three-phase approach consisting of a critical analysis of existing literature overviews, a systematic review of systematic reviews, and a series of systematic reviews and meta-analyses. We will follow the Cochrane Methodology for each of three phases. Our eligibility criteria are defined following a PICOS approach: Population , individuals or stakeholders participating in healthcare delivery, specifically, healthcare providers, caregivers, and end users; I ntervention, any type of strategy aiming to implement a knowledge product including, but not limited to, a decision support tool, a clinical practice guideline, a policy brief, or a decision-making tool, a one-pager, or a health intervention; Comparison, any comparator will be considered; Outcomes, Phases 1 and 2 – any outcome related to implementation strategies including, but not limited to, the measures of adherence/fidelity to the use of knowledge products, their acceptability, adoption, appropriateness, feasibility, adaptability, implementation costs, penetration/reach and sustainability; Phase 3 – any additional outcome related to patients (psychosocial, health behavioral, and clinical outcomes) or healthcare professionals (behavioral and performance outcomes); Setting , primary healthcare has to be covered. For each phase, two reviewers will independently perform the selection of studies, data extraction, and assess their methodological quality. We will analyze extracted data, and perform narrative syntheses and meta-analyses when possible. Discussion : Our results could inform not only the overviews’ methodology, but also the development of an online platform for the implementation strategies of knowledge products. This platform could be useful for stakeholders in implementation science.

scholarly journals Neutrophil counts and cancer prognosis: an umbrella review of systematic reviews and meta-analyses of observational studies

2018 ◽  
Author(s):  
Meghan A. Cupp ◽  
Margarita Cariolou ◽  
Ioanna Tzoulaki ◽  
Evangelou Evangelos ◽  
Antonio J. Berlanga-Taylor
Keyword(s):  
Systematic Reviews ◽  
Strong Evidence ◽  
Observational Studies ◽  
Cancer Prognosis ◽  
Small Study ◽  
List Type ◽  
Cancer Outcomes ◽  
Umbrella Review ◽  
Eligibility Criteria ◽  
Meta Analyses

ABSTRACTOBJECTIVETo evaluate the strength and validity of evidence on the association between the neutrophil to lymphocyte ratio (NLR) or tumour-associated neutrophils (TAN) and cancer prognosis.DESIGNUmbrella review of systematic reviews and meta-analyses of observational studies.DATA SOURCESMedline, EMBASE, and Cochrane Database of Systematic Reviews.ELIGIBILITY CRITERIASystematic reviews or meta-analyses of observational studies evaluating the association between NLR or TAN and specific cancer outcomes related to disease progression or survival.DATA SYNTHESISThe available evidence was graded as strong, highly suggestive, suggestive, or weak through the application of pre-set grading criteria. For each included meta-analysis, the grading criteria considered the significance of the random effects estimate, the significance of the largest included study, the number of studies and individuals included, the heterogeneity between included studies, the 95% prediction intervals, presence of small study effects, excess significance and credibility ceilings.RESULTS239 meta-analyses investigating the association between NLR or TAN and cancer outcomes were identified from 57 published studies meeting the eligibility criteria, with 81 meta-analyses from 36 studies meeting the criteria for inclusion. No meta-analyses found a hazard ratio (HR) in the opposite direction of effect (HR<1). When assessed for significance and bias related to heterogeneity and small study effects, only three (4%) associations between NLR and outcomes in gastrointestinal and nasopharyngeal cancers were supported by strong evidence.CONCLUSIONDespite many publications exploring the association between NLR and cancer prognosis, the evidence is limited by significant heterogeneity and small study effects. There is a lack of evidence on the association between TAN and cancer prognosis, with all nine associations identified arising from the same study. Further research is required to provide strong evidence for associations between both TAN and NLR and poor cancer prognosis.REGISTRATIONThis umbrella review is registered on PROSPERO (CRD42017069131)FUNDINGMedical Research CouncilCOPYRIGHTOpen access article under terms of CC BYSHORT TITLENeutrophils and cancer prognosis: an umbrella reviewKEY RESULTWhen assessed for significance and bias related to heterogeneity and small study effects, only three (4%) associations between NLR and overall survival and progression-free survival in gastrointestinal and nasopharyngeal cancers were supported by strong evidence.WHAT THIS PAPER ADDSWHAT IS ALREADY KNOWN ON THE TOPICNeutrophil counts have been linked to the progression of cancer due to their tumourigenic role in the cancer microenvironment.Numerous meta-analyses and individual studies have explored the association between neutrophil counts and cancer outcomes for a variety of cancer sites, leading to a large body of evidence with variable strength and validity.Uncertainty exists around the association between neutrophils and cancer outcomes, depending on the site, outcome and treatments considered.WHAT THIS STUDY ADDSAll meta-analyses included in this review indicated an association between high neutrophil counts and poor cancer prognosis.There is strong evidence supporting the association between the neutrophil to lymphocyte ratio and poor cancer prognosis in some respiratory and gastrointestinal cancers.Further research is required to strengthen the existing body of evidence, particularly for the association between tumour-associated neutrophils and cancer outcomes.

Anatomy of Ankle Syndesmotic Ligaments: A Systematic Review of Cadaveric Studies

2020 ◽  
Vol 13 (4) ◽  
pp. 341-350
Author(s):  
Akilesh Anand Prakash
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Surgical Management ◽  
Systematic Reviews ◽  
Current Understanding ◽  
Study Quality ◽  
Quality Appraisal ◽  
Eligibility Criteria ◽  
Diagnosis And Management ◽  
Meta Analyses

Diagnosis and management of isolated syndesmotic injuries are controversial and highly debated. Hence, the aim of this study is to explore and gain the current understanding pertaining to detailed anatomy of syndesmotic ligaments through a systematic review of published cadaveric studies. A systematic review was conducted online for literature published in English using PubMed and Google Scholar, as per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, up to April 30, 2019. Predefined eligibility criteria were applied, and the data thus compiled was analyzed. Study quality was assessed based on Quality Appraisal for Cadaveric Studies (QUACS) scale. A total of 12 studies reporting 365 ankles were included in this review. Considerable inconsistency in the naming and description of syndesmotic ligaments was observed, with only 2 studies reporting the vasculature of the ligaments. Hence further investigation of the anatomy of the syndesmotic ligaments is recommended so as to better inform clinical practice, as awareness of anatomy is critical for assessment, healing, and successful surgical management. Levels of Evidence: Level III: Systematic review of anatomical dissections

scholarly journals Eficácia da mobilização articular em pacientes idosos com dor cervical crônica: uma revisão sistemática

2021 ◽  
Vol 10 (15) ◽  
pp. e283101523037
Author(s):  
Antônia Neusa Lima Cardoso ◽  
Maria da Cruz Rodrigues da Silva Sousa ◽  
Patrícia Lima Ventura
Keyword(s):  
Chronic Pain ◽  
Neck Pain ◽  
Manual Therapy ◽  
Systematic Reviews ◽  
National Library ◽  
Evidence Database ◽  
Meta Analyses

Objetivos: Identificar a eficácia da mobilização articular em pacientes idosos com dor cervical crônica. Métodos: O estudo foi baseado em uma revisão sistemática baseada no Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), foi conduzida nas seguintes bases de dados eletrônicas: PEDro (Physiotherapy Evidence Database), PubMed (National Library of Medicine, EUA) e a Central (a base de dados de ECAs da colaboração de Cochrane Libary). A pesquisa foi realizada utilizando os descritores: “Terapia manual”. “Dor cervical”, “Dor crônica”, “Idoso” entre as palavras chaves com o propósito de otimizar os resultados e seus descritores em inglês: “Manual therapy”, “Neck pain”, “Chronic pain”, “ Aged” e o cruzamento das palavras através dos operadores booleanos “AND” e “OR”. Resultados: Os resultados demonstraram que a técnica de mobilização articular foram eficazes na melhora da dor cervical crônica.  Conclusão: A técnica da mobilização articular em paciente idoso com dor cervical, comprova a diminuição da dor e aumento da capacidade funcional, proporcionando uma melhor qualidade de vida e apresentando eficácia à curto e longo prazo pela melhora do quadro clinico da dor cervical.

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