scholarly journals Effectiveness of an educational and physical program in reducing accompanying symptoms in subjects with head and neck pain: a workplace controlled trial

2011 ◽  
Vol 12 (3) ◽  
pp. 339-345 ◽  
Author(s):  
Eugenia Rota ◽  
Andrea Evangelista ◽  
Giovannino Ciccone ◽  
Luca Ferrero ◽  
Alessandro Ugolini ◽  
...  
Author(s):  
Maruti Ram Gudavalli ◽  
Vikas Yadav ◽  
Robert Vining ◽  
Michael Seidman ◽  
Stacie Salsbury ◽  
...  

Objective: Neck pain is a prevalent musculoskeletal (MSK) complaint and costly societal burden. Doctors of chiropractic (DCs) provide manual therapies for neck pain patients to relieve discomfort and improve physical function. Manual cervical distraction (MCD) is a chiropractic procedure for neck pain. During MCD, the patient lies face down on a specially designed chiropractic table. The DC gently moves the head and neck in a cephalic direction while holding a gentle broad manual contact over the posterior neck, to create traction effects. MCD traction force profiles vary between clinicians making standardization of treatment delivery challenging. This paper reports on a bioengineering technology developed to provide clinicians with auditory and graphical feedback on the magnitude of cervical traction forces applied during MCD to simulated patients during training for a randomized controlled trial (RCT). Methods: The Cox flexion-distraction chiropractic table is designed with a moveable headpiece. The table allows for long axis horizontal movement of the head and neck, while the patient’s trunk and legs rest on fixed table sections. We instrument-modified this table with three-dimensional force transducers to measure the traction forces applied by the doctor. Motion Monitor software collects data from force transducers. The software displays the magnitude of traction forces graphically as a function of time. Real-time audible feedback produces a steady tone when measured traction forces are <20N, no tone when forces range between 20–50N, and an audible tone when forces exceed 50N. Peer debriefing from simulated patients reinforces traction force data from the bioengineering technology. Results: We used audible and graphical feedback to train and certify DCs to apply traction forces to the cervical spine of simulated patients within three specific ranges. This technology supports a RCT designed to assess the ability of clinicians to deliver MCD within specified force ranges to patients randomized to different force dosages as an intervention. Future applications may include training chiropractic students and clinicians to deliver the MCD treatment.


Author(s):  
I Rezaei ◽  
M Razeghi ◽  
S Ebrahimi ◽  
S Kayedi ◽  
A Rezaeian Zadeh

Background: Despite the potential benefits of virtual reality technology in physical rehabilitation, only a few studies have evaluated the efficacy of this type of treatment in patients with neck pain.Objective: The aim of this study was to compare the effects of virtual reality training (VRT) versus conventional proprioceptive training (CPT) in patients with neck pain.Methods: Forty four participants with nonspecific chronic neck pain were randomly assigned to VRT or CPT in this assessor-blinded clinical trial. A novel videogame called Cervigame® was designed for VRT. It comprises of 50 stages divided into unidirectional and two-directional stages ordered from easy to hard. CPT consisted of eye-follow, gaze stability, eye-head coordination and position and movement sense training. Both groups completed 8 training sessions over 4 weeks. Visual analogue scale score, neck disability index and Y-balance test results were recorded at baseline, immediately after and 5 weeks post-intervention. Mixed repeated measure ANOVA was used to analyze differences between mean values for each variable at an alpha level of 0.05.Results: There were significant improvements in all variables in both groups immediately after and 5 weeks after the intervention. Greater improvements were observed in the visual analogue scale and neck disability index scores in VRT group, and the results for all directions in Y-balance test were similar in both groups. No side effects were reported.Conclusion: Improvements in neck pain and disability were greater in VRT than CPT group. Cervigame® is a potentially practical tool for rehabilitation in patients with neck pain.


Author(s):  
Pierre Langevin ◽  
Philippe Fait ◽  
Pierre Frémont ◽  
Jean-Sébastien Roy

Abstract Background Mild traumatic brain injury (mTBI) is an acknowledged public health problem. Up to 25% of adult with mTBI present persistent symptoms. Headache, dizziness, nausea and neck pain are the most commonly reported symptoms and are frequently associated with cervical spine and vestibular impairments. The most recent international consensus statement (2017 Berlin consensus) recommends the addition of an individualized rehabilitation approach for mTBI with persistent symptoms. The addition of an individualized rehabilitation approach including the evaluation and treatment of cervical and vestibular impairments leading to symptoms such as neck pain, headache and dizziness is, however, recommended based only on limited scientific evidence. The benefit of such intervention should therefore be further investigated. Objective To compare the addition of a 6-week individualized cervicovestibular rehabilitation program to a conventional approach of gradual sub-threshold physical activation (SPA) alone in adults with persistent headache, neck pain and/or dizziness-related following a mTBI on the severity of symptoms and on other indicators of clinical recovery. We hypothesize that such a program will improve all outcomes faster than a conventional approach (between-group differences at 6-week and 12-week). Methods In this single-blind, parallel-group randomized controlled trial, 46 adults with subacute (3 to12 weeks post-injury) persistent mTBI symptoms will be randomly assigned to: 1) a 6-week SPA program or 2) SPA combined with a cervicovestibular rehabilitation program. The cervicovestibular rehabilitation program will include education, cervical spine manual therapy and exercises, vestibular rehabilitation and home exercises. All participants will take part in 4 evaluation sessions (baseline, week 6, 12 and 26) performed by a blinded evaluator. The primary outcome will be the Post-Concussion Symptoms Scale. The secondary outcomes will be time to clearance to return to function, number of recurrent episodes, Global Rating of Change, Numerical Pain Rating Scale, Neck Disability Index, Headache Disability Inventory and Dizziness Handicap Inventory. A 2-way ANOVA and an intention-to-treat analysis will be used. Discussion Controlled trials are needed to determine the best rehabilitation approach for mTBI with persistent symptoms such as neck pain, headache and dizziness. This RCT will be crucial to guide future clinical management recommendations. Trial registration ClinicalTrials.gov Identifier - NCT03677661, Registered on September, 15th 2018.


2021 ◽  
Vol 9 (1) ◽  
pp. 100304
Author(s):  
Laura E.R. Schutte ◽  
Heleen C. Melissant ◽  
Femke Jansen ◽  
Birgit I. Lissenberg-Witte ◽  
C. René Leemans ◽  
...  

Work ◽  
2021 ◽  
pp. 1-8
Author(s):  
Fabiana Foltran Mescollotto ◽  
Érica Brito Gonçalves ◽  
Ester Moreira de Castro Carletti ◽  
Ana Beatriz Oliveira ◽  
Elisa Bizetti Pelai ◽  
...  

Background: Excessive use of smartphones may be associated with behavioral and physical health changes and might cause musculoskeletal alterations in the head and neck region. Objective: To evaluate the prevalence of smartphone addiction in college students and its correlation with symptoms of head and neck pain and masticatory and trapezius muscle activity while resting, before and after smartphone use. Methods: Twenty university students participated in the study. They answered the Smartphone Addiction Scale and the Fonseca Anamnestic Index. Next, the participants were seated and prepared for electromyography through the placement of surface electrodes on the masseter, temporal, and trapezius muscles. Rest condition data were collected for 10 seconds before and after 30 minutes of smartphone use. Results: The results showed that 35% of the evaluated individuals were classified as smartphone addicted and 35% reported no head or neck pain in the previous 30 days. There was no association between smartphone use and head and neck pain. In the electromyography, there was an increase in RMS values after smartphone use in the right and left masseter muscles and the left trapezius. Conclusion: College students presented a high prevalence of smartphone addiction and head and neck pain, but these were not statistically associated. There was a change in muscle activity only in the right trapezius muscles before and after 30 minutes of smartphone use. These findings are contrary to the current belief that the use of smartphones correlates with pain in the neck region and changes in the electrical muscle activity, leading to fatigue in the cervical muscles.


Author(s):  
N. C. Kuipers ◽  
B. J. de Kleijn ◽  
J. Wedman ◽  
B. F. A. M. van der Laan ◽  
B. E. C. Plaat ◽  
...  

Abstract Purpose New energy-based sutureless vessel ligation devices, such as the Thunderbeat (Olympus Medical Systems Corp., Tokyo, Japan), could reduce operative time and limit blood loss in head and neck surgery; however, efficacy and safety in major head and neck surgery have not been investigated in a prospective, randomized study. Methods This prospective, double-arm, randomized controlled trial consisted of two parts: total laryngectomy (TL) and neck dissection (ND). Thirty patients planned for TL were randomized in two groups. For the ND part, forty-two operative sides were likewise randomized. In both parts, Thunderbeat was used in addition to the standard instrumentation in the intervention groups, while only standard instrumentation was used in the control groups. Primary outcome values were blood loss, operative time and complication rate. Results For the TL part there was no difference in mean blood loss (p = 0.062), operative time (p = 0.512) and complications (p = 0.662) between both hemostatic techniques. For the neck dissection part, there was a reduction in blood loss (mean 210 mL versus 431 mL, p = 0.046) and in operative time (median 101 (IQR 85–130) minutes versus 150 (IQR 130–199) minutes, p = 0.014) when Thunderbeat was used. There was no difference in complication rate between both hemostatic systems (p = 0.261). Conclusion The Thunderbeat hemostatic device significantly reduces operative blood loss and operative time for neck dissections, without increase in complications. In TL, blood loss using Thunderbeat was comparable with the standard technique, but the operative time tended to be shorter. Trial registration UMCG Research Register, Reg. no. 201700041, date of registration: 18/1/2017


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