Effectiveness of Neural Mobilisation Techniques in the Management of Musculoskeletal Neck Disorders with Nerve-Related Symptoms: A Systematic Review and Meta-Analysis with a Mapping Report

Pain Medicine ◽  
2021 ◽  
Author(s):  
Clovis Varangot-Reille ◽  
Ferran Cuenca-Martínez ◽  
Alberto Arribas-Romano ◽  
Rodrigo Bertoletti-Rodríguez ◽  
Álvaro Gutiérrez-Martín ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Pain Intensity ◽  
Range Of Motion ◽  
Meta Analysis ◽  
Cervical Range Of Motion ◽  
Arm Pain ◽  
Neck Disorders ◽  
Mean Differences ◽  
And Function

Abstract Objective The objective was to assess the effectiveness of neural mobilisation (NM) techniques in the management of musculoskeletal neck disorders with nerve-related symptoms (MND-NRS). Methods We conducted a systematic review with meta-analysis, using pain intensity, disability, perceived function, cervical range of motion and mechanosensitivity as the main outcome measures. Results The systematic review included 22 studies (n = 978). More favourable outcomes were observed for NM on pain intensity compared with control interventions (standardised mean differences (SMDs) −0.92; 95% CI − 1.66-−0.18), but not compared with other treatments (OTs) (SMD 1.06; 95% CI − 0.02-2.15). Regarding neck pain intensity, no significant differences were found in favour of NM compared with OTs (SMD 0.37; 95% CI − 0.35-1.1). However, between-treatment differences were found in favour of OT on arm-pain intensity (SMD 0.57; 95% CI 0.08-1.05). In addition, the grouped MA did not show statistically significant differences between NM and OT outcomes on the cervical range of motion (SMD 0.16; 95% CI − 0.06-0.38). However, compared with no intervention, NM was associated with significantly improved outcomes in cervical rotation (SMD 0.91; 95% CI 0.61-1.22). Similar results were found regarding disability (SMD −0.08; 95% CI − 0.36-−0.20, and SMD −1.44; 95% CI − 2.28-−0.6, respectively). Finally, NM was associated with more favourable outcomes on mechanosensitivity compared with OT (SMD 0.79; 95% CI 0.15-1.42) and greater improvements in function compared with no intervention (SMD 0.89; 95% CI 0.16-1.62). Conclusions NM appeared to be effective to improve overall pain intensity when embedded in a physiotherapy treatment in the management of MND-NRS. When compared with no intervention, it was effective to improve neck rotation, disability, and function. However, it was not superior to other types of treatments in improving overall pain intensity, neck pain intensity, arm pain intensity, cervical range of motion and disability, except for mechanosensitivity.

To What Degree Does Active Cervical Range of Motion Differ Between Patients With Neck Pain, Patients With Whiplash, and Those Without Neck Pain? A Systematic Review and Meta-Analysis

2017 ◽  
Vol 98 (7) ◽  
pp. 1407-1434 ◽  
Author(s):  
Martijn S. Stenneberg ◽  
Michiel Rood ◽  
Rob de Bie ◽  
Maarten A. Schmitt ◽  
Erik Cattrysse ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Range Of Motion ◽  
Meta Analysis ◽  
Cervical Range Of Motion ◽  
Pain Patients

Effects of electromyographic biofeedback interventions for shoulder pain and function: Systematic review and meta-analysis

2021 ◽  
pp. 026921552199095
Author(s):  
Danilo Harudy Kamonseki ◽  
Letícia Bojikian Calixtre ◽  
Rodrigo Py Gonçalves Barreto ◽  
Paula Rezende Camargo
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Confidence Interval ◽  
Shoulder Pain ◽  
Meta Analysis ◽  
Quality Of Evidence ◽  
Electromyographic Biofeedback ◽  
Mean Differences ◽  
And Function

Objective: To systematically review the effectiveness of electromyographic biofeedback interventions to improve pain and function of patients with shoulder pain. Design: Systematic review of controlled clinical trials. Literature search: Databases (Medline, EMBASE, CINAHL, PEDro, CENTRAL, Web of Science, and SCOPUS) were searched in December 2020. Study selection criteria: Randomized clinical trials that investigated the effects of electromyographic biofeedback for individuals with shoulder pain. Patient-reported pain and functional outcomes were collected and synthesized. Data synthesis: The level of evidence was synthesized using GRADE and Standardized Mean Differences and 95% confidence interval were calculated using a random-effects inverse variance model for meta-analysis. Results: Five studies were included with a total sample of 272 individuals with shoulder pain. Very-low quality of evidence indicated that electromyographic biofeedback was not superior to control for reducing shoulder pain (standardized mean differences = −0.21, 95% confidence interval: −0.67 to 0.24, P = 0.36). Very-low quality of evidence indicated that electromyographic biofeedback interventions were not superior to control for improving shoulder function (standardized mean differences = −0.11, 95% confidence interval: −0.41 to 0.19, P = 0.48). Conclusion: Electromyographic biofeedback may be not effective for improving shoulder pain and function. However, the limited number of included studies and very low quality of evidence does not support a definitive recommendation about the effectiveness of electromyographic biofeedback to treat individuals with shoulder pain.

Immediate effects of thoracic manipulation on cervical joint position sense in individuals with mechanical neck pain: A randomized controlled trial

2021 ◽  
pp. 1-9
Author(s):  
Emin Ulas Erdem ◽  
Banu Ünver ◽  
Eda Akbas ◽  
Gizem Irem Kinikli
Keyword(s):  
Neck Pain ◽  
Range Of Motion ◽  
Position Sense ◽  
Joint Position Sense ◽  
Position Error ◽  
Cervical Region ◽  
Joint Position ◽  
Cervical Range Of Motion ◽  
Arm Pain ◽  
Neck Function

BACKGROUND: Performing thoracic manipulations for neck pain can result in immediate improvements in neck function. OBJECTIVE: The aim of this study was to investigate the immediate effects of thoracic manipulation on cervical joint position sense and cervical range of motion in individuals with chronic mechanical neck pain. METHODS: Eighty male volunteers between 18–25 years and having chronic or recurrent neck or shoulder pain of at least 3 months duration with or without arm pain were randomized into two groups: Thoracic Manipulation Group (TMG:50) and Control Group (CG:30), with a pretest-posttest experimental design. The TMG was treated with thoracic extension manipulation while the CG received no intervention. Cervical joint position error and cervical range of motion of the individuals were assessed at baseline and 5 minutes later. RESULTS: There was no difference in demographic variables such as age (p= 0.764), Body Mass Index (p= 0.917) and Neck Pain Disability Scale (NPDS) scores (p= 0.436) at baseline outcomes between TMG and CGs. Joint position error outcomes between the two groups following intervention were similar in all directions at 30 and 50 degrees. Differences in range of motion following intervention in neck flexion (p< 0.001) and right rotation (p= 0.004) were higher in TMG compared to CG. CONCLUSIONS: A single session of thoracic manipulation seems to be inefficient on joint position sense in individuals with mild mechanical neck pain. However, thoracic manipulation might be an effective option to increase flexion and rotation of the cervical region as an adjunctive to treatment.

scholarly journals Is Dry Needling Effective When Combined with Other Therapies for Myofascial Trigger Points Associated with Neck Pain Symptoms? A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-24
Author(s):  
César Fernández-De-Las-Peñas ◽  
Gustavo Plaza-Manzano ◽  
Jorge Sanchez-Infante ◽  
Guido F Gómez-Chiguano ◽  
Joshua A Cleland ◽  
...  
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Range Of Motion ◽  
Dry Needling ◽  
Short Term ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Cervical Range Of Motion ◽  
Pressure Pain Thresholds

Objective. To evaluate the effects of combining dry needling with other physical therapy interventions versus the application of the other interventions or dry needling alone applied over trigger points (TrPs) associated to neck pain. Databases and Data Treatment. Electronic databases were searched for randomized controlled trials where at least one group received dry needling combined with other interventions for TrPs associated with neck pain. Outcomes included pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion. The risk of bias (RoB) was assessed using the Cochrane risk of bias tool, methodological quality was assessed with PEDro score, and the quality of evidence was assessed by using the GRADE approach. Between-groups mean differences (MD) and standardized mean difference (SMD) were calculated. Results. Eight trials were included. Dry needling combined with other interventions reduced pain intensity at short-term (SMD −1.46, 95% CI −2.25 to −0.67) and midterm (SMD −0.38, 95% CI −0.74 to −0.03) but not immediately after or at long-term compared with the other interventions alone. A small effect on pain-related disability was observed at short-term (SMD −0.45, 95% CI −0.87 to −0.03) but not at midterm or long-term. The inclusion of dry needling was also effective for improving pressure pain thresholds only at short-term (MD 112.02 kPa, 95% CI 27.99 to 196.06). No significant effects on cervical range of motion or pain catastrophism were observed. Conclusion. Low-to-moderate evidence suggests a positive effect to the combination of dry needling with other interventions for improving pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion in people with neck pain associated with TrPs at short-term. No midterm or long-term effects were observed.

scholarly journals Effectiveness of Dry Needling for Myofascial Trigger Points Associated with Neck Pain Symptoms: An Updated Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (10) ◽  
pp. 3300
Author(s):  
Marcos J. Navarro-Santana ◽  
Jorge Sanchez-Infante ◽  
César Fernández-de-las-Peñas ◽  
Joshua A. Cleland ◽  
Patricia Martín-Casas ◽  
...  
Keyword(s):  
Neck Pain ◽  
Range Of Motion ◽  
Trigger Points ◽  
Dry Needling ◽  
Short Term ◽  
Pressure Pain ◽  
Cervical Range Of Motion ◽  
Pressure Pain Thresholds ◽  
Mean Differences ◽  
Pain Symptoms

Our aim was to evaluate the effect of dry needling alone as compared to sham needling, no intervention, or other physical interventions applied over trigger points (TrPs) related with neck pain symptoms. Randomized controlled trials including one group receiving dry needling for TrPs associated with neck pain were identified in electronic databases. Outcomes included pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion. The Cochrane risk of bias tool and the Physiotherapy Evidence Database (PEDro) score were used to assessed risk of bias (RoB) and methodological quality of the trials. The quality of evidence was assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Between-groups mean differences (MD) and standardized mean differences (SMD) were calculated (3) Twenty-eight trials were finally included. Dry needling reduced pain immediately after (MD −1.53, 95% CI −2.29 to −0.76) and at short-term (MD −2.31, 95% CI −3.64 to −0.99) when compared with sham/placebo/waiting list/other form of dry needling and, also, at short-term (MD −0.51, 95% CI −0.95 to −0.06) compared with manual therapy. No differences in comparison with other physical therapy interventions were observed. An effect on pain-related disability at the short-term was found when comparing dry needing with sham/placebo/waiting list/other form of dry needling (SMD −0.87, 95% CI −1.60 to −0.14) but not with manual therapy or other interventions. Dry needling was effective for improving pressure pain thresholds immediately after the intervention (MD 55.48 kPa, 95% CI 27.03 to 83.93). No effect on cervical range of motion of dry needling against either comparative group was found. No between-treatment effect was observed in any outcome at mid-term. Low to moderate evidence suggests that dry needling can be effective for improving pain intensity and pain-related disability in individuals with neck pain symptoms associated with TrPs at the short-term. No significant effects on pressure pain sensitivity or cervical range of motion were observed.

Pain-Related Fear, Pain Intensity and Function in Individuals With Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 20 (12) ◽  
pp. 1394-1415 ◽  
Author(s):  
Javier Martinez-Calderon ◽  
Mar Flores-Cortes ◽  
Jose Miguel Morales-Asencio ◽  
Alejandro Luque-Suarez
Keyword(s):  
Systematic Review ◽  
Pain Intensity ◽  
Musculoskeletal Pain ◽  
Meta Analysis ◽  
Chronic Musculoskeletal Pain ◽  
And Function

Efficacy of dry needling as an adjunct to manual therapy for patients with chronic mechanical neck pain: a randomised clinical trial

2020 ◽  
Vol 38 (4) ◽  
pp. 244-254
Author(s):  
Gracia M. Gallego-Sendarrubias ◽  
David Rodríguez-Sanz ◽  
Cesar Calvo-Lobo ◽  
Jose Luis Martín
Keyword(s):  
Clinical Trial ◽  
Neck Pain ◽  
Pain Intensity ◽  
Range Of Motion ◽  
Manual Therapy ◽  
Intervention Group ◽  
Control Group ◽  
Dry Needling ◽  
Cervical Range Of Motion ◽  
Neck Disability

Objective: Chronic mechanical neck pain is associated with musculoskeletal tissue alterations. Active trigger points in the trapezius and levator scapulae muscles are common in patients with chronic mechanical neck pain. In this study, we compared the effect of dry needling (DN) combined with manual therapy (MT) to sham dry needling (SDN) combined with MT on pain, pain pressure threshold, cervical range of motion and neck disability in patients with chronic mechanical neck pain. Methods: A randomised, single-blind clinical trial was carried out involving 101 participants with chronic mechanical neck pain, divided into an intervention group (DN+MT, n=47) and a control group (SDN+MT, n=54). Participants received two treatment sessions. The intervention group received MT in conjunction with DN of the most mechano-sensitive myofascial trigger point (MTrP). The control group received MT plus SDN. Outcomes measures were: pain intensity (numeric pain rating scale, NPRS), pressure pain threshold (PPT), cervical range of motion (ROM) and neck disability (neck disability index, NDI). Results: This study found that between-group differences in pain intensity were statistically significant (P<0.01). Pain decreased after the first intervention in the DN+MT group (3.47±0.25 points on the NPRS) and even more so after the second intervention (4.76±0.24 points on the NPRS). After 4 weeks, pain intensity differed from baseline by 4.89±0.27 points on the NPRS. Statistically significant differences (P<0.001) in PPT were also found between the intervention group and the control group. After the first intervention, a significant increase in PPT within the DN+MT group (3.09±0.8 kg/cm2) was observed. Cervical ROM also showed highly statistically significant differences. After 4 weeks, a statistically significant reduction (P<0.001) in NDI was observed between the two groups. Conclusion: Our results show that DN+MT is efficacious and significantly better than SDN+MT at reducing pain intensity, PPT, neck disability and cervical ROM in patients with chronic mechanical neck pain. Level of evidence: 1b.

scholarly journals The Role of Anterior Cervical Discectomy and Fusion on Relieving Axial Neck Pain in Patients With Single-Level Disease: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 10 (3) ◽  
pp. 312-323
Author(s):  
Colby Oitment ◽  
Tracy Watson ◽  
Victor Lam ◽  
Mohammed Aref ◽  
Alex Koziarz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Meta Analysis ◽  
Neck Disability Index ◽  
Clinically Significant ◽  
Mean Differences ◽  
Neck Disability ◽  
Axial Neck Pain

Study Design: Systematic review and meta-analysis. Objectives: This study aims to evaluate the effects of anterior cervical decompression and fusion (ACDF) on axial neck pain in adult patients receiving surgery for myelopathy, radiculopathy, or a combination of both. Methods: Two independent reviewers completed a librarian-assisted search of 4 databases. Visual Analogue Scale (VAS) and Neck Disability Index (NDI) scores were extracted preoperatively and at 3, 6, 12, 24, 36, 48, and 48+ months postoperatively for ACDF groups and pooled using a random-effects model. Results: Of 17 850 eligible studies, 37 were included for analysis, totaling 2138 patients analyzed with VAS and 2477 with NDI score. Individual VAS mean differences were reduced at 6 weeks (−2.5 [95% confidence interval (CI): −3.5 to −1.6]), 3 months (−2.9 [−3.7 to −2.2]), 6 months (−3.2 [−3.9 to −2.6]), 12 months (−3.7 [−4.3 to −3.1]), 24 months (−4.0 [−4.4 to −3.5]), 48 months (−4.6 [−5.5 to −3.8]), and >48 months (−4.7 [−5.8 to −3.6]) follow-up ( P < .0001 for all endpoints). Individual NDI mean differences were reduced at 6 weeks (−26.7 [−30.9 to −22.6]), 3 months (−29.8 [−32.7 to −26.8]), 6 months (−31.2 [−35.5 to −26.8)], 12 months (−29.3 [−33.2 to −25.4]), 24 months (−28.9 [−32.6 to −25.2]), 48 months (−33.1 [−37.4 to −28.7]), and >48 months (−37.6 [−45.9 to −29.3]) follow-up ( P < .0001 for all endpoints). Conclusions: ACDF is associated with a significant reduction in axial neck pain compared with preoperative values in patients being treated specifically for myelopathy or radiculopathy. This influences the preoperative discussions surgeons may have with patients regarding their expectations for surgery. The effects seen are stable over time and represent a clinically significant reduction in axial neck pain.

scholarly journals Effects of motor imagery on strength, range of motion, physical function, and pain intensity in patients with total knee arthroplasty: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Raúl Ferrer-Peña ◽  
Ferran Cuenca-Martínez ◽  
Mario Romero-Palau ◽  
Luis Miguel Flores-Román ◽  
Pablo Arce-Vázquez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Pain Intensity ◽  
Range Of Motion ◽  
Physical Function ◽  
Motor Imagery ◽  
Knee Arthroplasty ◽  
Meta Analysis ◽  
Total Knee
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