Shi’s Daoyin Therapy for Neck Pain: A Randomized Controlled Trial

Objective. To compare the immediate and short term effectiveness of Shi’s Daoyin therapy (DT) rather than the Melbourne Protocol (MP) in terms of pain, mobility, and isometric strength of cervical muscles in nonacute nonspecific neck pain patients. Material and Methods. A total of 114 nonacute nonspecific neck pain patients aged 20~50 years were recruited and randomly assigned to be treated by either Shi’s DT or the MP. 56 cases and 54 cases received treatment for 3 weeks and were evaluated before and after intervention and at 3-week follow-up in Shi’s DT group and MP group, respectively. The outcome measures were Chinese version of the Neck Disability Index (NDI), cervical range of motion (ROM), maximal voluntary isometric force (MVIF), and pain intensity (Numeric Pain Rating Scale, NPRS). Results. All outcomes of both groups showed statistically significant improvements after the intervention and at 3-week follow-up (P < 0.05), while no statistically significant difference was found in NDI between groups. When followed up after 3 weeks, the ROM in axial rotation was significantly greater in the Shi’s DT group (P < 0.05), and the NPRS in the Shi’s DT group was significantly lower than the MP group (P < 0.05). At the end of the treatment period, the MVIF in lateral bending in the Shi’s DT group had a lower value (P = 0.044) than in the MP group, but there was no significant difference in flexion and extension between the two groups. Conclusions. Both Shi’s DT and MP groups demonstrated an obvious reduction in pain intensity and improvements in neck mobility after a short term follow-up period. The improvement of Shi’s DT in disability and pain during functional activities is generally similar to that of the MP for the treatment of nonacute nonspecific neck pain.

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Is a combined programme of manual therapy and exercise more effective than usual care in patients with non-specific chronic neck pain? A randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215519876675 ◽

2019 ◽

Vol 33 (12) ◽

pp. 1908-1918 ◽

Cited By ~ 1

Author(s):

Lucia Domingues ◽

Fernando Manuel Pimentel-Santos ◽

Eduardo Brazete Cruz ◽

Ana Cristina Sousa ◽

Ana Santos ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Neck Pain ◽

Usual Care ◽

Pain Intensity ◽

Manual Therapy ◽

Rating Scale ◽

Controlled Trial ◽

Chronic Neck Pain ◽

Randomized Controlled

Objective: The aim of this study was to compare the effectiveness of a combined intervention of manual therapy and exercise (MET) versus usual care (UC), on disability, pain intensity and global perceived recovery, in patients with non-specific chronic neck pain (CNP). Design: Randomized controlled trial. Setting: Outpatient care units. Subjects: Sixty-four non-specific CNP patients were randomly allocated to MET ( n = 32) or UC ( n = 32) groups. Interventions: Participants in the MET group received 12 sessions of mobilization and exercise, whereas the UC group received 15 sessions of usual care in physiotherapy. Main measures: The primary outcome was disability (Neck Disability Index). The secondary outcomes were pain intensity (Numeric Pain Rating Scale) and global perceived recovery (Patient Global Impression Change). Patients were assessed at baseline, three weeks, six weeks (end of treatment) and at a three-month follow-up. Results: Fifty-eight participants completed the study. No significant between-group difference was observed on disability and pain intensity at baseline. A significant between-group difference was observed on disability at three-week, six-week and three-month follow-up (median (P25–P75): 6 (3.25–9.81) vs. 15.5 (11.28–20.75); P < 0.001), favouring the MET group. Regarding pain intensity, a significant between-group difference was observed at six-week and three-month follow-up (median (P25–P75): 2 (1–2.51) vs. 5 (3.33–6); P < 0.001), with superiority of effect in MET group. Concerning the global perceived recovery, a significant between-group difference was observed only at the three-month follow-up ( P = 0.001), favouring the MET group. Conclusion: This study’s findings suggest that a combination of manual therapy and exercise is more effective than usual care on disability, pain intensity and global perceived recovery.

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Effectiveness of Progressive Resisted Exercise along with Conventional Exercise and Conventional Exercise Program alone in Subjects with Text Neck Syndrome

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i59b34412 ◽

2021 ◽

pp. 536-542

Author(s):

Divya Jain ◽

Swapna Jawade ◽

Neha Chitale

Keyword(s):

Neck Pain ◽

Pain Intensity ◽

Conventional Therapy ◽

Rating Scale ◽

Neck Disability Index ◽

Exercise Program ◽

Pain Rating ◽

Numerical Pain Rating Scale ◽

Neck Disability ◽

Pain Rating Scale

Background: "Text neck" is a term coined to describe the posture created by leaning forward for lengthy periods of time, such as when reading and texting on a cellphone which has been linked to stress injuries. Neck pain, upper back discomfort, shoulder pain, frequent headaches, and greater curvature of the spine are all dangerous indications of text neck. According to a survey, 35% of smartphone users suffer from text neck syndrome. People between the ages of 15 and 18 are more likely to have neck pain. This protocol has been created that describes the design of comparative study to evaluate effectiveness of progressive resisted exercise along with conventional exercise and conventional exercise program alone in text neck syndrome. Methods: The participants (n=80) will be recruited in the study suffering from text neck syndrome and meeting the inclusion criteria. Two groups will be formed such that patients in group A will be treated with conventional therapy and group B will be treated with progressive resisted exercise (PRE) along with conventional therapy. The protocol will cover 4 weeks of treatment. In the rehabilitation period, we will evaluate the pain intensity, strength of neck muscles and functional activity. Our outcome measures will be- Numerical pain rating scale (NPRS) and Neck disability index (NDI). Discussion: Efficacy of the intervention will be evaluated by analyzing the pain intensity by using Numerical pain rating scale (NPRS) and level of functional disability by using Neck disability index (NDI). The result of the study will significantly provide affirmation on either using combination therapy of PRE with conventional exercise or conventional exercise alone.

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Reliability and validity of the Mizo-version of neck disability index for non-specific neck pain in the rural North-East Indian population

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195929 ◽

2019 ◽

Vol 8 (1) ◽

pp. 317

Author(s):

Andrew Lalchhuanawma ◽

Divya Sanghi

Keyword(s):

Neck Pain ◽

Correlation Coefficient ◽

Rating Scale ◽

Neck Disability Index ◽

Reliability And Validity ◽

East Indian ◽

North East ◽

Study Results ◽

Significant Difference ◽

Neck Disability

Background: The Neck Disability Index (NDI) is an important self-assessment tool used extensively worldwide, in clinical practice with implications into scientific research fields. It is used to assess the extent of pain and levels of functional disability associated with neck pain. The NDI consists of 10 items where each item was scored from a scale of 0 to 5 giving the maximum score possible to 50. Though proven to be a reliable instrument in the English-speaking population, the NDI has never been validated and culturally adapted in the Mizo language among the rural north-east Indian region where English is not spoken as means of communication. The aim is to translate and cross culturally adapt the NDI into Mizo tawng (official language of Mizoram) with the objective of establishing reliability and validity of the M-NDI in patients with non-specific neck pain.Methods: A total of 49 subjects participated voluntarily from the rural primary health care, Lunglei district, Mizoram. Subject having chronic non-specific neck pain lasting more than 3 months were included after taking a written formal consent.Results: The internal consistency determined by Cronbach alpha, and the Intraclass Correlation Coefficient (ICC) using the test-retest reliability showed a good and an excellent reliability respectively (α=0.82, ICC=0.97, 95% CI= 0.95-0.98). Construct validity was determined between the variables-Numerical Pain Rating Scale (NPRS) and NDI by Pearson’s correlation coefficient and found to have a good correlation r=0.89 and significant difference at p<0.001.Conclusions: The study results concluded the Mizo version of NDI to be easy to understand, reliable and valid instrument for measuring disability and functional limitations of daily activities in non-specific neck pain in the Mizo speaking population.

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Effectiveness of Neural Mobilization on Pain, Range of motion, and Disability in Cervical Radiculopathy: a Randomized Controlled Trial

10.21203/rs.3.rs-223383/v1 ◽

2021 ◽

Author(s):

Shazia Rafiq ◽

Hamayun Zafar ◽

Prof. Dr. Syed Amir Gillani ◽

Muhammad Sharif Waqas ◽

Amna Zia ◽

...

Keyword(s):

Conservative Treatment ◽

Pain Intensity ◽

Range Of Motion ◽

Conventional Treatment ◽

Rating Scale ◽

Controlled Trial ◽

Neck Disability Index ◽

Sampling Technique ◽

Cervical Radiculopathy ◽

Neck Disability

Abstract Background: Cervical Radiculopathy (CR) is a disorder of the spinal nerve roots that is largely caused by space occupying lesion which can lead to nerve root inflammation and patient usually presents with radiating pain in his/her upper extremity known as cervical radiculopathy. The objective of the study was to compare the effectiveness of neural mobilization technique with conservative treatment on pain intensity, range of motion and disability.Methods: It was a double blinded randomized clinical trial; data was collected from Mayo Hospital, Lahore through convenience sampling technique. After taking consent from the patients, the patients fulfilling the inclusion and exclusion criteria were selected and randomized blindly and assigned through computer generated random number into two groups i.e. group 1 (neural mobilization), group 2 (conventional treatment). Pain intensity was measured on Numeric pain rating scale, range of motion measured with inclinometer and functional status with neck disability index (NDI). Data was analyzed using SPSS and difference in improvement before, after 02 and 04 weeks was noted and compared. Results: There was significant improvement in pain relief, neck disability and cervical ranges after the treatment in both groups compared to the pre-treatment status (p < 0.00) and when neural mobilization was compared , it was more effective technique than conventional treatment in reducing pain and neck disability (p < 0.00). But there was not statistical difference in mean score of cervical range of motion (p>0.05)Conclusions: The present study concluded that both neural mobilization and conservative treatment were effective as an exercise program for patient with cervical radiculopathy, however neural mobilization was more effective in reducing pain and neck disability in cervical radiculopathy.Trial registration: RCT20190325043109N1

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Short-Term Effects of PENS versus Dry Needling in Subjects with Unilateral Mechanical Neck Pain and Active Myofascial Trigger Points in Levator Scapulae Muscle: A Randomized Controlled Trial

Journal of Clinical Medicine ◽

10.3390/jcm9061665 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1665 ◽

Cited By ~ 2

Author(s):

Santiago Garcia-de-Miguel ◽

Daniel Pecos-Martin ◽

Tamara Larroca-Sanz ◽

Beatriz Sanz-de-Vicente ◽

Laura Garcia-Montes ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Neck Pain ◽

Pain Intensity ◽

Controlled Trial ◽

Trigger Points ◽

Mean Difference ◽

Dry Needling ◽

Short Term ◽

Myofascial Trigger Points ◽

Randomized Controlled

Procedures such as dry needling (DN) or percutaneous electrical nerve stimulation (PENS) are commonly proposed for the treatment of myofascial trigger points (MTrP). The aim of the present study is to investigate if PENS is more effective than DN in the short term in subjects with mechanical neck pain. This was an evaluator-blinded randomized controlled trial. Subjects were recruited through announcements and randomly allocated into DN or PENS groups. Pain intensity, disability, pressure pain threshold (PPT), range of motion (ROM), and side-bending strength were measured. The analyses included mixed-model analyses of variance and pairwise comparisons with Bonferroni correction. The final sample was composed of 44 subjects (22 per group). Both groups showed improvements in pain intensity (ηp2 = 0.62; p < 0.01), disability (ηp2 = 0.74; p < 0.01), PPT (ηp2 = 0.79; p < 0.01), and strength (ηp2 = 0.37; p < 0.01). The PENS group showed greater improvements in disability (mean difference, 3.27; 95% CI, 0.27–6.27) and PPT (mean difference, 0.88–1.35; p < 0.01). Mixed results were obtained for ROM. PENS seems to produce greater improvements in PPT and disability in the short term.

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Examination of Regional Interdependence Theory in Chronic Neck Pain: Interpretations from Correlation of Strength Measures in Cervical and Pain-Free Regions

Pain Medicine ◽

10.1093/pm/pnz206 ◽

2019 ◽

Author(s):

Leila Ghamkhar ◽

Amir Massoud Arab ◽

Mohammad Reza Nourbakhsh ◽

Amir Hossein Kahlaee ◽

Reyhaneh Zolfaghari

Keyword(s):

Neck Pain ◽

Pain Intensity ◽

Neck Disability Index ◽

Chronic Neck Pain ◽

Pain Intensity Score ◽

Painful Condition ◽

Asymptomatic Volunteers ◽

Interdependence Theory ◽

Regional Interdependence ◽

Pain Patients

Abstract Objective Impairments present in chronic pain conditions have been reported not to be limited to the painful region. Pain-free regions have also been proposed to be adversely affected as a cause or consequence of the painful condition. The aim of this study was to investigate the association between muscle strength in painful and pain-free regions and chronic neck pain. Design A cross-sectional study. Setting Rehabilitation hospital laboratory. Subjects One hundred twenty-two patients with chronic neck pain (87 female) and 98 asymptomatic volunteers (52 female) were included in the study. Methods Maximal isometric strength measures of the neck, scapulothoracic, shoulder, trunk, and hip muscles were assessed using a hand-held dynamometer in all participants. Pain intensity and pain-related disability were also assessed in patients through visual analog scale and Neck Disability Index scores, respectively. Results Principal component analysis revealed one component for each of the studied regions. Multivariate analysis of variance found neck (d = 0.46), scapulothoracic (d = 0.46), shoulder (d = 0.60), trunk flexor (d = 0.38), extensor (d = 0.36), and hip (d = 0.51) strength components to be lower in the neck pain patients compared with asymptomatic participants (P < 0.01). Logistic and linear regression analyses found the shoulder strength component both to be a significant predictor for neck pain occurrence (β = 0.53, P < 0.01) and to have a considerable effect on pain intensity score (β=–0.20, P = 0.02), respectively. Conclusions The results found that some pain-free regions in addition to the cervical spine to exhibit lower levels of muscular strength in neck pain patients. These findings support the regional interdependence theory, which proposes that impairments are not limited to the painful area and are possibly mediated by central mechanisms.

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“Short- and mid-term effects of adding upper cervical manual therapy to a conventional physical therapy program in patients with chronic mechanical neck pain. Randomized controlled clinical trial.”

Clinical Rehabilitation ◽

10.1177/0269215520965054 ◽

2020 ◽

pp. 026921552096505

Author(s):

Vanessa González-Rueda ◽

Carlos López-de-Celis ◽

Elena Bueno-Gracia ◽

Jacobo Rodríguez-Sanz ◽

Albert Pérez-Bellmunt ◽

...

Keyword(s):

Neck Pain ◽

Rating Scale ◽

Controlled Trial ◽

Neck Disability Index ◽

Chronic Neck Pain ◽

Control Group ◽

Controlled Clinical Trial ◽

Primary Care Center ◽

Randomized Controlled ◽

Upper Cervical

Objective: To evaluate the effect of adding an Upper Cervical Translatoric Mobilization (UCTM) or an Inhibitory Suboccipital Technique (IST) to a physiotherapy treatment in the symptomatology and function of mechanical chronic neck pain patients. Design: Randomized controlled trial. Setting: Primary Care Center in Cornellà, Spain. Subjects: 78 patients (64 women), with mean age (SD) of 59.96 (13.30) years with mechanical chronic neck pain were divided in three groups: control, IST and UCTM groups. Interventions: All groups received 15 physiotherapy sessions for three weeks. The UCTM and IST groups added 5 minutes of the assigned technique during six sessions. Main measures: Neck disability index (NDI) and numeric pain rating scale (NPRS) for neck pain were measured baseline, three-weeks and 15-weeks follow-up. Results: NDI (SD) at baseline, three-weeks and 15-weeks were 11.62 (7.08), 9.65 (6.25), 7.58 (5.64) for the control group, 14.38 (6.92), 8.50 (6.11), 7.12 (4.98) for the IST group and 13.19(7.23), 5.35(6.10), 4.35(2.76) for the UCTM group. NPRS (SD) at baseline, three-weeks and 15-weeks were 58.69 (19.46), 45.19 (23.43), 44.58 (24.08) for the control group; 64.08 (19.26), 42.19 (19.69), 34 (21.14) for the IST group; and 67.65 (20.65), 36.23 (20.10), 39.85 (25.44) for the UCTM group. Conclusions: Compared with no treatment, both forms of mobilization were associated with reduced disability at three weeks, and UCTM remained better than control at 15 weeks; there were no significant differences between the two mobilization groups. Trial registration: This study was registered in Clinicaltrials.gov (NCT02832232).

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A Higher-Order Analysis Supports Use of the 11-Item Version of the Tampa Scale for Kinesiophobia in People With Neck Pain

Physical Therapy ◽

10.2522/ptj.20120255 ◽

2013 ◽

Vol 93 (1) ◽

pp. 60-68 ◽

Cited By ~ 17

Author(s):

David Walton ◽

James M. Elliott

Keyword(s):

Neck Pain ◽

Pain Intensity ◽

Convergent Validity ◽

Rasch Analysis ◽

Rating Scale ◽

Neck Disability Index ◽

Measurement Properties ◽

Symptom Duration ◽

Cross Sectional ◽

Tampa Scale For Kinesiophobia

Background Despite increasing clinical and research use of the 11-item version of the Tampa Scale for Kinesiophobia (TSK-11) in people with neck pain, little is known about its measurement properties in this population. Objective The purpose of this study was to rigorously evaluate the measurement properties of the TSK-11 when used in people with mechanical neck pain. Design This study was a secondary analysis of 2 independent databases (N=235) of people with mechanical neck pain of primarily traumatic origin. Methods The TSK-11 was subjected to Rasch analysis and subsequent evaluation of concurrent associations with the Neck Disability Index and a numeric rating scale for pain intensity. Results The TSK-11 conformed well to the Rasch model for interval-level measurement, but less so for acute or nontraumatic etiologies. A transformation matrix suggested that small changes at the extremes of the scale are more meaningful than in the middle. Cross-sectional convergent validity testing suggested relationships of expected magnitude and direction compared with pain intensity and neck-related disability. The use of the linearly transformed TSK-11 led to potentially important differences in distribution of data compared with use of the raw scores. Limitations The sample size was slightly smaller than desired for Rasch analysis. The 2 databases were similar in terms of symptom duration, but differed in pain intensity and age. Conclusions The TSK-11 can be considered an interval-level measure when used in people with neck pain. It provides potentially important information regarding the nature of neck-related disability. Clinically important difference may not be consistent across the range of the scale.

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Traditional Acupuncture and Laser Acupuncture in Chronic Nonspecific Neck Pain: Study Protocol for a Randomized Controlled Trial

10.21203/rs.3.rs-853159/v1 ◽

2021 ◽

Author(s):

RAFAELA PERON ◽

Érika Patrícia Rampazo ◽

Richard Eloin Liebano

Keyword(s):

Neck Pain ◽

Pain Intensity ◽

Rating Scale ◽

Acupuncture Treatment ◽

Numerical Rating Scale ◽

Controlled Trial ◽

Pressure Pain Threshold ◽

Pain Modulation ◽

Laser Acupuncture ◽

Acupuncture Points

Abstract Background: Nonspecific neck pain is a multifactorial and very common condition in adult individuals. No reports were found in the literature comparing the effectiveness of Traditional Acupuncture (TA) and Laser Acupuncture (LA) in cases of chronic nonspecific neck pain. Therefore, the aim of the present study is to investigate the effectiveness of TA and LA therapies in individuals with chronic nonspecific neck pain.Methods/design: This study will be a controlled and randomized clinical trial. A total of 60 individuals will be randomized into two groups (30 each). The TA group will receive the acupuncture treatment using needles, while the LA group will receive the laser acupuncture treatment. The acupuncture points (Tianzhu, Fengchi, Jianjing, and Jianzhongshu) will be stimulated bilaterally with needles or laser. The primary outcome will be pain intensity, determined using the numerical rating scale. The secondary outcomes will be pressure pain threshold, temporal summation of pain, conditioned pain modulation, use of analgesic drugs after treatment, and the global perceived effect scale. The assessments will be performed immediately before and after treatment. At the follow-up, 1 months after the end of the treatments, evaluation will be made of the pain intensity and the global perceived effect. Statistical analysis of the data obtained will consider a significance level of p < 0.05.Discussion: This study will provide evidence concerning the effects of LA treatment, in comparison to TA, leading to benefits for individuals suffering from chronic nonspecific neck pain.Trial registration: RBR-7vbw5gd (Brazilian Registry of Clinical Trials - ReBEC)

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Immediate and Short-Term Effects of Upper Cervical High-Velocity, Low-Amplitude Manipulation on Standing Postural Control and Cervical Mobility in Chronic Nonspecific Neck Pain: A Randomized Controlled Trial

Journal of Clinical Medicine ◽

10.3390/jcm9082580 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2580

Author(s):

Francisco Gómez ◽

Pablo Escribá ◽

Jesús Oliva-Pascual-Vaca ◽

Roberto Méndez-Sánchez ◽

Ana Silvia Puente-González

Keyword(s):

Neck Pain ◽

Postural Control ◽

High Velocity ◽

Controlled Trial ◽

Short Term ◽

Upper Cervical ◽

Low Amplitude ◽

Cervical Rotation ◽

Short Term Effects

This study aimed to determine the immediate and short-term effects of a single upper cervical high-velocity, low-amplitude (HVLA) manipulation on standing postural control and cervical mobility in chronic nonspecific neck pain (CNSNP). A double-blinded, randomized placebo-controlled trial was performed. Forty-four patients with CNSNP were allocated to the experimental group (n = 22) or control group (n = 22). All participants were assessed before and immediately after the intervention, with a follow-up on the 7th and 15th days. In each evaluation, we assessed global and specific stabilometric parameters to analyze standing postural balance and performed the cervical flexion-rotation test (CFRT) to analyze upper cervical mobility. We obtained statistically significant differences, with a large effect size, in the limited cervical rotation and global stabilometric parameters. Upper cervical HVLA manipulation produced an improvement in the global stabilometric parameters, significantly decreasing the mean values of velocity, surface, path length, and pressure in all assessments (p < 0.001; ƞ 2 p = 0.323–0.856), as well as significantly decreasing the surface length ratio (L/S) on the 7th (−0.219 1/mm; p = 0.008; 95% confidence interval (CI): 0.042–0.395) and 15th days (−0.447 1/mm; p < 0.001; 95% CI: 0.265–0.629). Limited cervical rotation values increased significantly immediately after manipulation (7.409°; p < 0.001; 95% CI: 6.131–8.687) and were maintained during follow-up (p < 0.001). These results show that a single upper cervical HVLA manipulation produces an improvement in standing postural control and increases the rotational range of motion (ROM) in the upper cervical spine in patients with CNSNP.

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