Scapular exercise combined with cognitive functional therapy is more effective at reducing chronic neck pain and kinesiophobia than scapular exercise alone: a randomized controlled trial

Objective: The aim of this study was to compare the effectiveness of scapular exercises alone and combined with cognitive functional therapy in treating patients with chronic neck pain and scapular downward rotation impairment. Design: Single-blind randomized controlled trial. Setting: Outpatient. Subjects: A total of 72 patients (20–45 years old) with chronic neck pain were studied. Intervention: Allocation was undertaken into three groups: scapular exercise ( n = 24), scapular exercise with cognitive functional therapy ( n = 24) and control ( n = 24) groups. Each programme lasted three times a week for six weeks. Main outcomes: The primary outcome measure was pain intensity measured by the visual analogue scale scores. The secondary outcome measures included kinesiophobia and muscles activity. Results: Statistically significant differences in pain intensity were found when multidisciplinary physiotherapy group including a cognitive functional approach was compared with the scapular exercise alone group at six weeks (effect size (95% CI) = −2.56 (−3.32 to −1.80); P = 0.019). Regarding kinesiophobia, a significant between-group difference was observed at six-week (effect size (95% CI) = −2.20 (−2.92 to −1.49); P = 0.005), with the superiority of effect in multidisciplinary physiotherapy group. A significant between-group differences was observed in muscle activity. Also, there were significant between-group differences favouring experimental groups versus control. Conclusion: A group-based multidisciplinary rehabilitation programme including scapular exercise plus cognitive functional therapy was superior to group-based scapular exercise alone for improving pain intensity, kinesiophobia and muscle activation in participants with chronic 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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Letter to the editor concerning the article: Scapular exercise combined with cognitive functional therapy is more effective at reducing chronic neck pain and kinesiophobia than scapular exercise alone: A randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215520967940 ◽

2020 ◽

pp. 026921552096794

Author(s):

Julia Castro ◽

Luciana C Lunkes ◽

Michele Menezes ◽

Ney Meziat-Filho

Keyword(s):

Randomized Controlled Trial ◽

Neck Pain ◽

Controlled Trial ◽

Chronic Neck Pain ◽

Functional Therapy ◽

Randomized Controlled ◽

Letter To The Editor

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Effectiveness of Specific Neck Stabilization Exercises or a General Neck Exercise Program for Chronic Neck Disorders: A Randomized Controlled Trial

The Journal of Rheumatology ◽

10.3899/jrheum.080376 ◽

2009 ◽

Vol 36 (2) ◽

pp. 390-397 ◽

Cited By ~ 21

Author(s):

CATHRIN GRIFFITHS ◽

KRYSIA DZIEDZIC ◽

JACKIE WATERFIELD ◽

JULIUS SIM

Keyword(s):

Randomized Controlled Trial ◽

Clinical Outcome ◽

Neck Pain ◽

Controlled Trial ◽

Exercise Program ◽

Chronic Neck Pain ◽

Group Differences ◽

Specific Exercise ◽

Randomized Controlled ◽

Neck Stabilization

Objective.In a cohort of primary care patients with chronic neck pain, to determine whether specific neck stabilization exercises, in addition to general neck advice and exercise, provide better clinical outcome at 6 weeks than general neck advice and exercise alone.Methods.This was a multicenter randomized controlled trial in 4 physical therapy departments. Seventy-four participants (mean age 51.3 yrs) were randomized to specific neck stabilization exercises with a general neck advice and exercise program (n = 37) or a general neck advice and exercise program alone (n = 37). They attended a 1-hour clinical examination, followed by a maximum of 4 treatment sessions. Assessments were undertaken at baseline, 6 weeks, and 6 months. The primary outcome was the Neck Pain and Disability Scale (NPDS). Analysis was by intention to treat.Results.Seventy-one (96%) participants received their allocated intervention. There was 91% followup at 6 weeks and 92% followup at 6 months. The mean (SD) 6-week improvement (reduction) in NPDS score was 10.6 (20.2) for the specific exercise program and 9.3 (15.7) for the general exercise program. There were no significant between-group differences in the NPDS at either 6 weeks or 6 months. For secondary outcomes, participants in the specific exercise group were less likely to be taking pain medication at 6-week followup (p = 0.02). There were no other significant between-group differences.Conclusion.Adding specific neck stabilization exercises to a general neck advice and exercise program did not provide better clinical outcome overall in the physical therapy treatment of chronic neck pain.

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The clinical and EMG assessment of the effects of stabilization exercise on nonspecific chronic neck pain: A randomized controlled trial

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-160735 ◽

2017 ◽

Vol 30 (2) ◽

pp. 211-219 ◽

Cited By ~ 11

Author(s):

Fariba Ghaderi ◽

Mohammad Asghari Jafarabadi ◽

Khodabakhsh Javanshir

Keyword(s):

Randomized Controlled Trial ◽

Neck Pain ◽

Controlled Trial ◽

Chronic Neck Pain ◽

Stabilization Exercise ◽

Randomized Controlled

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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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