Lumbar motor control training as a complementary treatment for chronic neck pain: A randomized controlled trial

2021 ◽  
pp. 026921552110380
Author(s):  
Zohre Khosrokiani ◽  
Amir Letafatkar ◽  
Amy Gladin

Objective: We investigated whether adding lumbar motor control training with a pressure biofeedback unit improves outcomes of a conservative deep cervical flexor motor control program on neck pain, neck disability, deep cervical flexor endurance, and health status in middle-aged patients with chronic neck pain and forward head posture after eight weeks of interventions. Design: Randomized controlled trial. Setting: Outpatient setting. Subjects and interventions: A total of 113 males and females (mean age 39 ± 5 years) with chronic neck pain were randomized to three treatment groups, group 1 ( n = 38) combined deep cervical flexor motor-control training and lumbar motor control exercise, group 2 ( n = 37) deep cervical flexor motor control training alone, and group 3 ( n = 38) passive treatment and education. Main outcome measures: Pain, neck disability, deep cervical flexor muscular endurance, and health status. Results: There were significant improvements in the combination group compared with the deep cervical flexor motor-control group alone ( d = 2.03, 95% confidence interval (CI): −2.8 to −1.27, P = 0.021) for pain ( d = −0.99, 95% CI = −1.75 to −0.23, P = 0.023), disability ( d = 1.92, 95% CI = 0.86 to 2.98, P = 0.001), deep cervical flexor endurance, and ( d = −2.75, 95% CI = −8.81 to −1.68, P = 0.037) for health status favoring the combination group. There were significant between-group differences favoring both active groups versus the passive control in all out comes. Conclusion: The addition of Lumbar motor control training as a complementary treatment may enhance effectiveness of deep cervical flexor motor control training on neck pain, neck disability, and deep cervical flexor endurance in patients with chronic moderate neck pain and forward head posture.

2019 ◽  
Vol 33 (9) ◽  
pp. 1458-1467
Author(s):  
Manuel Albornoz-Cabello ◽  
José Manuel Pérez-Mármol ◽  
Cristo Jesus Barrios Quinta ◽  
Guillermo A Matarán-Peñarrocha ◽  
Adelaida María Castro-Sánchez ◽  
...  

Objective: To evaluate the effect of adding interferential current stimulation to exercise on pain, disability, psychological status and range of motion in patients with neck pain. Design: A single-blinded randomized controlled trial. Setting: Primary care physiotherapy units. Subjects: A total of 84 patients diagnosed with non-specific mechanical neck pain. This sample was divided into two groups randomly: experimental ( n = 42) versus control group ( n = 42). Interventions: Patients in both groups had a supervised therapeutic exercise programme, with the experimental group having additional interferential current stimulation treatment. Main measures: The main measures used were intensity of neck pain according to the Visual Analogue Scale; the degree of disability according to the Neck Disability Index and the CORE Outcome Measure; anxiety and depression levels according to the Goldberg scale; apprehension as measured by the Personal Psychological Apprehension scale; and the range of motion of the cervical spine. The sample was evaluated at baseline and posttreatment (10 sessions/two weeks). Results: Statistically significant differences between groups at posttreatment were observed for Visual Analogue Scale (2.73 ± 1.24 vs 4.99 ± 1.56), Neck Disability Index scores (10.60 ± 4.77 vs 18.45 ± 9.04), CORE Outcome Measure scores (19.18 ± 9.99 vs 35.12 ± 13.36), Goldberg total score (6.17 ± 4.27 vs 7.90 ± 4.87), Goldberg Anxiety subscale, Personal Psychological Apprehension Scale scores (28.17 ± 9.61 vs 26.29 ± 11.14) and active and passive right rotation. Conclusions: Adding interferential current stimulation to exercise resulted in better immediate outcome across a range of measures.


Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Carlos Bernal-Utrera ◽  
Juan José González-Gerez ◽  
Manuel Saavedra-Hernandez ◽  
Miguel Ángel Lérida-Ortega ◽  
Cleofás Rodríguez-Blanco

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Pavlos Bobos ◽  
Evdokia Billis ◽  
Dimitra-Tania Papanikolaou ◽  
Constantinos Koutsojannis ◽  
Joy C. MacDermid

Background. We need to understand more about how DNF performs in different contexts and whether it affects the pain threshold over myofascial trigger points (MTrPs). Purpose. The objectives were to investigate the effect of neck muscles training on disability and pain and on pain threshold over MTrPs in people with chronic neck pain. Methods. Patients with chronic neck pain were eligible for participation with a Neck Disability Index (NDI) score of over 5/50 and having at least one MTrP on either levator scapulae, upper trapezoid, or splenius capitis muscle. Patients were randomly assigned into either DNF training, superficial neck muscle exercise, or advice group. Generalized linear model (GLM) was used to detect differences in treatment groups over time. Results. Out of 67 participants, 60 (47 females, mean age: 39.45 ± 12.67) completed the study. Neck disability and neck pain were improved over time between and within groups (p<0.05). However, no differences were found within and between the therapeutic groups (p<0.05) in the tested muscles’ PPTs and in cervicothoracic angle over a 7-week period. Conclusion. All three groups improved over time. This infers that the pain pathways involved in the neck pain relief are not those involved in pain threshold.


2020 ◽  
pp. 026921552096505
Author(s):  
Vanessa González-Rueda ◽  
Carlos López-de-Celis ◽  
Elena Bueno-Gracia ◽  
Jacobo Rodríguez-Sanz ◽  
Albert Pérez-Bellmunt ◽  
...  

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).


2020 ◽  
Vol 34 (12) ◽  
pp. 1485-1496 ◽  
Author(s):  
Norollah Javdaneh ◽  
Amir Letafatkar ◽  
Sadredin Shojaedin ◽  
Malihe Hadadnezhad

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.


Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Carlos Bernal-Utrera ◽  
Juan Jose Gonzalez-Gerez ◽  
Ernesto Anarte-Lazo ◽  
Cleofas Rodriguez-Blanco

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