Randomized controlled trial of exercise interventions for chronic whiplash-associated disorders: One-year follow-up of the effect on neck muscle endurance, active cervical range of motion and grip strength.

Mapping Intimacies ◽

10.21203/rs.3.rs-35272/v1 ◽

2020 ◽

Author(s):

Gunnel Peterson ◽

Maria Landén Ludvigsson ◽

Anneli Peolsson

Keyword(s):

Neck Pain ◽

Pain Intensity ◽

Grip Strength ◽

Reference Values ◽

Muscle Endurance ◽

Neck Muscle ◽

Exercise Interventions ◽

Randomized Controlled ◽

Whiplash Associated Disorders

Abstract Background: Years after whiplash injury, more than 40 % of people experience persistent neck pain and disability, called whiplash-associated disorders (WAD). The relations between neck related function, neck pain and disability are inconclusive and need to be further investigated. The aims were; a) to compare the effect of three different exercise interventions – neck-specific exercise (NSE), NSE with a behavioral approach (NSEB) and prescribed physical activity (PPA) – on neck-muscle endurance (NME), active cervical range of motion (AROM), grip strength and pain intensity immediately before and after the tests, and b) to compare neck-disability in individuals who are below or above the cut-off for normative reference values of healthy individuals regarding NME, AROM and grip strength.Methods: This is a secondary analysis of a randomized controlled multicenter study including 12 months’ follow-up. A total of 216 individuals with chronic WAD grades II or III were recruited. Data were recorded at baseline, 3, 6, and 12 months. Linear mixed models were used and sub-group analyses were evaluated with non-parametric tests.Results: NSE and NSEB resulted in greater improvements compared to PPA (p < .01) and were maintained at 12 months’ follow-up in ventral (only males) and dorsal NME, AROM and pain intensity during testing. In grip strength, there were no significant between-group differences (p > 0.05). There were no significant differences between the NSE and NSEB groups (p > .05). Sub-group analyses revealed improvement in disability at 12 months follow-up in NSE and/or NSEB for individuals both below and above the cut-off reference value in NME and AROM. More severe disability was seen in individuals below the reference values both at baseline and 12 months’ follow-up. Individuals in the PPA group below the reference values in NME and AROM reported increasing disability at 12 months compared to baseline.Conclusion: The results suggest that neck-specific exercises (NSE, NSEB) improved clinical function and decreased disability in chronic WAD compared to PPA. The results may imply that higher neck-related clinical function can be important for reduced disability. Trial Registration: ClinicalTrials.gov: NCT01528579, date of registration: February 8, 2012, retrospectively registered; https://clinicaltrials.gov/ct2/show/NCT0152857

Download Full-text

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.

Download Full-text

Effect of specific deep cervical muscle exercises on functional disability, pain intensity, craniovertebral angle, and neck-muscle strength in chronic mechanical neck pain: a randomized controlled trial

Journal of Pain Research ◽

10.2147/jpr.s190125 ◽

2019 ◽

Vol Volume 12 ◽

pp. 915-925 ◽

Cited By ~ 4

Author(s):

Thavatchai Suvarnnato ◽

Rungthip Puntumetakul ◽

Sureeporn Uthaikhup ◽

Rose Boucaut

Keyword(s):

Randomized Controlled Trial ◽

Muscle Strength ◽

Neck Pain ◽

Pain Intensity ◽

Functional Disability ◽

Controlled Trial ◽

Neck Muscle ◽

Randomized Controlled ◽

Cervical Muscle ◽

Craniovertebral Angle

Download Full-text

The effect of osteopathic medicine on pain in musicians with nonspecific chronic neck pain: a randomized controlled trial

Therapeutic Advances in Musculoskeletal Disease ◽

10.1177/1759720x20979853 ◽

2020 ◽

Vol 12 ◽

pp. 1759720X2097985

Author(s):

Gabriele Rotter ◽

Isabel Fernholz ◽

Sylvia Binting ◽

Theresa Keller ◽

Stephanie Roll ◽

...

Keyword(s):

Neck Pain ◽

Pain Intensity ◽

Chronic Neck Pain ◽

Trial Registration ◽

Analysis Of Covariance ◽

Control Group ◽

Osteopathic Medicine ◽

Randomized Controlled ◽

Pain Disability

Background: Nonspecific chronic neck pain (cNP) is common in adult violinists and violists and is often treated with osteopathic medicine (OM), although the effectiveness of this treatment has not been determined to date. This study aimed to evaluate the effectiveness and safety of OM in adult violinists and violists with cNP. Methods: In a two-armed randomized controlled single-center open trial, adult violinists and violists, including music students, with cNP (⩾12 weeks) were randomized to either five individualized OM sessions (OM group) or to no intervention (control group, CG) in the outpatient clinic for integrative medicine, Charité - Universitätsmedizin Berlin, Germany. All patients received a musicians’ medicine consultation and paracetamol on demand. The primary outcome parameter was the neck pain intensity on a visual analog scale (VAS, 0–100 mm, 0 = no pain, 100 = worst imaginable pain) after 12 weeks. Secondary outcomes included neck pain disability (Neck Disability Index, NDI, 0–100%) after 12 weeks. The last follow-up visit was after 52 weeks. Statistical analysis included analysis of covariance adjusted for respective baseline value. Results: Altogether, 62 outpatients were included [OM group ( n = 28), CG ( n = 34); 81% female; mean age, 41.6 ± 11.1 years; mean baseline neck pain, 55.9 ± 11.6 mm]. After 12 weeks, OM was associated with an improvement in the OM group versus the CG in neck pain on the VAS [14.6 mm (95% confidence interval 8.0; 21.2) versus 40.8 mm (34.7; 46.9), p < 0.001, Cohen’s d = 1.4], and neck pain disability as determined by the NDI [8.8% (6.7; 10.8) versus 17.2% (15.3; 19.1), p < 0.001]. Some improvements were maintained until 52 weeks of follow-up. No serious adverse events were observed. Conclusions: The results of this study suggest that OM might be effective in reducing pain intensity in adult violinists and violists with nonspecific cNP. Further studies should investigate the efficacy of OM in comparison with a sham procedure and with other effective therapy methods in high-quality multicenter trials. Trial registration: WHO Trial Registration https://apps.who.int/trialsearch/NoAccess.aspx?aspxerrorpath=/trialsearch/Trial2.aspx by German Clinical Trials Register DRKS00009258, Universal Trial Number (UTN): U1111-1173-5943.

Download Full-text

Loss of benefits after cessation of exercise interventions in nursing home residents: randomized controlled trial follow-up

Geriatric Nursing ◽

10.1016/j.gerinurse.2021.03.009 ◽

2021 ◽

Vol 42 (3) ◽

pp. 621-627

Author(s):

Ana Rodriguez-Larrad ◽

Haritz Arrieta ◽

Chloe Rezola-Pardo ◽

Izaro Esain ◽

Pablo Mendia-Oria ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Nursing Home ◽

Controlled Trial ◽

Nursing Home Residents ◽

Exercise Interventions ◽

Randomized Controlled

Download Full-text

Neck pain intensity does not predict pressure pain hyperalgesia: re-analysis of seven randomized controlled trials

Journal of Rehabilitation Medicine ◽

10.2340/16501977-1815 ◽

2014 ◽

Vol 46 (6) ◽

pp. 553-560 ◽

Cited By ~ 10

Author(s):

R Lauche ◽

H Cramer ◽

J Langhorst ◽

G Dobos ◽

B Gerdle

Keyword(s):

Neck Pain ◽

Randomized Controlled Trials ◽

Pain Intensity ◽

Controlled Trials ◽

Pressure Pain ◽

Randomized Controlled

Download Full-text

Internet-Based Multimodal Pain Program With Telephone Support for Adults With Chronic Temporomandibular Disorder Pain: Randomized Controlled Pilot Trial

Journal of Medical Internet Research ◽

10.2196/22326 ◽

2020 ◽

Vol 22 (10) ◽

pp. e22326

Author(s):

Julia Lam ◽

Peter Svensson ◽

Per Alstergren

Keyword(s):

Pain Intensity ◽

Temporomandibular Disorder ◽

Functional Limitation ◽

Pilot Trial ◽

The Internet ◽

Occlusal Splint ◽

Splint Therapy ◽

Randomized Controlled ◽

Temporomandibular Pain

Background Chronic pain from temporomandibular disorders remains an undertreated condition with debate regarding the most effective treatment modalities. Objective The aim of the study was to investigate the treatment effect of an internet-based multimodal pain program on chronic temporomandibular disorder pain and evaluate the feasibility of a larger randomized controlled trial. Methods An unblinded randomized controlled pilot trial was conducted with 43 participants (34 females, 9 males; median age 27, IQR 23-37 years) with chronic temporomandibular pain. Participants were recruited within the Public Dental Health Service and randomized to intervention (n=20) or active control (n=23). The intervention comprised a dentist-assisted internet-based multimodal pain program with 7 modules based on cognitive behavior therapy and self-management principles. The control group received conventional occlusal splint therapy. Primary outcomes included characteristic pain intensity, pain-related disability, and jaw functional limitation. Secondary outcomes were depression, anxiety, catastrophizing, and stress. Outcomes were self-assessed through questionnaires sent by mail at 3 and 6 months after treatment start. Feasibility evaluation included testing the study protocol and estimation of recruitment and attrition rates in the current research setting. Results Only 49% of participants (21/43) provided data at the 6-month follow-up (internet-based multimodal pain program: n=7; control: n=14). Of the 20 participants randomized to the internet-based multimodal pain program, 14 started treatment and 8 completed all 7 modules of the program. Between-group analysis showed no significant difference for any outcome measure at 3- or 6-month follow-up—characteristic pain intensity (3 months: P=.58; 6 months: P=.41), pain-related disability (3 months: P=.51; 6 months: P=.12), jaw functional limitation (3 months: P=.45; 6 months: P=.90), degree of depression (3 months: P=.64; 6 months: P=.65), anxiety (3 months: P=.93; 6 months: P=.31), stress (3 months: P=.66; 6 months: P=.74), or catastrophizing (3 months: P=.86; 6 months: P=.85). Within-group analysis in the internet-based multimodal pain program group showed a significant reduction in jaw functional limitation score at the 6-month follow-up compared to baseline (Friedman: χ2=10.2, P=.04; Wilcoxon: z=–2.3, P=.02). In the occlusal splint group, jaw function limitation was also reduced at the 6-month follow-up (Friedman: χ2=20.0, P=.045; Wilcoxon: z=–2.3, P=.02), and there was a reduction in characteristic pain intensity at the 3- and 6-month follow-up (Friedman: χ2=25.1, P=.01; Wilcoxon 3 months: z=–3.0, P=.003; Wilcoxon 6 months: z=-3.3, P=.001). Conclusions This study was not able to demonstrate a difference in treatment outcome between an internet-based multimodal pain program and occlusal splint therapy in patients with chronic temporomandibular pain. However, the findings suggested that the internet-based multimodal pain program improves jaw function. The results also confirmed the treatment effect of occlusal splint therapy for chronic temporomandibular pain. Furthermore, because of the high attrition rate, this pilot study showed that a randomized controlled trial with this design is not feasible. Trial Registration ClinicalTrials.gov NCT04363762; https://clinicaltrials.gov/show/NCT04363762

Download Full-text

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.

Download Full-text

Approaches to cervical spine mobilization for neck pain: a pilot randomized controlled trial

Chiropractic & Manual Therapies ◽

10.1186/s12998-020-00348-z ◽

2020 ◽

Vol 28 (1) ◽

Author(s):

Claire Lagoutaris ◽

Justin Sullivan ◽

Michelle Hancock ◽

Andrew M. Leaver

Keyword(s):

Clinical Trial ◽

Randomized Controlled Trial ◽

Cervical Spine ◽

Neck Pain ◽

Controlled Trial ◽

Trial Registration ◽

Single Treatment ◽

Randomized Controlled ◽

Pilot Randomized Controlled Trial

Abstract Study design Pilot randomized controlled trial. Background Better understanding of the relative effectiveness of different approaches to cervical spine mobilization has been identified as a research priority in manual therapy practice. Two distinct approaches to the practice of mobilization have emerged in recent years, based on different reasoning models for selection of mobilization techniques. The objective of this pilot study was to assess feasibility aspects for a future randomized clinical trial by exploring short-term pain and disability outcomes after a single treatment with pragmatic versus prescriptive approaches to cervical mobilization for people with recent-onset neck pain at 48-h follow-up after randomization. Methods Twenty adults with a new episode of mechanical neck pain were randomly allocated to either pragmatic or prescriptive mobilization intervention groups. The pragmatic group received a single treatment of cervical mobilization with the technique, target segment, and grade selected by their treating therapist. The prescriptive group received a single treatment of standardized mobilization with techniques similar to a previous mobilization clinical trial. Feasibility outcomes were recruitment rates, randomization audit and completion of treatment and follow-up per protocol. The primary clinical outcome of interest was disability level measured at 48-h follow-up after randomization. Results Recruitment rates were approximately 2.5 participants per week and 100% of eligible participants were deemed suitable for treatment with cervical mobilization. There was sufficient variety in the range of pragmatic treatments selected and the data collection process imposed minimal burden on participants. Conclusions Our results provide supporting evidence for the feasibility of a future larger scale randomized clinical trial. Trial registration Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12616000446460). Registered 6th April 2016. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370448&isReview=true

Download Full-text

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 ◽

10.1177/0269215520941910 ◽

2020 ◽

Vol 34 (12) ◽

pp. 1485-1496 ◽

Cited By ~ 2

Author(s):

Norollah Javdaneh ◽

Amir Letafatkar ◽

Sadredin Shojaedin ◽

Malihe Hadadnezhad

Keyword(s):

Randomized Controlled Trial ◽

Neck Pain ◽

Pain Intensity ◽

Effect Size ◽

Controlled Trial ◽

Chronic Neck Pain ◽

Secondary Outcome ◽

Group Differences ◽

Functional Therapy ◽

Randomized Controlled

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.

Download Full-text