Postural Correction in Persons with Neck Pain. I. A Survey of Neck Positions Recommended by Physical Therapists

Background:Mobile health applications are frequently used to increase exercise adherence in patients with musculoskeletal problems. However, the usability of these health mobile applications mostly has not been proven. In our previous study, the usability of the mobile app, which includes postural correction and neck spinal stabilization exercises, has been proven. (M.U-NeckExercise application)Objectives:The aim of this study is to evaluate the effectiveness of the mobile application-based home exercise program for patients with chronic neck pain.Methods:60 people with chronic neck pain were participated in the our study. They were randomized into two groups. The first group (n:30) received home exercises via the novel mobile app, and the second group (n:30) received the same home exercises via the brochure. The exercise program consisted of neck and thoracic postural correction and neck spinal stabilization exercises. Participants has been requested to do the exercises 3 days in a week for 6 weeks. Participants’ pain levels were assessed by using the Visual Analogue Scale (VAS), their neck-related functional limitations were evaluated by Neck Pain and Disability Index (BADI). Exercise adherence was meausered with a ratio of total participated sessions compared with the target defined by patient activation monitor and exercise adherance questionnaire. Targeted participation were %60 of total sessions.Results:In both groups, the improvement in VAS and BADI scores was statistically significant (p<0.05). It was found that the pain parameters of VAS score decreased statistically more in the mobile application-based exercise group (p<0.05). While there was no statistically significant difference between the groups in the BADI score, the effect size results was higher in the mobile app group (effect size= 0.411). Our exercise commitment target in the mobile app group was an average of 10.5 sessions. The target session number has been reached 11.25 sessions.Conclusion:It has been observed that the mobile application-based exercise program is effective in reducing pain and increasing exercise adherence in people with chronic neck pain. The findings support M.U-NeckExercise-App could be recommended to health professionals for exercise prescription in patients with cronic neck pain.References:[1]Tonga E, Can M, Polat MG (2019). ”SAT0730-HPR development and design of smartphone application for postural alignment of cervical and thoracic spine for young adults.” Annals of the Rheumatic Diseases, 78,2.[2]Voth, E. C., Oelke, N. D., & Jung, M. E. (2016). A theory-based exercise app to enhance exercise adherence: a pilot study. JMIR mHealth and uHealth, 4(2), e62.VariableGroupX±SSzpPost-Exercise VAS Value (0-10 cm)Mobile app2,90±2,04-3,272**0,001Brochure4,63±1,69Post-Exercise BADI ValueMobile app38,86±12,380,0310,861Brochure32,23±12,35Disclosure of Interests:None declared

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Manual Physical Therapists’ Use of Biopsychosocial History Taking in the Management of Patients with Back or Neck Pain in Clinical Practice

The Scientific World JOURNAL ◽

10.1155/2015/170463 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 13

Author(s):

Rob A. B. Oostendorp ◽

Hans Elvers ◽

Emilia Mikołajewska ◽

Marjan Laekeman ◽

Emiel van Trijffel ◽

...

Keyword(s):

Chronic Pain ◽

Neck Pain ◽

Physical Therapists ◽

Social Dimension ◽

History Taking ◽

Social Dimensions ◽

Process Indicators ◽

The Social ◽

Audio Recordings ◽

And Behavior

Objective.To develop and evaluate process indicators relevant to biopsychosocial history taking in patients with chronic back and neck pain.Methods.The SCEBS method, covering the Somatic, Psychological (Cognition, Emotion, and Behavior), and Social dimensions of chronic pain, was used to evaluate biopsychosocial history taking by manual physical therapists (MPTs). In Phase I, process indicators were developed while in Phase II indicators were tested in practice.Results.Literature-based recommendations were transformed into 51 process indicators. Twenty MTPs contributed 108 patient audio recordings. History taking was excellent (98.3%) for the Somatic dimension, very inadequate for Cognition (43.1%) and Behavior (38.3%), weak (27.8%) for Emotion, and low (18.2%) for the Social dimension. MTPs estimated their coverage of the Somatic dimension as excellent (100%), as adequate for Cognition, Emotion, and Behavior (60.1%), and as very inadequate for the Social dimension (39.8%).Conclusion.MTPs perform screening for musculoskeletal pain mainly through the use of somatic dimension of (chronic) pain. Psychological and social dimensions of chronic pain were inadequately covered by MPTs. Furthermore, a substantial discrepancy between actual and self-estimated use of biopsychosocial history taking was noted. We strongly recommend full implementation of the SCEBS method in educational programs in manual physical therapy.

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Postural Correction in Persons with Neck Pain. II. Integrated Electromyography of the Upper Trapezius in Three Simulated Neck Positions

Journal of Orthopaedic and Sports Physical Therapy ◽

10.2519/jospt.1986.8.5.240 ◽

1986 ◽

Vol 8 (5) ◽

pp. 240-242 ◽

Cited By ~ 16

Author(s):

Chukuka S. Enwemeka ◽

Ivette M. Bonet ◽

Jayanti A. Ingle ◽

Somsri Prudhithumrong ◽

Frank E. Ogbahon ◽

...

Keyword(s):

Neck Pain ◽

Upper Trapezius ◽

Postural Correction

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Does Continuing Education Improve Physical Therapists’ Effectiveness in Treating Neck Pain? A Randomized Clinical Trial

manuelletherapie ◽

10.1055/s-0028-1109558 ◽

2009 ◽

Vol 13 (03) ◽

pp. 135-136

Author(s):

F. Aretz ◽

R. Kriesling

Keyword(s):

Clinical Trial ◽

Neck Pain ◽

Continuing Education ◽

Randomized Clinical Trial ◽

Physical Therapists

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Does Continuing Education Improve Physical Therapists’ Effectiveness in Treating Neck Pain? A Randomized Clinical Trial

Physical Therapy ◽

10.2522/ptj.20080033 ◽

2009 ◽

Vol 89 (1) ◽

pp. 38-47 ◽

Cited By ~ 29

Author(s):

Joshua A Cleland ◽

Julie M Fritz ◽

Gerard P Brennan ◽

Jake Magel

Keyword(s):

Physical Therapy ◽

Neck Pain ◽

Continuing Education ◽

Rating Scale ◽

Physical Therapists ◽

Neck Disability Index ◽

Mean Difference ◽

Educational Outreach ◽

Final Visit ◽

Pain Rating

Background and PurposePhysical therapists often attend continuing education (CE) courses to improve their overall clinical performance and patient outcomes. However, evidence suggests that CE courses may not improve the outcomes for patients receiving physical therapy for the management of neck pain. The purpose of this study was to investigate the effectiveness of an ongoing educational intervention for improving the outcomes for patients with neck pain.ParticipantsThe study participants were 19 physical therapists who attended a 2-day CE course focusing on the management of neck pain. All patients treated by the therapists in this study completed the Neck Disability Index (NDI) and a pain rating scale at the initial examination and at their final visit.MethodsTherapists from 11 clinics were invited to attend a 2-day CE course on the management of neck pain. After the CE course, the therapists were randomly assigned to receive either ongoing education consisting of small group sessions and an educational outreach session or no further education. Clinical outcomes achieved by therapists who received ongoing education and therapists who did not were compared for both pretraining and posttraining periods. The effects of receiving ongoing education were examined by use of linear mixed-model analyses with time period and group as fixed factors; improvements in disability and pain as dependent variables; and age, sex, and the patient's initial NDI and pain rating scores as covariates.ResultsPatients treated by therapists who received ongoing education experienced significantly greater reductions in disability during the study period (pretraining to posttraining) than those treated by therapists who did not receive ongoing training (mean difference=4.2 points; 95% confidence interval [CI]=0.69, 7.7). Changes in pain did not differ for patients treated by the 2 groups of therapists during the study period (mean difference=0.47 point; 95% CI=−0.11, 1.0). Therapists in the ongoing education group also used fewer visits during the posttraining period (mean difference=1.5 visits; 95% CI=0.81, 2.3).Discussion and ConclusionThe results of this study demonstrated that ongoing education for the management of neck pain was beneficial in reducing disability for patients with neck pain while reducing the number of physical therapy visits. However, changes in pain did not differ for patients treated by the 2 groups of therapists. Although it appears that a typical CE course does not improve the overall outcomes for patients treated by therapists attending that course, more research is needed to evaluate other educational strategies to determine the most clinically effective and cost-effective interventions.

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Impact of Continuing Education Interventions on Clinical Outcomes of Patients With Neck Pain Who Received Physical Therapy

Physical Therapy ◽

10.2522/ptj.20050382 ◽

2006 ◽

Vol 86 (9) ◽

pp. 1251-1262 ◽

Cited By ~ 21

Author(s):

Gerard P Brennan ◽

Julie M Fritz ◽

Stephen J Hunter

Keyword(s):

Physical Therapy ◽

Neck Pain ◽

Continuing Education ◽

Clinical Outcomes ◽

Clinical Improvement ◽

Physical Therapists ◽

Improvement Project ◽

Clinical Databases ◽

Education Interventions ◽

Ongoing Project

Abstract Background and Purpose. Physical therapists frequently attend continuing education courses with the goal of providing better care, yet the effectiveness of continuing education for improving outcomes has not been examined. Subjects. Data were obtained for all eligible patients (n=1,365; mean age=42.1 years, SD=14.0 years; 69.9% female) with a chief complaint of neck pain who were treated in 13 physical therapy clinics over a 24-month period. Disability data (Neck Disability Index scores) from the initial and final therapy sessions were recorded from clinical databases. Methods. Thirty-four of 57 physical therapists employed within the 13 clinics attended a 2-day continuing education course. Eleven of the 34 attendees also participated in an ongoing clinical improvement project for patients with neck pain. Clinical outcomes were compared in the pre- and post-course periods for therapists attending or not attending the course, and for therapists participating or not participating in the ongoing project. Results. There were no differences in clinical outcomes based on attendance at the continuing education course. There was an interaction between time and participation in the ongoing project, such that participants achieved greater change in disability after the course. The percentage of patients achieving at least the minimum detectable amount of change in disability with treatment increased significantly for participants after the course. Discussion and Conclusion. Attendance at a 2-day continuing education course was not associated with improvement in clinical outcomes, but participation in an ongoing improvement project did result in greater clinical improvement for patients with neck pain. Further investigation of educational methods to improve clinical outcomes is needed. These results suggest that traditional continuing education formats may not be effective for improving patient care. [Brennan GP, Fritz JM, Hunter SJ. Impact of continuing education interventions on clinical outcomes of patients with neck pain who received physical therapy. Phys Ther. 2006;86:1251–1262.]

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Immediate Effect of Posture Correction of Trapezius Activity in Computer Users Having Neck Pain – An Electromyographic Analysis

Internet Journal of Allied Health Sciences and Practice ◽

10.46743/1540-580x/2013.1461 ◽

2013 ◽

Author(s):

Kanwalpreet Kaur ◽

Pooja Das ◽

P. Lenka ◽

Shahhawaz Anwer

Keyword(s):

Neck Pain ◽

Computer Use ◽

Neck Disability Index ◽

Trapezius Muscle ◽

Computer Users ◽

Control Group ◽

Group A ◽

Postural Correction ◽

Group B ◽

Lower Trapezius

Objectives: Aberrant activity of the trapezius muscle and associated postural abnormalities have been identified as potential factors for neck pain in computer users, thus postural correction is often advocated. The purpose of this trial was to examine the effect of specific scapular postural correction exercises on middle and lower trapezius activity. Methods: Sixty participants matched for the duration of daily computer use were included in the study. Twenty had no neck pain and exhibited “good” scapular posture (constituting Control group C), while forty reported pain (Neck Disability Index ≥ 15/100) for ≥ 3 months over 12 month period. The latter were randomly allocated to one of the two groups (A and B). Electromyographic recordings were taken from the middle and lower trapezius at rest and during typing. After 20-minutes of typing participants in group A (n=20) practiced scapular postural correction exercises while participants in group B (n=20) relaxed. Electromyographic recordings were repeated in a second typing task. Results: Following correction of the scapular posture in group A, middle trapezius activity became similar to the control group (P = 0.229) with no effect on lower trapezius activity (P < 0.001). Significant normalization did not occur after relaxation exercises (P = 0.004). Conclusion: Intermittent scapular postural correction exercises were effective in altering the middle and lower trapezius activity during computer use and may be advised for prevention of neck pain.

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