Fascial treatment versus manual therapy (HVLA) in patients with chronic neck pain: A randomized controlled trial

2021 ◽  
pp. 1-10
Author(s):  
Katrin Brück ◽  
Kirsten Jacobi ◽  
Tobias Schmidt
Keyword(s):  
Neck Pain ◽  
Manual Therapy ◽  
Repeated Measures ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Severity Of Illness ◽  
Chronic Neck Pain ◽  
Secondary Outcome ◽  
Control Group ◽  
Industrialized Nations

BACKGROUND: Chronic neck pain (CNP) is a common health problem in western industrialized nations. In recent years, the fascial tissue has attracted the attention of therapists, and a treatment of the fasciae promises to be a meaningful approach in the therapy of patients with CNP. OBJECTIVE: The aim of this study was to investigate the effectiveness of a fascial treatment (FT) compared to manual therapy (MT) and to no intervention (control group, CG) in patients with CNP. METHODS: Sixty participants with CNP were randomized into three groups. Primary outcome parameters were pain intensity as measured by the visual analogue scale (VAS), and severity of illness as measured by the Neck Pain and Disability Scale (NPAD). Secondary outcome parameter was the range of motion (ROM) of the cervical spine. RESULTS: Repeated measures t-tests demonstrated significant decreases with medium to large effect sizes for the FT (VAS: dR⁢M= 1.14; NPAD: dR⁢M= 0.51) and for the MT (VAS: dR⁢M= 1.15; NPAD: dR⁢M= 0.72). CONCLUSION: Our results confirmed the effectiveness of MT on pain and severity of illness in the treatment of patients suffering from CNP. Furthermore, the results demonstrated the effectiveness and clinical relevance of FT for this population.

scholarly journals Manual therapy versus therapeutic exercise in non-specific chronic neck pain: study protocol for a randomized controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Carlos Bernal-Utrera ◽  
Juan José González-Gerez ◽  
Manuel Saavedra-Hernandez ◽  
Miguel Ángel Lérida-Ortega ◽  
Cleofás Rodríguez-Blanco
Keyword(s):  
Randomized Controlled Trial ◽  
Neck Pain ◽  
Manual Therapy ◽  
Study Protocol ◽  
Controlled Trial ◽  
Chronic Neck Pain ◽  
Therapeutic Exercise ◽  
Randomized Controlled

“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.”

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).

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

2020 ◽  
Vol 34 (12) ◽  
pp. 1485-1496 ◽  
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.

scholarly journals Manual therapy versus therapeutic exercise in non-specific chronic neck pain: a randomized controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Carlos Bernal-Utrera ◽  
Juan Jose Gonzalez-Gerez ◽  
Ernesto Anarte-Lazo ◽  
Cleofas Rodriguez-Blanco
Keyword(s):  
Randomized Controlled Trial ◽  
Neck Pain ◽  
Manual Therapy ◽  
Controlled Trial ◽  
Chronic Neck Pain ◽  
Therapeutic Exercise ◽  
Randomized Controlled

scholarly journals Effect of Combined Manual Therapy and Therapeutic Exercise Protocols on the Postural Stability of Patients with Non-Specific Chronic Neck Pain. A Secondary Analysis of Randomized Controlled Trial

2021 ◽  
Vol 11 (1) ◽  
pp. 84
Author(s):  
Carlos Bernal-Utrera ◽  
Ernesto Anarte-Lazo ◽  
Juan Jose Gonzalez-Gerez ◽  
Manuel Saavedra-Hernandez ◽  
Elena De-La-Barrera-Aranda ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Neck Pain ◽  
Manual Therapy ◽  
Postural Stability ◽  
Chronic Neck Pain ◽  
Control Group ◽  
Placebo Control ◽  
Therapeutic Exercise ◽  
The Relationship

Postural stability is a little-studied factor in non-specific chronic neck pain; the causes that can alter it are unknown. The relationship with chronic pain could be a determining factor for its deficit. The aim of this study was to investigate the relationship between sustained pain and a postural stability deficit. A randomized and blinded clinical trial (double-blind; placebo control; 12 weeks follow-up) was conducted with a total of 69 subjects divided into three groups, two experimental (manual therapy and specific exercise) and a control treatment, and carried out over a treatment period of three weeks with a follow-up after 12 weeks. Their postural stability was assessed through the overall balance index (OBI). The postural stability of subjects with non-specific chronic neck pain improved in the experimental treatments. There were no statistically significant differences between the experimental groups. This trial found that manual therapy and therapeutic exercise significantly improved OBI compared to the control group. Trial registration: Brazilian Clinical Trial Registry, RBR-2vj7sw.

scholarly journals Manual Therapy Versus Therapeutic Exercise in non-specific chronic neck pain: study protocol for a randomized controlled trial.

2019 ◽  
Author(s):  
Carlos Bernal-Utrera ◽  
Juan Jose Gonzalez-Gerez ◽  
Manuel Saavedra-Hernandez ◽  
Miguel Angel Lerida-Ortega ◽  
Cleofas Rodriguez-Blanco
Keyword(s):  
Neck Pain ◽  
Manual Therapy ◽  
Postural Stability ◽  
Controlled Trial ◽  
Pressure Pain Threshold ◽  
Decisive Role ◽  
Chronic Neck Pain ◽  
Therapeutic Exercise ◽  
Clinical Trial Registry ◽  
Significance Level

Abstract • Background: Underlying mechanisms of non-specific chronic neck pain relapses are not clear, but it could be associated with a deficit and alteration of neck muscles propioception that play a decisive role in cervical joint position, motor control of the head and postural stability. Numerous treatments for non-specific chronic neck pain have been described in the scientific literature. However, few studies analyze its influence on postural stability, since these alterations are not fully described, and various theories emerge about the reasons that cause it. Our mainly aim is analyze the differences in postural stability, pain, cervical disability and the relation between them produced by a treatment based on manual therapy and other based on therapeutic exercise. • Methods: The short-term and mid-term changes produced by different therapies on subjects with non-specific chronic neck pain will be studied. The sample will be randomly divided into three groups, manual therapy, therapeutic exercise and placebo. As dependent variables of the study, we will take: a) overall balance index, measured through a dynamic stabilometric platform; b) pain, based on the visual analog scale and the pressure pain threshold; c) cervical disability, through the cervical disability index. The findings will be analyzed statistically considering a 5% significance level (p ≤ 0.05) • Discussion: Our study aims to provide knowledge about postural stability and its relationship with pain in subjects with non-specific chronic neck pain. Analyzing the results produced by different types of therapy will allow us to draw conclusions about the mechanisms that may elicit these alterations, structural or central mechanisms. • Trial registration: Brazilian Clinical Trial Registry, RBR-2vj7sw. Registered on 28 November 2018.

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

2019 ◽  
Vol 33 (12) ◽  
pp. 1908-1918 ◽  
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.

scholarly journals Triaging and Referring In Adjacent General and Emergency Departments (the TRIAGE trial): a cluster randomised controlled trial

2021 ◽  
Author(s):  
Stefan Morreel ◽  
Hilde Philips ◽  
Diana De Graeve ◽  
Koenraad G Monsieurs ◽  
Jarl Kampen ◽  
...  
Keyword(s):  
Primary Care ◽  
Randomised Controlled Trial ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Intervention Group ◽  
Cluster Randomised Controlled Trial ◽  
Secondary Outcome ◽  
Control Group ◽  
Predictive Values ◽  
Randomised Controlled

Objectives: To determine the effectiveness and safety of a tool diverting low urgency patients eligible for primary care from an emergency department (ED) to the adjacent general practitioner cooperative (GPC). Methods: Unblinded, randomised controlled trial with weekends serving as clusters (three intervention clusters for each control). The intervention was nurse-led triage using a new tool assigning patients to either ED or GPC. During intervention weekends, patients were encouraged to follow this assignment while it was not communicated to the patients during control weekends (they remained at the ED). The primary outcome was the proportion of patients assigned to and handled by the GPC during intervention weekends. The trial was randomised for the secondary outcome: the proportion of patients assigned to the GPC during intervention and control weekends. Additional outcomes were association of these outcomes with possible confounders (study tool parameters, nurse, and patient characteristics), proportion of patients referred back to the ED by the GPC, hospitalisations, and performance of the study tool to detect primary care eligible patients (with the opinion of the treating physician as the gold standard). Results: In the intervention group, 838/6374 patients (13.3%, 95% CI 12.5 to 14.2) were assigned to the GPC (secondary outcome), in the control group 431/1744 (24.7%, 95% CI 22.7 to 26.8). In the intervention group, 599/6374 patients (9.5%, 95% CI 8.8 to 10.3) experienced the primary outcome which was influenced by the chosen MTS presentational flowchart, patient's age, and the nurse. 24/599 patients (4.0%, 95% CI 2.7 to 5.9) patients were referred back to the ED of which three were hospitalised. Positive and negative predictive values of the studied tool during intervention weekends were 0.96 (95%CI 0.94 to 0.97) and 0.60 (95% CI 0.58 to 0.62). Out of the patients assigned to the GPC, 2.4% (95% CI 1.7 to 3.4) were hospitalised. Conclusions: ED nurses using a new tool safely diverted 9.5% of the included patients to primary care. ClinicalTrials.gov Identifier: NCT03793972 Funding: Research Foundation, Flanders (FWO)

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