scholarly journals Does the Addition of Manual Therapy Approach to a Cervical Exercise Program Improve Clinical Outcomes for Patients with Chronic Neck Pain in Short- and Mid-Term? A Randomized Controlled Trial

2020 ◽  
Vol 17 (18) ◽  
pp. 6601 ◽  
Author(s):  
Jacobo Rodríguez-Sanz ◽  
Miguel Malo-Urriés ◽  
Jaime Corral-de-Toro ◽  
Carlos López-de-Celis ◽  
María Orosia Lucha-López ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Manual Therapy ◽  
Exercise Program ◽  
Chronic Neck Pain ◽  
Exercise Group ◽  
Home Exercise ◽  
Upper Cervical Spine ◽  
Upper Cervical ◽  
Cervical Spine Dysfunction

Chronic neck pain is one of today’s most prevalent pathologies. The International Classification of Diseases categorizes four subgroups based on patients’ associated symptoms. However, this classification does not encompass upper cervical spine dysfunction. The aim is to compare the short- and mid-term effectiveness of adding a manual therapy approach to a cervical exercise protocol in patients with chronic neck pain and upper cervical spine dysfunction. Fifty-eight subjects with chronic neck pain and upper cervical spine dysfunction were recruited (29 = Manual therapy + Exercise; 29 = Exercise). Each group received four 20-min sessions, one per week during four consecutive weeks, and a home exercise regime. Upper flexion and flexion-rotation test range of motion, neck disability index, craniocervical flexion test, visual analogue scale, pressure pain threshold, global rating of change scale, and adherence to self-treatment were assessed at the beginning, end of the intervention and at 3- and 6-month follow-ups. The Manual therapy + Exercise group statistically improved short- and medium-term in all variables compared to the Exercise group. Four 20-min sessions of Manual therapy + Exercise along with a home-exercise program is more effective in the short- to mid-term than an exercise protocol and a home-exercise program for patients with chronic neck pain and upper cervical dysfunction.

scholarly journals Comparison of an exercise program with and without manual therapy for patients with chronic neck pain and upper cervical rotation restriction. Randomized controlled trial

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12546
Author(s):  
Jacobo Rodríguez-Sanz ◽  
Miguel Malo-Urriés ◽  
María Orosia Lucha-López ◽  
Carlos López-de-Celis ◽  
Albert Pérez-Bellmunt ◽  
...  
Keyword(s):  
Neck Pain ◽  
Manual Therapy ◽  
Neck Disability Index ◽  
Pressure Pain Threshold ◽  
Exercise Program ◽  
Chronic Neck Pain ◽  
Exercise Group ◽  
Home Exercise ◽  
Upper Cervical ◽  
Neck Disability

Background Cervical exercise has been shown to be an effective treatment for neck pain, but there is still a need for more clinical trials evaluating the effectiveness of adding manual therapy to the exercise approach. There is a lack of evidence on the effect of these techniques in patients with neck pain and upper cervical rotation restriction. Purpose To compare the effectiveness of adding manual therapy to a cervical exercise protocol for the treatment of patients with chronic neck pain and upper cervical rotation restriction. Methods Single-blind randomized clinical trial. Fifty-eight subjects: 29 for the Manual Therapy+Exercise (MT+Exercise) Group and 29 for the Exercise group. Neck disability index, pain intensity (0–10), pressure pain threshold (kPa), flexion-rotation test (°), and cervical range of motion (°) were measured at the beginning and at the end of the intervention, and at 3-and 6-month follow-ups. The MT+Exercise Group received one 20-min session of manual therapy and exercise once a week for 4 weeks and home exercise. The Exercise Group received one 20-min session of exercise once a week for 4 weeks and home exercise. Results The MT+Exercise Group showed significant better values post-intervention in all variables: neck disability index: 0% patient with moderate, severe, or complete disability compared to 31% in the Exercise Group (p = 0.000) at 6-months; flexion-rotation test (p = 0.000) and pain intensity (p = 0.000) from the first follow-up to the end of the study; cervical flexion (p = 0.002), extension (p = 0.002), right lateral-flexion (p = 0.000), left lateral-flexion (p = 0.001), right rotation (p = 0.000) and left rotation (p = 0.005) at 6-months of the study, except for flexion, with significative changes from 3-months of follow up; pressure pain threshold from the first follow-up to the end of the study (p values range: 0.003–0.000). Conclusion Four 20-min sessions of manual therapy and exercise, along with a home-exercise program, was found to be more effective than an exercise protocol and a home-exercise program in improving the neck disability index, flexion-rotation test, pain intensity, and pressure pain threshold, in the short, medium, and medium-long term in patients with chronic neck pain and upper rotation restriction. Cervical range of motion improved with the addition of manual therapy in the medium and medium-long term. The high dropout rate may have compromised the external validity of the study.

scholarly journals Neck Pain Following Concussion

Concussion ◽  
2019 ◽  
pp. 151-154
Author(s):  
Brian Hainline ◽  
Lindsey J. Gurin ◽  
Daniel M. Torres
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Cervical Spine Injury ◽  
Cervicogenic Headache ◽  
Spine Injury ◽  
Upper Cervical Spine ◽  
Persistent Symptoms ◽  
Upper Cervical ◽  
Vestibular Symptoms ◽  
Serious Injury

Neck pain and cervicalgia are common following concussion. The cervical spine should be carefully examined in any individual who has sustained a concussion, because neck pain may be a sign of more serious underlying cervical spine injury. Even when a more serious injury has been ruled out, it is noteworthy that the cervical structures are vulnerable to stress and injury at their end range of motion, and such motion occurs commonly in an accelerated fashion with concussion. Further, cervical spine injury may cause faulty proprioceptive input from the upper cervical spine, resulting in vestibular symptoms. Cervicalgia is a source of persistent symptoms following concussion and frequently manifests with dizziness and cervicogenic headache. Individuals with persistent symptoms of cervicalgia or cervicogenic headache may benefit from a combination of physical therapy and vestibular therapy.

scholarly journals Extension and flexion in the upper cervical spine in neck pain patients

2015 ◽  
Vol 20 (4) ◽  
pp. 547-552 ◽  
Author(s):  
Markus J. Ernst ◽  
Rebecca J. Crawford ◽  
Sarah Schelldorfer ◽  
Anne-Kathrin Rausch-Osthoff ◽  
Marco Barbero ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Upper Cervical Spine ◽  
Upper Cervical ◽  
Pain Patients

scholarly journals Extension and flexion in the upper cervical spine in neck pain patients

2016 ◽  
Vol 25 ◽  
pp. e70-e71
Author(s):  
M. Ernst ◽  
R. Crawford ◽  
A.-K. Rausch-Osthoff ◽  
M. Barbero ◽  
J. Kool ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Upper Cervical Spine ◽  
Upper Cervical ◽  
Pain Patients

scholarly journals The benefits of manual therapy and active cervical exercises in pacients with cerviogenic headache

2021 ◽  
Vol 67 (3) ◽  
pp. 149-153
Author(s):  
Manuela Lalu ◽  
Petru Mihancea ◽  
Olivia Andreea Marcu
Keyword(s):  
Cervical Spine ◽  
Manual Therapy ◽  
Demographic Data ◽  
Trigger Points ◽  
Cervicogenic Headache ◽  
Upper Cervical Spine ◽  
Endurance Test ◽  
Cervicogenic Headaches ◽  
Upper Cervical ◽  
Orofacial Region

Abstract Introduction: Cervicogenic headache stems from a dysfunctional mechanism that frequently affects the upper region of the cervical spine, often involving multiple tissues connected with the occipital, submandibular, and orofacial region. Objectives: The main objective of this study is to demonstrate the therapeutic effectiveness of a personalized program of manual therapy and specific exercises in patients with cervicogenic headaches. Material and Methods: The study included 44 patients. Specific functional tests of the cranio-cervical-mandibular complex, namely the evaluation of the cranio-cervical-mandibular complex (according to Rocabado), cervical flexion-rotation test, cervical flexor endurance test, cervical extensors endurance test, and palpation of trigger points and cervical spine dynamics, were employed. Results: The analysis of demographic data shows a significantly increased prevalence of headache among women. The symptomatology that almost always accompanies episodes of cervicogenic headache is localized neck pain. The intensity and frequency of the symptoms are strongly associated with alterations in the dynamics of the upper cervical spine and chronic sleep disorders. Conclusion: Cranio-cervical manual therapy has proven effective in patients with cervicogenic headaches. The implementation of a strategy based on manual therapy and active exercise had a superior statistical and clinical result compared to the exclusively manual therapeutic approach.

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