scholarly journals Effects of the Manual Therapy Approach of Segments C0-1 and C2-3 in the Flexion-Rotation Test in Patients with Chronic Neck Pain: A Randomized Controlled Trial

2021 ◽  
Vol 18 (2) ◽  
pp. 753
Author(s):  
Jacobo Rodríguez-Sanz ◽  
Miguel Malo-Urriés ◽  
María Orosia Lucha-López ◽  
Albert Pérez-Bellmunt ◽  
Andoni Carrasco-Uribarren ◽  
...  
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Range Of Motion ◽  
Manual Therapy ◽  
Chronic Neck Pain ◽  
Exercise Session ◽  
Cervical Range Of Motion ◽  
Rotation Test ◽  
Randomized Controlled ◽  
Side Bending

Background: Flexion-rotation test predominantly measures rotation in C1-2 segment. Restriction in flexion-rotation may be due to direct limitation in C1-2, but also to a premature tightening of the alar ligament as a result of lack of movement in C0-1 or C2-3. The aim of this study was to compare the effect of a 20-min single cervical exercise session, with or without manual therapy of C0-1 and C2-3 segment in flexion-rotation test, in patients with chronic neck pain and positive flexion-rotation test. Methods: Randomized controlled clinical trial in 48 subjects (24 manual therapy+exercise/24 exercise). Range of motion and pain during flexion-rotation test, neck pain intensity and active cervical range of motion were measured before and after the intervention. Results: Significant differences were found in favour of the manual therapy group in the flexion-rotation test: right (p < 0.001) and left rotation (p < 0.001); pain during the flexion-rotation test: right (p < 0.001) and left rotation (p < 0.001); neck pain intensity: (p < 0.001); cervical flexion (p < 0.038), extension (p < 0.010), right side-bending (p < 0.035), left side-bending (p < 0.002), right rotation (p < 0.001), and left rotation (p < 0.006). Conclusions: Addition of one C0-C1 and C2-C3 manual therapy session to cervical exercise can immediately improve flexion-rotation test and cervical range of motion and reduce pain intensity.

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.

Efficacy of dry needling as an adjunct to manual therapy for patients with chronic mechanical neck pain: a randomised clinical trial

2020 ◽  
Vol 38 (4) ◽  
pp. 244-254
Author(s):  
Gracia M. Gallego-Sendarrubias ◽  
David Rodríguez-Sanz ◽  
Cesar Calvo-Lobo ◽  
Jose Luis Martín
Keyword(s):  
Clinical Trial ◽  
Neck Pain ◽  
Pain Intensity ◽  
Range Of Motion ◽  
Manual Therapy ◽  
Intervention Group ◽  
Control Group ◽  
Dry Needling ◽  
Cervical Range Of Motion ◽  
Neck Disability

Objective: Chronic mechanical neck pain is associated with musculoskeletal tissue alterations. Active trigger points in the trapezius and levator scapulae muscles are common in patients with chronic mechanical neck pain. In this study, we compared the effect of dry needling (DN) combined with manual therapy (MT) to sham dry needling (SDN) combined with MT on pain, pain pressure threshold, cervical range of motion and neck disability in patients with chronic mechanical neck pain. Methods: A randomised, single-blind clinical trial was carried out involving 101 participants with chronic mechanical neck pain, divided into an intervention group (DN+MT, n=47) and a control group (SDN+MT, n=54). Participants received two treatment sessions. The intervention group received MT in conjunction with DN of the most mechano-sensitive myofascial trigger point (MTrP). The control group received MT plus SDN. Outcomes measures were: pain intensity (numeric pain rating scale, NPRS), pressure pain threshold (PPT), cervical range of motion (ROM) and neck disability (neck disability index, NDI). Results: This study found that between-group differences in pain intensity were statistically significant (P<0.01). Pain decreased after the first intervention in the DN+MT group (3.47±0.25 points on the NPRS) and even more so after the second intervention (4.76±0.24 points on the NPRS). After 4 weeks, pain intensity differed from baseline by 4.89±0.27 points on the NPRS. Statistically significant differences (P<0.001) in PPT were also found between the intervention group and the control group. After the first intervention, a significant increase in PPT within the DN+MT group (3.09±0.8 kg/cm2) was observed. Cervical ROM also showed highly statistically significant differences. After 4 weeks, a statistically significant reduction (P<0.001) in NDI was observed between the two groups. Conclusion: Our results show that DN+MT is efficacious and significantly better than SDN+MT at reducing pain intensity, PPT, neck disability and cervical ROM in patients with chronic mechanical neck pain. Level of evidence: 1b.

scholarly journals Comparison of Dry Needling versus Orthopedic Manual Therapy in Patients with Myofascial Chronic Neck Pain: A Single-Blind, Randomized Pilot Study

2015 ◽  
Vol 2015 ◽  
pp. 1-15 ◽  
Author(s):  
Irene Campa-Moran ◽  
Etelvina Rey-Gudin ◽  
Josué Fernández-Carnero ◽  
Alba Paris-Alemany ◽  
Alfonso Gil-Martinez ◽  
...  
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Manual Therapy ◽  
Pain Catastrophizing ◽  
Chronic Neck Pain ◽  
Mechanical Hyperalgesia ◽  
Time Interval ◽  
Dry Needling ◽  
Neck Disability ◽  
Side Bending

Objective. The aim of this study was to compare the efficacy of three interventions for the treatment of myofascial chronic neck pain. Methods. Thirty-six patients were randomly assigned to one of three intervention groups: orthopedic manual therapy (OMT), dry needling and stretching (DN-S), and soft tissue techniques (STT). All groups received two treatment sessions with a 48 h time interval. Outcome measures included neck pain intensity measured using a visual analogue scale, cervical range of motion (ROM), pressure pain threshold for measuring mechanical hyperalgesia, and two self-reported questionnaires (neck disability index and pain catastrophizing scale). Results. The ANOVA revealed significant differences for the group × time interaction for neck disability, neck pain intensity, and pain catastrophizing. The DN-S and OMT groups reduced neck disability. Only the OMT group showed decreases in mechanical hyperalgesia and pain catastrophizing. The cervical ROM increased in OMT (i.e., flexion, side-bending, and rotation) and DN-S (i.e., side-bending and rotation) groups. Conclusions. The three interventions are all effective in reducing pain intensity. Reduction in mechanical hyperalgesia and pain catastrophizing was only observed in the OMT group. Cervical ROM improved in the DN-S and OMT groups and also neck disability being only clinically relevant for OMT group.

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

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 Prognostic Factors for Improvement in Pain and Disability after Multidisciplinary Rehabilitation in Patients with Chronic Neck Pain

2020 ◽  
Author(s):  
Martin Weigl ◽  
Josefine Letzel ◽  
Felix Angst
Keyword(s):  
Mental Health ◽  
Prognostic Factors ◽  
Neck Pain ◽  
Range Of Motion ◽  
Psychological Treatment ◽  
Short Form ◽  
Chronic Neck Pain ◽  
Rehabilitation Programme ◽  
Cervical Range Of Motion ◽  
Pain Disability

Abstract Background: Recent clinical studies support the effectiveness of chronic neck pain specific multidisciplinary biopsychosocial rehabilitation programmes, but prognostic factors for improvement in pain and disability are unknown. The aim of this study was to identify predictors of improvement in patients with chronic neck pain after participation in a three-week multidisciplinary biopsychosocial rehabilitation programme. Methods: In this observational prospective cohort study patients were assessed at the beginning and the end of a multidisciplinary biopsychosocial rehabilitation programme. Inclusion for participation in the rehabilitation programme depended upon an interdisciplinary pain assessment. Consecutive patients who fulfilled the inclusion criteria were invited to participate in the study. A total of 112 patients participated. The primary outcomes, pain and disability, were measured by the Northern American Spine Society questionnaire (NASS), quantified by effect sizes (ES), and modelled with various co-factors. Secondary outcomes were mental health measured by the Short-Form 36 and total cervical active range of motion measured by a reliable, validated cervical range of motion instrument.Results: Patients’ mean age was 59.7 years (standard deviation=10.8); 70.5% were female. Patients improved significantly (p<0.001) in pain+disability (ES=0.56), mental health (ES=0.45) and cervical range of motion (ES=0.39). Prognostic factors for improvement in pain+disability were worse baseline scores (partial, adjusted correlation r=0.41, p<0.001), higher age (r=0.22, p=0.024), higher improvement in cervical range of motion (r=0.21, p=0.033) and higher improvement in mental health scale (r=0.20; p=0.047). Conclusions: Better outcomes for patients with improvement in neck range of motion, improvement of mental health, and higher age support the use of multidisciplinary biopsychosocial rehabilitation that combines physical and psychological treatment components. Furthermore, the results suggest that older patients may improve more compared to younger patients.

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