scholarly journals Focus on the Scapular Region in the Rehabilitation of Chronic Neck Pain Is Effective in Improving the Symptoms: A Randomized Controlled Trial

2021 ◽  
Vol 10 (16) ◽  
pp. 3495
Author(s):  
Norollah Javdaneh ◽  
Tadeusz Ambroży ◽  
Amir Hossein Barati ◽  
Esmaeil Mozafaripour ◽  
Łukasz Rydzik

Chronic neck pain is a common human health problem. Changes in scapular posture and alteration of muscle activation patterns of scapulothoracic muscles are cited as potential risk factors for neck pain. The purpose of this study was to compare the effects of neck exercise training (NET) with and without scapular stabilization training (SST) on pain intensity, the scapula downward rotation index (SDRI), forward head angle (FHA) and neck range of motion (ROM) in patients with chronic neck pain and scapular dyskinesia. A total of sixty-six subjects with chronic neck pain and scapular dyskinesia were randomly divided into three groups: neck exercise training, n = 24, combined training (NET + SST), n = 24 and a control group, n = 24. Pain intensity, SDRI, FHA and ROM were measured by the numerical rating scale, caliper, photogrammetry and IMU sensor, respectively. When the combined intervention group consisting of NET and SST was compared with NET alone at six weeks, there was a statistically significant difference in pain intensity, SDRI, FHA and cervical ROM for flexion and extension (p ≤ 0.05). Adding scapular exercises to neck exercises had a more significant effect in decreasing pain intensity, SDRI, FHA and increased cervical ROM than neck exercises alone in patients with chronic neck pain. These findings indicate that focus on the scapular posture in the rehabilitation of chronic neck pain effectively improves the symptoms.

2020 ◽  
Vol 2 (2) ◽  
pp. 74
Author(s):  
Kirnawan Fadholi ◽  
Akhmad Mustofa

Pain management in postoperative patients so far in the Shofa Room of PKU Muhammadiyah Hospital in Temanggung is still limited to pharmacotherapy in the form of 1 gram injection metamizole or 30mg ketorolac injection and the provision of deep breath therapy. Giving this therapy is not optimal in dealing with patient pain. Therefore other therapies need to be given for example non-pharmacology, one of them is a combination of murottal Al-Qur'an therapy and virtual reality when the pharmacotherapy reaction is finished and the complementary therapy has never been done in the room. The purpose of this study was to determine the effect of a combination of Murottal Al-Qur'an therapy and virtual reality on pain intensity in postoperative patients. The research design used in this study was quasi-experimental with a pre-posttest with a control group design approach. The subjects of this study were 32 post-operative patients at PKU Muhammadiyah Temanggung Hospital. The sampling technique used was purposive sampling. The instrument used in obtaining data is the Numeric Rating Scale. The results showed that: 1) there were differences in the average pretest and posttest intensity of postoperative pain in the intervention group with a p-value of 0,000; 2) there is a difference in the average pretest and posttest intensity of postoperative pain in the control group with a p-value of 0.003; and 3) there is a significant difference in the decrease in intensity of postoperative pain in the intervention group and the control group with a p-value of 0.009 where the experimental group showed a decrease in intensity more effectively than the control group. The results of this study indicate that the combination of Murottal Al-Qur'an therapy and virtual reality is effective in reducing pain intensity in postoperative patients.


2020 ◽  
Vol 22 (3) ◽  
Author(s):  
Monticha Sakuna ◽  
Keerin Mekhora ◽  
Wattana Jalajondeja ◽  
Chutima Jalajondeja

Purpose: The aim of this paper was to evaluate the effects of breathing retraining with chest wall mobilization on the onset of accessory breathing muscle recruitment and respiratory reserve in individuals with chronic neck pain. Methods: Thirty-two participants with non-specific chronic neck pain were randomly assigned into intervention and control groups. The intervention group received 30 minutes of breathing retraining with chest wall mobilization and the control group was assigned to rest for 30 minutes. Electromyography (EMG) of upper trapezius (UT), scalene (SC), and sternocleidomastoid (SCM) muscles were recorded during respiratory excursions by cycling for 12 minutes. Measurement of maximum voluntary ventilation (MVV), chest expansion, and pain intensity were taken during normal breathing. The immediate effects within each group and between two groups were analyzed. Results: Significant improvement in respiratory reserve was observed in the intervention group compared to control group through prolonged EMG onset of accessory breathing muscles. Moreover, increase of MVV, chest expansion and decrease in pain intensity were observed. Conclusions: This research suggests that breathing patterns and chest expansion should be considered within the physical assessment of breathing retraining, and that chest wall mobilization offers clinically important improvements in patients with chronic neck pain.


2020 ◽  
pp. 026921552096505
Author(s):  
Vanessa González-Rueda ◽  
Carlos López-de-Celis ◽  
Elena Bueno-Gracia ◽  
Jacobo Rodríguez-Sanz ◽  
Albert Pérez-Bellmunt ◽  
...  

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).


2007 ◽  
Vol 87 (4) ◽  
pp. 408-417 ◽  
Author(s):  
Deborah Falla ◽  
Gwendolen Jull ◽  
Trevor Russell ◽  
Bill Vicenzino ◽  
Paul Hodges

Background and PurposePoor sitting posture has been implicated in the development and perpetuation of neck pain symptoms. This study had 2 purposes: (1) to compare change in cervical and thoracic posture during a distracting task between subjects with chronic neck pain and control subjects and (2) to compare the effects of 2 different neck exercise regimens on the ability of people with neck pain to maintain an upright cervical and thoracic posture during this task.SubjectsFifty-eight subjects with chronic, nonsevere neck pain and 10 control subjects participated in the study.MethodChange in cervical and thoracic posture from an upright posture was measured every 2 minutes during a 10-minute computer task. Following baseline measurements, the subjects with neck pain were randomized into one of two 6-week exercise intervention groups: a group that received training of the craniocervical flexor muscles or a group that received endurance-strength training of the cervical flexor muscles. The primary outcomes following intervention were changes in the angle of cervical and thoracic posture during the computer task.ResultsSubjects with neck pain demonstrated a change in cervical angle across the duration of the task (mean=4.4°; 95% confidence interval [CI]=3.3–5.4), consistent with a more forward head posture. No significant difference was observed for the change in cervical angle across the duration of the task for the control group subjects (mean=2.2°; 95% CI=1.0–3.4). Following intervention, the craniocervical flexor training group demonstrated a significant reduction in the change of cervical angle across the duration of the computer task.Discussion and ConclusionThis study showed that people with chronic neck pain demonstrate a reduced ability to maintain an upright posture when distracted. Following intervention with an exercise program targeted at training the craniocervical flexor muscles, subjects with neck pain demonstrated an improved ability to maintain a neutral cervical posture during prolonged sitting.


2017 ◽  
Vol 12 (2) ◽  
pp. 212-217
Author(s):  
Roy Januardi Irawan

Pencak Silat is a martial art that has a risk of causing micro-trauma due to physical impact. This trauma will stimulate the secretion of prostaglandin, a compound in the body which is a mediator of pain and inflammatory response that promote pain in bruised trauma. Passion fruit contains high level of anti-inflammatory and antioxidant substances. The objective of this study was to understand the effectiveness of passion fruit juice consumption in reducing bruised trauma pain in Pencak Silat athletes of PSHT Belotan Magetan. The research design is a quantitative descriptive with quasi-experimental. The pretest and posttest group of 20 people PSHT Belotan Magetan Pencak Silat athletes with an average age of 13.4 0.94 years were divided into treatment group (K1) and control group (K0) with 10 subjects respectively. Each treatment group (K1) subject was given the juice twice a day for 10 consecutive days. We used paired sample T-test to assess the mean variance of the group. The result showed that there was a decrease of pain intensity in both the treatment group and the control group. The pain intensity difference assessed by a Bourbonnais Rating Scale in the treatment group showed a significant difference with the t value of 7,216 and a probability value of 0,000, while the control group showed t value of 3,000 and probability value of 0,015. There was a decrease in the athletes muscle soreness who were given passion fruit juice twice a day for 10 days. The athletes pain intensity was in middle category.


Author(s):  
Mariyam Momeni ◽  
Mansoureh Jamshidimanesh ◽  
Hadi Ranjbar

Background: Pregnancy and childbirth are natural phenomena in a women’s life, associated with stress and anxiety, leading to adverse effects in the mother and fetus. Using complementary medicine, such as aromatherapy, music, light radiation, and aquariums in an environment that engage a person’s multiple senses can make mothers relax through mental deviations. Objectives: The aim of this study was to evaluate the effects of a Snoezelen room on fear, anxiety, and satisfaction of childbirth’s nulliparous women. Methods: This randomized clinical trial was carried out on 130 eligible women in a selected hospital affiliated to the Iran University of Medical Sciences in Tehran. One hundred thirty women were randomly assigned to the intervention (n = 65) and control (n = 65) groups using six modes blocks using the convenient sampling method. The delivery room was designed to distract women’s minds in the intervention group. Data were collected using a demographic characteristics form, Harman’s Childbirth Attitude questionnaire (CAQ), Visual Analogue scale (VAS) to measure childbirth anxiety, and the Mackey Childbirth Satisfaction Rating scale. Data were analyzed by SPSS version 16 using independent t-test, repeated measures analysis of variance, and Bonferroni and chi-square tests. Results: The results showed a significant reduction in fear in the active phase and postpartum in the intervention group compared with the control group (P < 0.001 and P < 0.001, respectively). Anxiety showed a significant difference and was lower at dilatation of 6 to 7 and 7 to 8 cm, and after childbirth in the interventional group. The satisfaction of childbirth significantly increased in the interventional group (P < 0.001). Conclusions: These results confirmed the importance of a Snoezelen room in the childbirth of nulliparous women, which can promote vaginal childbirth.


2019 ◽  
Vol 33 (12) ◽  
pp. 1908-1918 ◽  
Author(s):  
Lucia Domingues ◽  
Fernando Manuel Pimentel-Santos ◽  
Eduardo Brazete Cruz ◽  
Ana Cristina Sousa ◽  
Ana Santos ◽  
...  

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.


2015 ◽  
Vol 23 (5) ◽  
pp. 551-557 ◽  
Author(s):  
David Brauge ◽  
Cyrille Delpierre ◽  
Philippe Adam ◽  
Jean Christophe Sol ◽  
Pierre Bernard ◽  
...  

OBJECT Acute cervical spine injuries have been extensively studied in high-level contact sports. However, the relation between the appearance of degenerative cervical spine disease and the exposure to repeated trauma in such sports as rugby is still unclear. Using clinical and MRI evaluation, we aimed to determine if former professional rugby players had more serious degenerative cervical spine symptoms than the general population. METHODS Two groups, one composed of 101 former rugby players (all men, mean age 40.3 years, range 35–47 years, SD 2.3 years) and the other of 85 male volunteers serving as a control group (mean age 41.6 years, range 35–49 years, SD 4.5 years) were studied. The former rugby players were evaluated on average 5.8 years after retirement (range 1–16 years, SD 3.5 years). The groups were matched in terms of sex, age, job, current sports training, and smoking habits. Each participant received a complete neurological evaluation. Clinical symptoms were evaluated using the Japanese Orthopaedic Association (JOA) questionnaire, and chronic neck pain was specifically evaluated using a visual analog scale (VAS) and the Neck Disability Index (NDI). Overall, 25 MRI studies were performed in each group. MRI studies, including dynamic sequences, focused on degenerative lesions (Matsumoto score and canal diameter) and on muscular and medullary morphological analysis. RESULTS Significantly more former rugby players than controls complained of chronic neck pain (51 [50.50%] of 101 vs 27 [31.76%] of 85, p = 0.01). Rugby players also had significant reductions of neck mobility. Nevertheless, in those complaining of pain, there was no statistically significant difference between groups with respect to VAS and NDI scores (p = 0.57). On MRI, former rugby players had a narrower vertebral canal (on average 0.88 ± 0.167 cm vs 0.99 ± 0.130 cm, p = 0.007) and more foraminal stenosis (p = 0.01). No significant difference in the Matsumoto score was found between the 2 groups with respect to other degenerative lesions. Former rugby players had more often undergone surgery for a degenerative condition than had members of the control group (10 cases vs 0 in the control group, p = 0.0021). CONCLUSIONS A few years after retirement, former professional rugby players seem to have more frequent cervical spine pain and MRI degenerative lesions, such as foraminal stenosis and narrowing of the spinal canal, compared with controls who had not been professional rugby players. A longer evaluation is necessary to determine if these findings persist over time.


2014 ◽  
Vol 21 (8) ◽  
pp. 929-945 ◽  
Author(s):  
Meryem Yilmaz ◽  
Hesna Gurler

Background: Attention to patients’ spirituality, as a moral obligation of care, is now widely accepted in nursing practice. However, until recently, many nursing programs have paid little attention to spirituality. Objective: The objective of this study was to identify the impact of two different curricula, used to teach undergraduate nursing students, on increasing nursing student awareness of spirituality in the care of patients. Research design: A quasi-experimental post-intervention two-group design was conducted in 2009–2010 and 2010–2011 academic years. Participants and research context: The study included a total of 130 volunteer senior-year students. The students were assigned as “the intervention group/integrated system” that were informed about spirituality or as “the control group/traditional system” that received no information on spirituality. Data were collected via a personal information form and the Spirituality and Spiritual Care Rating Scale was used to assess responses. The study was conducted at the Department of Nursing of the Faculty of Health Sciences, Cumhuriyet University, in Central Anatolia/Turkey. Ethical considerations: Permission to conduct the study at the nursing school was obtained from the schools’ management teams. The rights of the participants were protected in this study by obtaining informed consent. Findings: The results revealed that the intervention group had a higher mean score on the Spirituality and Spiritual Care Rating Scale than did the control group. The students in the intervention group defined the terms of spirituality and spiritual care more accurately than did the control group students. Discussion: Nurses are professionally and ethically responsible for providing spiritual care. Nurses’ competence in meeting the spiritual needs of their patients should be improved by undergraduate education on spiritual care. Nursing scholars reported a significant difference in the knowledge and attitudes toward spirituality of nursing students as a result of the integration of spirituality into the undergraduate nursing curriculum. Conclusion: Spirituality should be more widely included in nursing education.


10.2196/31482 ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. e31482
Author(s):  
Daniel Pach ◽  
Susanne Blödt ◽  
Jiani Wang ◽  
Theresa Keller ◽  
Beatrice Bergmann ◽  
...  

Background Chronic neck pain is a highly prevalent condition. Learning a relaxation technique is recommended by numerous guidelines for chronic neck pain. Smartphone apps can provide relaxation exercises; however, their effectiveness, especially in a self-care setting, is unclear. Objective The aim of this pragmatic randomized trial is to evaluate whether app-based relaxation exercises, including audio-based autogenic training, mindfulness meditation, or guided imagery, are more effective in reducing chronic neck pain than usual care alone. Methods Smartphone owners aged 18 to 65 years with chronic (>12 weeks) neck pain and the previous week’s average neck pain intensity ≥4 on the Numeric Rating Scale (0=no pain to 10=worst possible pain) were randomized into either an intervention group to practice app-based relaxation exercises or a control group (usual care and app for data entry only). For both groups, the follow-up data were collected using app-based diaries and questionnaires. The primary outcome was the mean neck pain intensity during the first 3 months based on daily measurements. Secondary outcomes included neck pain based on weekly measurements, pain acceptance, neck pain–related stress, sick-leave days, pain medication intake, and adherence, which were all measured until the 6-month follow-up. For the primary analysis, analysis of covariance adjusted for baseline neck pain intensity was used. Results We screened 748 participants and enrolled 220 participants (mean age 38.9, SD 11.3 years; mean baseline neck pain 5.7, SD 1.3 points). The mean neck pain intensity in both groups decreased over 3 months; however, no statistically significant difference between the groups was found (intervention: 4.1 points, 95% CI 3.8-4.4; control: 3.8 points, 95% CI 3.5-4.1; group difference: 0.3 points, 95% CI −0.2 to 0.7; P=.23). In addition, no statistically significant between-group differences regarding neck pain intensity after 6 months, responder rate, pain acceptance, pain medication intake, or sick-leave days were observed. There were no serious adverse events that were considered related to the trial intervention. In week 12, only 40% (44/110) of the participants in the intervention group continued to practice the exercises with the app. Conclusions The study app did not effectively reduce chronic neck pain or keep the participants engaged in exercising in a self-care setting. Future studies on app-based relaxation interventions should take into account the most recent scientific findings for behavior change techniques. Trial Registration ClinicalTrials.gov NCT02019134; https://clinicaltrials.gov/ct2/show/NCT02019134 International Registered Report Identifier (IRRID) RR2-10.1186/1745-6215-15-490


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