scholarly journals Median Nerve Neural Mobilization Adds No Additional Benefit When Combined with Cervical Lateral Glide in the Treatment of Neck Pain: A Randomized Clinical Trial

2021 ◽  
Vol 10 (21) ◽  
pp. 5178
Author(s):  
Daniel Martin-Vera ◽  
Josué Fernández-Carnero ◽  
David Rodríguez-Sanz ◽  
Cesar Calvo-Lobo ◽  
Ibai López-de-Uralde-Villanueva ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Neck Pain ◽  
Pain Intensity ◽  
Median Nerve ◽  
Research Question ◽  
Neck Disability Index ◽  
Total Sample ◽  
Additional Benefit ◽  
Controlled Clinical Trial ◽  
Pressure Pain Thresholds

Background: This study aimed to compare the effectiveness of cervical lateral glide (CLG) added to median nerve neural mobilization (MNNM) in patients with neck pain (NP). Methods: A single-blinded randomized controlled clinical trial was carried out in a Pain Management Unit from a Hospital. A total sample of 72 patients with NP was recruited from a hospital. Patients were randomized to receive isolated CLG (n = 36) or CLG + MNNM (n = 36). Bilateral elbow extension range of motion (ROM) on upper limb neurodynamic test 1 (ULNT1), bilateral pressure pain thresholds (PPT) on the median nerve at elbow joint, C6 zygapophyseal joint and tibialis anterior, Visual analogue scale (VAS), body chart distribution of pain, active cervical ROM (CROM), Neck Disability Index (NDI), and Tampa Scale of Kinesiophobia (TSK-11) were measured at baseline as well as immediately, 15 days, and 1 month after treatment. Results: There were no statistically significant interactions (p > 0.05) between treatment and time for median nerve mechanosensitivity outcomes, pain intensity, symptom distribution, and PPT of the widespread pain assessment, as well as cervical function, and kinesiophobia. Conclusions: MNNM gave no additional benefit to CLG in patients with NP regarding pain intensity, symptom distribution, mechanosensitivity, functionality, and kinesiophobia. Only two treatment sessions and the short follow-up are important issues, therefore, justifying further studies to answer the research question with better methodology.

scholarly journals Neurophysiological Effects of Dry Needling in Patients with Neck Pain, A Randomized Clinical Trial

2021 ◽  
Author(s):  
Luis Martín-Sacristán ◽  
Cesar Calvo-Lobo ◽  
Daniel Pecos-Martín ◽  
Josue Fernández-Carnero ◽  
Jose Luis Alonso-Pérez
Keyword(s):  
Clinical Trial ◽  
Neck Pain ◽  
Pain Intensity ◽  
Trigger Point ◽  
Neck Disability Index ◽  
Pressure Pain Threshold ◽  
Dry Needling ◽  
Post Intervention ◽  
Upper Trapezius ◽  
Tibialis Muscle

Abstract The purpose was to determine the efficacy of deep dry needling (DDN) applied on an active myofascial trigger point (MTrP) versus a latent-MTrP versus a non-MTrP location, on pain reduction and cervical disability, in patients with chronic neck pain. A randomized, double-blind clinical trial design was used. A sample of 65 patients was divided into non-MTrP-DDN, active-MTrP-DDN and latent-MTrP-DDN groups. The visual analog scale (VAS), reproduction of the patient’s pain, number of local twitch responses, pressure pain threshold (PPT) and Neck Disability Index (NDI) were assessed before, during and after the intervention and up to 1 month post-intervention. The active-MTrP-DDN-group reduced pain intensity more than non-MTrP-DDN-group after a week and a month (p<0.01). Active-MTrP-DDN-group showed the greatest improvement in tibialis muscle PPT. An association was found with a higher percentage of subjects in whom their neck pain was reproduced when the active-MTrP (77.3%) and the latent-MTrP (81.8%) were treated. The application of DDN on an active-MTrP in the upper trapezius muscle shows greater improvements in pain intensity after one week and one month post-intervention, as well as lesser improvement in PPT in the tibialis muscle, compared to DDN applied in latent-MTrPs or outside of MTrPs in patients with neck pain

scholarly journals Efficacy and safety of Shi-style cervical manipulation therapy for treating acute and subacute neck pain: study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mingcai Zhang ◽  
Guoqing Du ◽  
Congying Liu ◽  
Wei Li ◽  
Jiayu Yang ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Neck Pain ◽  
Clinical Observation ◽  
Rating Scale ◽  
Neck Disability Index ◽  
Trial Registration ◽  
Activity Measurement ◽  
Manipulation Therapy ◽  
Self Evaluation ◽  
Cervical Manipulation

Abstract Background Neck pain is a common clinical disease, which seriously affects people’s mental health and quality of life and results in loss of social productivity. Improving neck pain’s curative effect and reducing its recurrence rate are major medical problems. Shi’s manipulation therapy has unique advantages and technical features that aid in the diagnosis and treatment of neck pain. Compared with first-line non-steroidal anti-inflammatory drug (NSAID) treatment of neck pain, Shi’s cervical manipulation lacks the relevant research basis of therapeutic advantage, safety, and satisfaction for treating acute and subacute neck pain. Herein, we aim to confirm our hypothesis in a clinical trial that the safety and efficacy of Shi’s cervical manipulation will be more effective, safer, and more satisfactory than NSAIDs to treat acute and subacute neck pain. Methods In this multicenter, positive-controlled, randomized clinical trial, traditional analgesic drug (NSAID) is used to evaluate and show that Shi’s manipulation is more effective, safe, and satisfactory for treating acute and subacute neck pain. Overall, 240 subjects are randomly divided into the trial and control groups, with both groups treated by the corresponding main intervention method for up to 12 weeks. Clinical data will be collected before the intervention and immediately after the first treatment; at 3 days and 1, 2, 4, 8, and 12 weeks after the intervention; and at 26 and 52 weeks after treatment follow-up of clinical observation index data collection. The clinical observation indices are as follows: (1) cervical pain is the primary observation index, measured by Numerical Rating Scale. The secondary indices include the following: (2) cervical dysfunction index, measured by patient self-evaluation using cervical Neck Disability Index; (3) cervical activity measurement, measured by the cervical vertebra mobility measurement program of Android mobile phone system; (4) overall improvement, measured by patient self-evaluation with SF-36; and (5) satisfactory treatment, determined by patient self-evaluation. Discussion We will discuss whether Shi’s cervical manipulation has greater advantages in efficacy, safety, and satisfaction of acute and subacute neck pain than traditional NSAIDs, to provide a scientific basis for the dissemination and application of Shi’s cervical manipulation. Trial registration China Registered Clinical Trial Registration Center ChiCTR1900021371. Registered on 17 February 2019

scholarly journals Effectiveness of Progressive Resisted Exercise along with Conventional Exercise and Conventional Exercise Program alone in Subjects with Text Neck Syndrome

2021 ◽  
pp. 536-542
Author(s):  
Divya Jain ◽  
Swapna Jawade ◽  
Neha Chitale
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Conventional Therapy ◽  
Rating Scale ◽  
Neck Disability Index ◽  
Exercise Program ◽  
Pain Rating ◽  
Numerical Pain Rating Scale ◽  
Neck Disability ◽  
Pain Rating Scale

Background: "Text neck" is a term coined to describe the posture created by leaning forward for lengthy periods of time, such as when reading and texting on a cellphone which has been linked to stress injuries. Neck pain, upper back discomfort, shoulder pain, frequent headaches, and greater curvature of the spine are all dangerous indications of text neck. According to a survey, 35% of smartphone users suffer from text neck syndrome. People between the ages of 15 and 18 are more likely to have neck pain. This protocol has been created that describes the design of comparative study to evaluate effectiveness of progressive resisted exercise along with conventional exercise and conventional exercise program alone in text neck syndrome. Methods: The participants (n=80) will be recruited in the study suffering from text neck syndrome and meeting the inclusion criteria. Two groups will be formed such that patients in group A will be treated with conventional therapy and group B will be treated with progressive resisted exercise (PRE) along with conventional therapy. The protocol will cover 4 weeks of treatment. In the rehabilitation period, we will evaluate the pain intensity, strength of neck muscles and functional activity. Our outcome measures will be- Numerical pain rating scale (NPRS) and Neck disability index (NDI). Discussion: Efficacy of the intervention will be evaluated by analyzing the pain intensity by using Numerical pain rating scale (NPRS) and level of functional disability by using Neck disability index (NDI). The result of the study will significantly provide affirmation on either using combination therapy of PRE with conventional exercise or conventional exercise alone.

Examination of Regional Interdependence Theory in Chronic Neck Pain: Interpretations from Correlation of Strength Measures in Cervical and Pain-Free Regions

Pain Medicine ◽  
2019 ◽  
Author(s):  
Leila Ghamkhar ◽  
Amir Massoud Arab ◽  
Mohammad Reza Nourbakhsh ◽  
Amir Hossein Kahlaee ◽  
Reyhaneh Zolfaghari
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Neck Disability Index ◽  
Chronic Neck Pain ◽  
Pain Intensity Score ◽  
Painful Condition ◽  
Asymptomatic Volunteers ◽  
Interdependence Theory ◽  
Regional Interdependence ◽  
Pain Patients

Abstract Objective Impairments present in chronic pain conditions have been reported not to be limited to the painful region. Pain-free regions have also been proposed to be adversely affected as a cause or consequence of the painful condition. The aim of this study was to investigate the association between muscle strength in painful and pain-free regions and chronic neck pain. Design A cross-sectional study. Setting Rehabilitation hospital laboratory. Subjects One hundred twenty-two patients with chronic neck pain (87 female) and 98 asymptomatic volunteers (52 female) were included in the study. Methods Maximal isometric strength measures of the neck, scapulothoracic, shoulder, trunk, and hip muscles were assessed using a hand-held dynamometer in all participants. Pain intensity and pain-related disability were also assessed in patients through visual analog scale and Neck Disability Index scores, respectively. Results Principal component analysis revealed one component for each of the studied regions. Multivariate analysis of variance found neck (d = 0.46), scapulothoracic (d = 0.46), shoulder (d = 0.60), trunk flexor (d = 0.38), extensor (d = 0.36), and hip (d = 0.51) strength components to be lower in the neck pain patients compared with asymptomatic participants (P < 0.01). Logistic and linear regression analyses found the shoulder strength component both to be a significant predictor for neck pain occurrence (β = 0.53, P < 0.01) and to have a considerable effect on pain intensity score (β=–0.20, P = 0.02), respectively. Conclusions The results found that some pain-free regions in addition to the cervical spine to exhibit lower levels of muscular strength in neck pain patients. These findings support the regional interdependence theory, which proposes that impairments are not limited to the painful area and are possibly mediated by central mechanisms.

“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).

Effect of an early mobilisation programme on pain intensity after laparoscopic surgery: a randomised clinical trial

2020 ◽  
pp. bmjspcare-2020-002618
Author(s):  
Azam Dehghani ◽  
Ali Hajibagheri ◽  
Ismail Azizi-Fini ◽  
Fatemeh Atoof ◽  
Noushin Mousavi
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Surgery ◽  
Pain Intensity ◽  
Repeated Measures ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Early Mobilisation ◽  
Repeated Measures Analysis ◽  
The Mean

BackgroundPain is a common complication after laparoscopic surgery. This study aimed to examine the effect of an early mobilisation programme on postoperative pain intensity after laparoscopic surgery.MethodsA randomised controlled clinical trial was conducted on 80 patients who underwent laparoscopic surgery in Shahid Beheshti Hospital in Kashan, Iran. The patients were randomly allocated to intervention (n=40) and a control (n=40) group. In the intervention group, an early mobilisation programme was implemented in two rounds. The patient’s perceived pain was assessed using a Visual Analogue Scale 15 min before and 30 min after each round of early mobilisation. Data were analysed through the independent samples t, χ2 and Fisher’s exact tests and the repeated measures analysis.ResultsThe repeated measures analysis showed that the mean pain scores have been decreased over time (F=98.88, p<0.001). Considering the observed interaction between time and the intervention, the t test was used for pairwise comparisons and showed that the mean pain score was not significantly different between the two groups in 15 min before the first round of early mobilisation (p=0.95). However, the mean pain in the intervention group was significantly less than the control group in all subsequent measurements (p<0.05).ConclusionEarly mobilisation programmes such as the one implemented in the current study are easy and inexpensive and can be implemented safely for the reduction of pain after laparoscopic surgeries.

Effects of Median Nerve Neural Mobilization in Treating Cervicobrachial Pain: A Randomized Waiting List-Controlled Clinical Trial

Pain Practice ◽  
2017 ◽  
Vol 18 (4) ◽  
pp. 431-442 ◽  
Author(s):  
David Rodríguez-Sanz ◽  
Daniel López-López ◽  
Francisco Unda-Solano ◽  
Carlos Romero-Morales ◽  
Irene Sanz-Corbalán ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Median Nerve ◽  
Waiting List ◽  
Controlled Clinical Trial

scholarly journals A Higher-Order Analysis Supports Use of the 11-Item Version of the Tampa Scale for Kinesiophobia in People With Neck Pain

2013 ◽  
Vol 93 (1) ◽  
pp. 60-68 ◽  
Author(s):  
David Walton ◽  
James M. Elliott
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Convergent Validity ◽  
Rasch Analysis ◽  
Rating Scale ◽  
Neck Disability Index ◽  
Measurement Properties ◽  
Symptom Duration ◽  
Cross Sectional ◽  
Tampa Scale For Kinesiophobia

Background Despite increasing clinical and research use of the 11-item version of the Tampa Scale for Kinesiophobia (TSK-11) in people with neck pain, little is known about its measurement properties in this population. Objective The purpose of this study was to rigorously evaluate the measurement properties of the TSK-11 when used in people with mechanical neck pain. Design This study was a secondary analysis of 2 independent databases (N=235) of people with mechanical neck pain of primarily traumatic origin. Methods The TSK-11 was subjected to Rasch analysis and subsequent evaluation of concurrent associations with the Neck Disability Index and a numeric rating scale for pain intensity. Results The TSK-11 conformed well to the Rasch model for interval-level measurement, but less so for acute or nontraumatic etiologies. A transformation matrix suggested that small changes at the extremes of the scale are more meaningful than in the middle. Cross-sectional convergent validity testing suggested relationships of expected magnitude and direction compared with pain intensity and neck-related disability. The use of the linearly transformed TSK-11 led to potentially important differences in distribution of data compared with use of the raw scores. Limitations The sample size was slightly smaller than desired for Rasch analysis. The 2 databases were similar in terms of symptom duration, but differed in pain intensity and age. Conclusions The TSK-11 can be considered an interval-level measure when used in people with neck pain. It provides potentially important information regarding the nature of neck-related disability. Clinically important difference may not be consistent across the range of the scale.

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