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.

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: The underlying mechanisms that are causes of non-specific chronic neck pain relapses are not clear, but it could be associated with a deficit and alteration of the proprioception of the neck muscles that play a decisive role in the cervical joint position, motor control of the head and about 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 another 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. The general stability index, measured through a dynamic stabilometric platform, pain based on the visual analog scale and the pressure pain threshold, and the cervical disability through the cervical disability index were taken as dependent variables of the study. 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 provoke these alterations, structural or central mechanisms. • Trial registration: Brazilian Clinical Trial Registry, RBR-2vj7sw. Registered on 28 November 2018.

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.

scholarly journals Efficacy of Manual Therapy and Transcutaneous Electrical Nerve Stimulation in Cervical Mobility and Endurance in Subacute and Chronic Neck Pain: A Randomized Clinical Trial

2021 ◽  
Vol 10 (15) ◽  
pp. 3245
Author(s):  
Belén Díaz-Pulido ◽  
Yolanda Pérez-Martín ◽  
Daniel Pecos-Martín ◽  
Isabel Rodríguez-Costa ◽  
Milagros Pérez-Muñoz ◽  
...  
Keyword(s):  
Primary Care ◽  
Neck Pain ◽  
Manual Therapy ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Sagittal Plane ◽  
Chronic Neck Pain ◽  
Post Intervention ◽  
Electrical Nerve Stimulation

Neck pain is a frequent health problem. Manual therapy (MT) and transcutaneous electrical nerve stimulation (TENS) are recommended techniques for treatment of mechanical neck disorders (MND) in Spanish Public Primary Care Physiotherapy Services. The aim of this study was to compare the efficacy of MT versus TENS in active mobility and endurance in cervical subacute or chronic neck pain. Ninety patients with MND were randomly allocated to receive ten 30-min sessions of either MT or TENS, in a multi-centered study through 12 Primary Care Physiotherapy Units in the Madrid community. Active cervical range of motion (CD-ROM) and endurance (Palmer and Epler test) were evaluated pre- and post-intervention and at 6-month follow-up. A generalized linear model of repeated measures was constructed for the analysis of differences. Post-intervention MT yielded a significant improvement in active mobility and endurance in patients with subacute or chronic MND, and at 6-month follow-up the differences were only significant in endurance and in sagittal plane active mobility. In the TENS group, no significant improvement was detected. With regard to other variables, MT improved mobility and endurance more effectively than TENS at post-intervention and at 6-month follow-up in the sagittal plane. Only MT generated significant improvements in cervical mobility and endurance in the three movement planes.

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

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 The Effect of Combination Therapy; Manual Therapy and Exercise, in Patients With Non-Specific Chronic Neck Pain: A Randomized Clinical Trial

2017 ◽  
pp. 113-121 ◽  
Author(s):  
Maryam Ghodrati ◽  
Zahra Mosallanezhad ◽  
Mohsen Shati ◽  
Forouzan Rastgar Koutenaei ◽  
Mohammad Reza Nourbakhsh ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Combination Therapy ◽  
Neck Pain ◽  
Randomized Clinical Trial ◽  
Manual Therapy ◽  
Chronic Neck Pain ◽  
Therapy Manual

scholarly journals The Effect of Manual Therapy and Stabilizing Exercises on Forward Head and Rounded Shoulder Postures: a six-week intervention with a one-month follow-up study (Preprint)

2017 ◽  
Author(s):  
Kiana Fatholahnezhad ◽  
Amir Letafatkar ◽  
Malihe Hadadnezhad
Keyword(s):  
Neck Pain ◽  
Manual Therapy ◽  
Combined Treatment ◽  
Control Group ◽  
Post Intervention ◽  
Before And After ◽  
Group 2 ◽  
And Function ◽  
Group 1

BACKGROUND forward head and round shoulder posture is believed to alter scapular kinematics and muscle activity placing increased stress on the shoulder, leading to shoulder pain and dysfunction. OBJECTIVE The purpose of this study was to evaluate the effect of a six-week combined treatment consisting of manual therapy and stabilizing exercises, with a one-month follow-up, on neck pain with forward head and rounded shoulder postures. METHODS A total of 60 women aged 32-42 years of age with neck pain, and forward head and rounded shoulder postures were randomized into three groups: group 1 performed stabilizing exercises and received manual therapy (n=20), group 2 performed stabilizing exercises (n=20), and group 3 (control group) performed home exercises (n=20) over six weeks.The follow-up time was one month after the post test. The craniocervical and rounded shoulder angles, pain, and function were measured before and after six-week interventions, and a one-month follow- up. RESULTS The results showed significant positive changes within the experimental groupsin all variables, but there were minor changes in the control group in all variables before and after the intervention. Also, there were significant function and pain improvement in the experimental group 1 comparing to group 2. There were no differences between post intervention and one-month follow-up on posture and function in the experimental groups. CONCLUSIONS These findings suggest that both interventions were significantly effective for reducing neck pain, and improving function and posture in patients with chronic neck pain, and forward head and rounded shoulder postures. However, the improvement in function and pain was more effective in group 1 than those of group 2 suggesting that manual therapy can be used as a supplement method to the stabilizing intervention in the treatment of neck pain. More research is needed to confirm the result of this study.

scholarly journals Efficacy and Safety of Modified Qing-Ying Decoction for Atopic Dermatitis in Children: Study Protocol for a Randomized Controlled Trial

2021 ◽  
Author(s):  
Mei Kwan LAI ◽  
Chi Him SUM ◽  
Connie YC KAM ◽  
Tianhe SONG ◽  
Pui Kuan CHEONG ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Chinese Medicine ◽  
Atopic Eczema ◽  
Gut Microbiome ◽  
Secondary Outcome ◽  
Control Group ◽  
Placebo Control ◽  
Efficacy And Safety ◽  
Long Term Treatment

Abstract BackgroundAtopic Dermatitis (AD), also known as atopic eczema, is a chronic skin disease characterized by recurring episodes of itchiness with skin erythema and surface damages, such as dry skin, skin thickening and swelling. Long-term treatment with conventional medicine for subacute and moderate atopic eczema is not satisfactory. Evidence from randomized clinical trials suggests the effectiveness of Chinese medicine for the treatmement of AD. The purpose of this study is to explore the efficacy and safety of the modified Qing-Ying Decoction (mQYD) for the treatment of subacute and chronic AD in children through examining the clinical symptoms, quality of life, gut microbiome, and Chinese medicine (CM) body constitution.Methods/designThis is a parallel, randomized, placebo-controlled, double-blind clinical trial with a 12-week treatment and a 4-week follow-up period. A total of 64 participants will be randomly allocated to the treatment group receiving oral mQYD granules or the placebo control group receiving oral placebo granules. Eczema Area and Severity Index (EASI) score will be the primary outcome. Secondary outcome measures include change in symptoms using the Patient-Oriented Eczema Measure (POEM), the Children’s Dermatology Life Quality Index (CDLQI), and the use of concomitant medicines as well as the change in the gut microbiome and CM body constitution types after the 12-week treatment of the mQYD and 4-week follow-up compared to placebo control. Safety parameters include report of adverse events and pathology tests during the trial period.DiscussionThis is the first clinical trial of its kind to test the efficacy and gut microbiome of an innovative Chinese herbal formula modified from a famous ancient formula for the treatment of AD. The outcomes of this trial will provide clinical evidence on the effectiveness and safety of mQYD for the treatment of AD.Trial registrationClinicalTrials.gov, ID: NCT04419584. Registered on 28 July 2020.

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