A study to observe the effects of physiotherapy with and without manual therapy in the management postural neck pain: a randomized control trial

Author(s):  
Rubab Jawed ◽  
Muhammad Fareed Nasir ◽  
Nabeel Naeem Baig ◽  
Maryam Younus ◽  
Ayesha Arshad ◽  
...  

Abstract Objective: To compare the effects of physiotherapy with and without manual therapy in the management of postural neck pain. Method: The randomised controlled trial was conducted at the Physiotherapy Department of South City Hospital, Karachi, from September 2017 to July 2018, and comprised subjects with >6 months of neck pain with no related medical dysfunction. The patients were enrolled by non-probability consecutive sampling technique and   randomly divided into Group A and Group B using computer-generated numbers. Group A received physiotherapy along with manual therapy, while Group B only had physiotherapy. Group A was also taught a home exercise programme. A printed exercise sheet was provided with frequency and repetition details. Visual analogue scale for pain intensity level and neck disability index were used to measure outcome at 3rd and 12th week. Data was analysed using SPSS 22. Results: Of the 60 subjects, there were 30(50%) in each of the two groups. The mean age in Group A was 32.77±7.44 years and it was 32.53±7.9 years in Group B. Overall, there were 21(35%) males and 39(65%) females. Significant reduction in pain intensity and neck disability levels at 3 and 12 weeks was noted compared to baseline (p<0.05). Inter-group comparison at final follow-up showed better Group A results compared to Group B (p<0.05). Conclusion: Physiotherapy with manual therapy was found to be better compared to physiotherapy alone. Key Words: Neck pain, Visual analogue scale, Neck disability index, Manual therapy, Exercise. Continuous...

Author(s):  
I Rezaei ◽  
M Razeghi ◽  
S Ebrahimi ◽  
S Kayedi ◽  
A Rezaeian Zadeh

Background: Despite the potential benefits of virtual reality technology in physical rehabilitation, only a few studies have evaluated the efficacy of this type of treatment in patients with neck pain.Objective: The aim of this study was to compare the effects of virtual reality training (VRT) versus conventional proprioceptive training (CPT) in patients with neck pain.Methods: Forty four participants with nonspecific chronic neck pain were randomly assigned to VRT or CPT in this assessor-blinded clinical trial. A novel videogame called Cervigame® was designed for VRT. It comprises of 50 stages divided into unidirectional and two-directional stages ordered from easy to hard. CPT consisted of eye-follow, gaze stability, eye-head coordination and position and movement sense training. Both groups completed 8 training sessions over 4 weeks. Visual analogue scale score, neck disability index and Y-balance test results were recorded at baseline, immediately after and 5 weeks post-intervention. Mixed repeated measure ANOVA was used to analyze differences between mean values for each variable at an alpha level of 0.05.Results: There were significant improvements in all variables in both groups immediately after and 5 weeks after the intervention. Greater improvements were observed in the visual analogue scale and neck disability index scores in VRT group, and the results for all directions in Y-balance test were similar in both groups. No side effects were reported.Conclusion: Improvements in neck pain and disability were greater in VRT than CPT group. Cervigame® is a potentially practical tool for rehabilitation in patients with neck pain.


Author(s):  
I Rezaei ◽  
M Razeghi ◽  
S Ebrahimi ◽  
S Kayedi ◽  
A Rezaeian Zadeh

Background: Despite the potential benefits of virtual reality technology in physical rehabilitation, only a few studies have evaluated the efficacy of this type of treatment in patients with neck pain.Objective: The aim of this study was to compare the effects of virtual reality training (VRT) versus conventional proprioceptive training (CPT) in patients with neck pain.Methods: Forty four participants with nonspecific chronic neck pain were randomly assigned to VRT or CPT in this assessor-blinded clinical trial. A novel videogame called Cervigame® was designed for VRT. It comprises of 50 stages divided into unidirectional and two-directional stages ordered from easy to hard. CPT consisted of eye-follow, gaze stability, eye-head coordination and position and movement sense training. Both groups completed 8 training sessions over 4 weeks. Visual analogue scale score, neck disability index and Y-balance test results were recorded at baseline, immediately after and 5 weeks post-intervention. Mixed repeated measure ANOVA was used to analyze differences between mean values for each variable at an alpha level of 0.05.Results: There were significant improvements in all variables in both groups immediately after and 5 weeks after the intervention. Greater improvements were observed in the visual analogue scale and neck disability index scores in VRT group, and the results for all directions in Y-balance test were similar in both groups. No side effects were reported.Conclusion: Improvements in neck pain and disability were greater in VRT than CPT group. Cervigame® is a potentially practical tool for rehabilitation in patients with neck pain.


Author(s):  
Kotteeswaran. K ◽  
Chiranjibi Kumar Nayak

Background: Cervical spine dysfunction is a cause of neck pain. The cause for it is believed to be a disorder (most likely malalignment) of the pain-sensitive facet joints (which may also be due to disc disruption). Dysfunction can also cause secondary muscle spasm, which can may lead to more pain and stiffness. Objective: To find the effectiveness of SNAGs and scapular strengthening exercises in the patients with chronic cervical dysfunction. To find the Neck disability index (NDI) score difference between the functional activities of experimental group and conventional treatment group. Methodology: According to inclusion and exclusion criteria a prior to the study, the principal researcher explained the procedures to all the subjects and inform consent obtained, 30 subjects taken through Random block design and numbering was done for all the subjects. All the odd numbers in one group and all the even numbers in another group are allocated by random table where each group had 15 subjects. The collected data was tabulated and analyzed using descriptive and inferential statistics. To all parameters mean and standard deviation (SD) were used. Paired t-test was used to analyze significant changes between pre-test and post-test measurements. Unpaired t-test was used to analyze significant changes between two groups. Result: rom statistical analysis made with the quantitative data revealed statistically significant difference between the Group A and Group B, and also within the group. The Posttest mean value of Neck Disability Index (NDI) in group A is 12.00 and in group B is 13.80. This shows that Neck Disability Index (NDI) in Group B disability value were comparatively more than Group A disability value, P<0.0001. Conclusion: This study shows better improvement in reducing cervical spine dysfunction (neck pain) by scapular strengthening exercise than resisted neck isometrics. Both the techniques can be used in clinical practice.


Author(s):  
Mohammad Zeeshan ◽  
Siddhartha Sen ◽  
Pooja Bhardwaj Dhawan

Introduction: Mechanical neck pain is a significant societal burden and may include symptoms in the neck and upper extremity. It has been reported that the lifetime and point prevalence of neck pain are almost as high as those of low back pain. It appears to run a chronic episodic course, which is characterised by episodes of persistent, recurrent, or fluctuating pain and disability. It has been found that an altered muscle activity in the Trapezius and the Serratus anterior muscles can be associated with the presence of pain in the neck during functional activities. Aim: To find out the effects of Kinesiotaping on the improvement of sensorimotor function and neck disability in patients with chronic neck pain. Materials and Methods: This was a pre-test, post-test control group design with 30 subjects randomly selected and divided into two groups, an experimental group (Group A) and a control group (Group B) with 15 subjects in each. Experimental group received Kinesio Tape (KT) for 1 week whereas control group received Sham tape. Measurements were taken on the first day and 1 week after the intervention for Cervical Joint Position Sense (CJPE), range of motion and neck disability using an inclinometer instrument, universal goniometer, Neck Disability Index (NDI) questionnaire, respectively. The data was analysed using SPSS 17 software package. Independent t-test was done to find effect between the groups and paired t-test was done to find out the effect within the group. Results: The study clearly demonstrated a significant improvement in CJPE, Cervical Range of Motion (CROM) and NDI within group A (p<0.05) whereas improvement showed significance in CROM and NDI for group B. While comparing both the groups, significant improvement in proprioception and NDI was shown but not in CROM. Conclusion: The study concludes that patients with chronic mechanical neck pain can be benefitted by the use of Kinesiotaping with improvement of sensorimotor function.


2021 ◽  
Vol 6 (2) ◽  
pp. 289-298
Author(s):  
Nawal M Mulla ◽  
Parag Kulkarni ◽  
Ajay Kumar

Background: The most common form of neck pain is non-specific which is deep, dull aching & poorly localized. Non-specific pain is associated with upper trapezius tenderness. For people who work at desks and computers, or who spend many hours driving, have poor ergonomics which causes the upper trapezius to become sore and painful. The soreness can lead to the development of tender points which can be the major reason for developing neck pain and muscle spasm. Physiotherapy techniques like muscle energy technique and Strain counterstrain has been proposed to treat tenderness in trapezius. Objective: To compare the immediate effect of Strain Counterstrain Technique & Muscle Energy Technique on pain, pain pressure sensitivity & mobility on non-specific neck pain with upper trapezius tenderness using Visual analogue scale, Pressure Algometer & Universal Goniometer respectively. Method: 60 subjects were selected as per inclusion and exclusion criteria& were randomly assigned to Group A (n=30) & Group B (n=30); Strain Counterstrain and Muscle Energy Technique respectively. Visual Analogue Scale, Pain Pressure Sensitivity & Cervical Rotation & Lateral Flexion Motion bilaterally was noted before & after application of both techniques and the data was statistically analysed. Result: Both groups showed statistical significance (p< 0.05) differences in all outcome measures between pre test and post test values of Group A and Group B but there is no statistical significant (p> 0.05) difference in the outcome measures between groups. Conclusion: The study concludes that both techniques are equally effective in treating pain, increasing lateral flexion and rotation range of motion, and improving pain pressure sensitivity. Keywords: Strain Counterstrain, muscle energy technique, upper trapezius tenderness,visual analog scale, non-specific neck pain,pain pressures sensitivity.


2021 ◽  
pp. 026921552110441
Author(s):  
Yi-Jia Lin ◽  
Wei-Chun Hsu ◽  
Lin-Fen Hsieh ◽  
Kae-Chwen Chang ◽  
Ying-Chen Kuo ◽  
...  

Objectives To study the addition of feedback-guided neck strength home exercise to physical therapy as an enhanced rehabilitation programme in the treatment of patients with chronic neck pain. Design A prospective randomised controlled trial. Setting Rehabilitation department of an academic hospital. Subjects Patients with chronic neck pain. Interventions The patients in both groups received supervised physical therapy sessions 3 times a week for 12 weeks. Patients in Group A ( N = 38) used the neck strengthening exerciser device for 20 min daily at home for 6 weeks and patients in Group B ( N = 20) performed 20 min of daily regular neck exercise at home for 6 weeks. Outcome measures Neck disability index, pain visual analogue scale, active range of motion of the neck, Patient Global Assessment and patient evaluation of treatment effect. All subjects were assessed at baseline as well as at 6- and 12-week follow-ups. Results At the 6-week follow-up, Group A exhibited significantly greater improvements ( P < 0.05) in pain Visual Analogue Scale (Group A: 2.97 ± 1.57; Group B: 4.20 ± 1.82), neck disability index (Group A: 13.95 ± 8.07; Group B: 20.07 ± 9.14) and active cervical extension (Group A: 65.26 ± 12.76; Group B: 51.45 ± 11.78). At 12-week follow-up, Group A also exhibited significantly greater active cervical extension (Group A: 67.74 ± 11.94; Group B: 53.85 ± 14.09; P < 0.05). Conclusion Adding neck strengthening exerciser home training to physical therapy was demonstrated to be more effective than physical therapy alone for patients with chronic neck pain.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Konstantinos Mylonas ◽  
Pavlos Angelopoulos ◽  
Evdokia Billis ◽  
Elias Tsepis ◽  
Konstantinos Fousekis

Abstract Background The purpose of this study was to evaluate the short- and intermediate-term effects of the combined application of instrument-assisted soft tissue mobilization (IASTM) techniques and neuromuscular exercises of the cervical and thoracic area on the improvement of the functionality of patients with mechanical neck pain and accompanying forward head posture (FHP). Methods Twenty patients with neck pain and FHP were randomized and received eight treatment sessions of either targeted IASTM in combination with neuromuscular exercises (Group A) or a classical massage and the same set of exercises (Group B). The cervical vertebral angle (CVA), cervical range of motion (ROM) and strength, pain (visual analogue scale-VAS), and neck disability index (NDI) were measured throughout the treatment period and in the two- and four-week post-treatment periods. Results The combined application of IASTM and neuromuscular exercises contributed to a significantly greater improvement in CVA (Group A: + 7,2 deg vs Group B: + 1,1 deg) and NDI (Group A:-25,2 vs Group B:-5,8) than massage and the application of the same exercises. Both interventions improved cervical ROM and strength in the short term. Pain was also significantly improved in both groups in both the short (Group A VAS: − 5,97 vs Group B VAS: − 3,1) and intermediate term (Group A VAS:-5,5 vs Group B:-1,5). Conclusions Combining IASTM and exercises for the cervical and thoracic area can induce positive postural adaptations and improve the functional status of neck pain patients. Trial registration ISRCTN, ISRCTN54231174. Registered 19 March 2020 - Retrospectively registered.


2020 ◽  
pp. 1-4
Author(s):  
George-Sebastian Iacob ◽  
Constantin Munteanu

Cervical back pain is one of the most important and common musculoskeletal disorders in medical recovery clinics and clinics. The main objective of the study was to highlight the effectiveness of an individualized therapeutic program adapted to the particularities of 22 subjects, which combines physical exercise with manual therapy. Subjects were randomly assigned to two equal groups. Group A - rehabilitation protocol consisting of therapeutic exercises (specific to the head, neck and upper limbs). Group B - rehabilitation protocol that included both therapeutic exercises and manual therapy (specific maneuvers of vertebral mobilization, massage, myofascial techniques, stretching and manipulations). The Visual Analogue Pain Scale (VAS) and the Neck Disability Index (NDI) were used to monitor the evolution of the research subjects, both of which have a specific applicability character to chronic pain. According to VAS (p <0.001), Group B showed mean values reduced to 2.2 ± 0.9 at week 12, compared to 7.3 ± 0.92, following the initial assessment. NDI values indicate better functional status after 12 weeks of treatment for both groups of subjects. NDI showed a beneficial decrease for Group B (13.2 ± 2.2 after 12 weeks, compared to 25.8 ± 2.3 in the first week). The mean results of VAS and NDI indicated a better evolution of symptoms in the case of the protocol that combined exercise and manual therapy (group B), but there were no statistically significant differences (compared to group A).


Author(s):  
K. Kotteeswaran ◽  
Syed Gaffar ◽  
Krishna. R ◽  
Keerthana Priya. R.

Aim: To find the effectiveness of laser therapy and ultrasound therapy along with muscle energy technique in treatment of Trapezitis. Materials and Methods: Non-equivalent quasi experimental study design was used in this study. Total of 30 subjects with trapezitis were selected using non probability convenient sampling technique.30 Subjects was divided into two groups by lot system. Group A received laser therapy and Group B received ultrasound therapy and for both the group muscle energy technique was given. The outcome measures are Neck Disability Index (NDI) for measuring Functional Disability. Data collected and tabulated was statistically analyzed. Result: Statistical analysis of post-test, Neck Disability Index (NDI) revealed that there is statistically significant difference seen between Group A and Group B. Conclusion: From the result, it has been concluded that Laser therapy with muscle energy technique (Group A) was more effective than Ultrasound therapy with muscle energy technique (Group B) on improving functional ability in subjects with Trapezitis.


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