Effects of different methods of physiotherapy in individuals with cervicogenic headaches

Objective. To assess the effects of different physiotherapy methods in individuals with cervicogenic headache. Methods. 20 subjects with cervicogenic headaches have been studied. Subjects were randomized to two groups of 10 subjects. The first group of subjects underwent physiotherapy with post – isometric relaxation, the second group – physiotherapy in combination with vibration. Before and after the interventions, pain intensity, neck disability index, active cervical range of motion and neck muscle strength were evaluated in all subjects. Results. Physiotherapy reduces the intensity of pain (from strong and very strong to moderate intensity), improves neck function (from severe to moderate disability), increases active cervical range of motion by four to six degrees and increases neck muscle strength (p < 0,05). When comparing results between groups, no statistically significant difference in results were observed (p > 0,05). Conclusion: Complex physiotherapy in combination with post – isometric relaxation or vibration helps to improve the function of individual neck, increase active cervical range of motion and strength of muscle strength.

Exercise Effects on Neck Function Among F-15E Aircrew

BACKGROUND: Neck pain (NP) is common among high performance aircrew, yet evidence remains insufficient to guide examination, treatment, and prevention. The purpose of this randomized pilot study was to collect baseline data for neck function for F-15E aircrew and determine efficacy and feasibility of two separate exercise protocols in measuring short-term outcomes of subjective and objective neck function in order to inform future study design. METHODS: Randomized to either progressive (PRO) or general (GEN) exercise groups were 41 F-15E aircrew. Data collection occurred at baseline, 3 wk, and 3 mo. RESULTS: At baseline, 39% of the subjects reported current NP, 79.5% reported a history of NP attributed to flying, 12.8% reported being removed from flying duties due to NP, and 10% reported receiving medical care for NP. PRO and GEN group randomization showed similar baseline assessment data. Blinding was successful and exercise logs showed 31.6% compliance with prescribed exercise regimens. There were small but statistically significant increases in neck range of motion in both groups over the course of the study. Aircrew with current NP had significantly higher F-15E flight hours. DISCUSSION: This study supports the high prevalence of NP in aircrew, yet low frequency of seeking care for NP. Future studies to assess NP prevention and treatment in aircrew require an integrated approach that includes operational exercise policy and long-term data collection in flying units with dedicated resources for assessment and analysis. Lee MS, Briggs R, Scheirer V, Kearby G, Young BA. Exercise effects on neck function among F-15E aircrew. Aerosp Med Hum Perform. 2021; 92(10):815824.

Effectiveness of Deep Cervical Flexor (DCF) Exercise on Neck Functional Scores in Helicopter Crew with Mechanical Neck Pain

Background: Mechanical neck pain is defined as neck pain due to biomechanical dysfunction in the neck or upper back. Exercise can reduce muscle tension and strengthen deep cervical flexor (DCF) muscles by helping to relieve pain. The prevalence of neck pain is considered high in helicopter crews compared to the general population. Aim: To investigate the effectiveness of DCF exercise on neck functional scores (study of helicopter crews with mechanical neck pain).Material and Methods: Experimental one pre and post-test group design. The samples were 14 squadron-31/serbu helicopter crew performing conventional DCF muscle exercise 12 times for 4 weeks with a frequency of 3 times each week. Neck function was assessed using the Neck Outcome Score (NOOS) which consists of domains of mobility, stiffness, symptoms, sleep disturbances, everyday activity and pain, participating in everyday life, and quality of life.Results: This study showed that the mean NOOS score before intervention was 30.64 (SD: 9.44) and the mean NOOS score after intervention was 8.57 (SD: 5.33). There was a significant difference in the NOOS score before and after deep cervical flexor exercise (p = 0.001).Conclusion: DCF exercises are effective for improving neck functionality in helicopter crew with mechanical neck pain.

Optimal Time Period of Wearing Protective Collar after Anterior Cervical Discectomy and Fusion

Objective: There is still no consensus on the time period of wearing protective collar after Anterior Cervical Discectomy and Fusion (ACDF). We aim to investigate the optimal time period of wearing collar after ACDF. Methods: We retrospectively reviewed patients with cervical spondylosis who underwent one or two segment ACDF during January 2016 and December 2017, and included 97 patients who met inclusion and exclusion criteria. Patients were divided into three groups, 1-4 week group, 5-8 week group and 9-12 week group, according to the actual time period of wearing collar after ACDF. We analyzed Japanese Orthopedic Association (JOA) score, Axial Symptom (AS) score and Neck Disability Index (NDI) before surgery and at post-operative 3 months to investigate the optimal time period of wearing collar after ACDF procedure. Results: 1) JOA score: All three groups have a better post-operative JOA score compared with that before surgery (paired t test, p<0.05). There is no significant difference among the three groups with respect to post-operative JOA (ANOVA, p>0.05). 2) AS score: The post-operative AS scores of 1-4 week group and 5-8 week group were significantly better than that before surgery (paired t test, p>0.05). While the post-operative AS score of 9-12 week group was significantly worse than preoperative AS score (paired t test, p<0.05). 3) NDI: All three groups have a better post-operative NDI compared with that before surgery (McNemar test, p<0.05). Of note, in 5-8 weeks group, the percentage of no deficit increased by 45%, and the percentage of mild deficit decreased by 45% accordingly. That percentage is 26% and 31% in 1-4 week group and 9-12 week group, respectively. There was significant difference among these three groups (Fisher’s exact probability test, p<0.05). Conclusion: For cervical spondylosis patients who underwent 1 or 2 segment ACDF, the optimal time period of wearing protective is 5-8 weeks. This time period results in comparable neurological outcome, least risk of axial symptoms, and highest chance of no deficit with neck function.

Immediate effects of thoracic manipulation on cervical joint position sense in individuals with mechanical neck pain: A randomized controlled trial

BACKGROUND: Performing thoracic manipulations for neck pain can result in immediate improvements in neck function. OBJECTIVE: The aim of this study was to investigate the immediate effects of thoracic manipulation on cervical joint position sense and cervical range of motion in individuals with chronic mechanical neck pain. METHODS: Eighty male volunteers between 18–25 years and having chronic or recurrent neck or shoulder pain of at least 3 months duration with or without arm pain were randomized into two groups: Thoracic Manipulation Group (TMG:50) and Control Group (CG:30), with a pretest-posttest experimental design. The TMG was treated with thoracic extension manipulation while the CG received no intervention. Cervical joint position error and cervical range of motion of the individuals were assessed at baseline and 5 minutes later. RESULTS: There was no difference in demographic variables such as age (p= 0.764), Body Mass Index (p= 0.917) and Neck Pain Disability Scale (NPDS) scores (p= 0.436) at baseline outcomes between TMG and CGs. Joint position error outcomes between the two groups following intervention were similar in all directions at 30 and 50 degrees. Differences in range of motion following intervention in neck flexion (p< 0.001) and right rotation (p= 0.004) were higher in TMG compared to CG. CONCLUSIONS: A single session of thoracic manipulation seems to be inefficient on joint position sense in individuals with mild mechanical neck pain. However, thoracic manipulation might be an effective option to increase flexion and rotation of the cervical region as an adjunctive to treatment.