The effect of therapeutic exercise and vegan diet on pain and quality of life in young female patients with chronic non-specific neck pain

Background and purpose In recent years, dietary practices have begun to be used in painful conditions. This study aimed to investigate the effect of a vegan diet and therapeutic exercise in patients with chronic non-specific neck pain. Materials and methods A total of 45 young female patients with chronic non-specific neck pain, aged 18–25 years, participated in the study. Body mass index and body fat percentage were measured with bioelectrical impedance analysis. Pain severity was assessed using the Visual Analogue Scale, quality of life with the short form-36 scale, kinesiophobia with the Tampa scale of kinesiophobia and neck disability with the Neck Disability Index. Results The pain severity reduced in the diet group and exercise group after treatment (p = 0.001). After treatment, Neck Disability Index score decreased in the diet group and exercise group (p = 0.001). Tampa scale of kinesiophobia score decreased in the diet group and exercise group (p = 0.001). The eight domains of the short form-36 scale score increased in the diet group and exercise group (p < 0.05). No difference was found in the body mass index and fat percentage in all groups before and after treatment (p˃ 0.05). Conclusion A vegan diet and therapeutic exercise are beneficial to patients with chronic non-specific neck pain in terms of pain severity and quality of life.

Effectiveness of Myofascial Release vs High Frequency TENS for Pain Relief and Functional Improvement in College Students with Trapezius Myalgia: A Comparative Study

Background: Trapezius Myalgia is characterized by pain in the trapezius muscle. The patient suffering from myalgia usually complaints of pain, stiffness and tightness of the upper trapezius muscle. Acute or chronic neck-shoulder pain is the hallmark of this condition. The pain in the muscle usually lasts for few days or it can be even longer. The presence of spasm in upper trapezius muscle is shown by neck pain in the back of the neck and between the bases of the neck and the shoulder. This protocol has been created that describes the design of experimental study to evaluate and compare the effect of Myofascial Release (MFR) versus High-Frequency TENS for pain relief and functional improvement in subjects with Trapezius Myalgia. Methods: The participants (n=45) will be recruited in the study suffering from Trapezius Myalgia and meeting the inclusion criteria. Two groups will be formed such that group A will be treated with Myofascial Release technique and group B will be treated with High Frequency TENS modality. The protocol will cover 4 weeks of treatment. Regular assessment will be carried out on 1st and 4th week of the rehabilitation period. During the rehabilitation period, we will evaluate pain status and functional improvement and range of motion of the neck in the subject at regular intervals. Our outcome measures will be – Numerical Pain Rating Scale (NPRS) and Neck Disability Index (NDI). Discussion: The efficacy of the intervention will be evaluated by analyzing pain relief using Numerical Pain Rating Scale (NPRS) and functional improvement by using Neck Disability Index (NDI). The result of the study will significantly provide affirmation on using these modalities for treating myalgia patients.

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

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.

Is the Severity of Cervical Foraminal Stenosis Related to the Severity and Sidedness of Symptoms?

(1) Background: Cervical foraminal stenosis (CFS) is a common cause of axial neck and arm pain. The aim of this study was to determine the relationship between the severity of CFS and clinical symptoms in terms of severity and sidedness. (2) Methods: We retrospectively reviewed 75 consecutive patients with degenerative CFS. We graded 900 foramina from C3–4 to T1–2 using Park’s grading system. We collected visual analogue scale (VAS) and neck disability index (NDI) values from the neck and both arms. We analyzed the relationships with CFS grades and total number. We defined four types of left/right dominance of CFS (none, left-dominant, right-dominant, and both) by comparing left and right sides using total counts and maximal grade of CFS, respectively. We compared arm pain sidedness (no arm pain, left-only, right only, and bilateral) among different left and right CFS dominance types. (3) Results: Mean neck and left and right arm VAS scores were 4.4 ± 2.5, 4.9 ± 1.6, and 4.6 ± 2.0, respectively. The mean total NDI was 16.0 ± 8.0. The CFS grade at C3–4 and total count were correlated with neck VAS. Arm VAS was also correlated with CFS grade and total counts. Total NDI score was not correlated with radiological parameters. The presence and sidedness of arm pain were significantly different between left and right CFS dominance groups divided by total count of grade 2 and 3 CFS. (4) Conclusions: The CFS grade and total count were correlated with neck and arm VAS. Arm pain occurred more frequently on the side with more grade 2 and 3 CFS.

Anterior Corpectomy and Plating with Carbon-PEEK Instrumentation for Cervical Spinal Metastases: Clinical and Radiological Outcomes

Background: Anterior cervical corpectomy and plating has been recognized as a valuable approach for the surgical treatment of cervical spinal metastases. This study aimed to report the surgical, clinical and radiological outcomes of anterior carbon-PEEK instrumentations for cervical spinal metastases. Methods: Demographical, clinical, surgical and radiological data were collected from 2017 to 2020. The Neck Disability Index (NDI) questionnaire for neck pain, EORTC QLQ-C30 questionnaire for quality of life, Nurick scale for myelopathy and radiological parameters (segmental Cobb angle and cervical lordosis) were collected before surgery, at 6 weeks postoperatively and follow-up. Results: Seventeen patients met inclusion criteria. Mean age was 60.9 ± 7.6 years and mean follow-up was 12.9 ± 4.0 months. The NDI (55.4 ± 11.7 to 25.1 ± 5.4, p < 0.001) scores and the EORTC QLQ-C30 global health/QoL significantly improved postoperatively and at the last follow-up. The segmental Cobb angle (10.7° ± 5.6 to 3.1° ± 2.2, p < 0.001) and cervical lordosis (0.9° ± 6.7 to −6.2 ± 7.8, p = 0.002) significantly improved postoperatively. Only one minor complication (5.9%) was recorded. Conclusions: Carbon/PEEK implants represent a safe alternative to commonly used titanium ones and should be considered in cervical spinal metastases management due to their lower artifacts in postoperative imaging and radiation planning. Further larger comparative and cost-effectiveness studies are needed to confirm these results.

The Short Form of the Fonseca Anamnestic Index for the Screening of Temporomandibular Disorders: Validity and Reliability in a Spanish-Speaking Population

The Short Form of the Fonseca Anamnestic Index (SFAI) is a simple and quick questionnaire used for screening temporomandibular disorders (TMDs). The present study aimed to validate the Spanish version of the SFAI in patients with TMDs. The study sample comprised 112 subjects (50 TMDs and 52 controls). Test–retest reliability, factorial validity, internal consistency, concurrent validity, and the SFAI’s ability to discriminate between TMDs subjects and healthy controls were analyzed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD protocol) as the reference. Factor analysis showed a single factor that explained 63% of the total variance. Cronbach’s alpha was 0.849. The reliability of the items measured with the Kappa index showed values from 0.767 to 0.888. Test–retest reliability was substantial (intraclass correlation coefficient = 0.837). The total SFAI score showed a significant correlation with orofacial pain, vertigo, and neck disability measurements. For a cut-off point of >10 points, the SFAI showed a sensitivity of 78% and specificity of 78.85% at differentiating between TMDs patients and healthy subjects, with an area under the curve (AUC) of 0.852. The Spanish version of the SFAI is a valid and reliable instrument for diagnosing people with TMDs and shows generally good psychometric properties.

Prevalence of Musculo-skeletal Discomfort and Level of Functional Limitations among Physiotherapists in Karachi City

Introduction: Musculoskeletal discomfort is one of the most prevalent muscular pain condition hindering normal activities reported by physical therapists and health care professionals generally engaged in handling and mobilizing patients. The study was conducted to find the prevalence of musculoskeletal discomfort and level of functional limitations in physiotherapists. Method: This research was questionnaire based cross sectional study conducted in Karachi city from January to April 2019.Data collection was completed from registered physical therapists employed in different institutions. Two questionnaires were filled by the physiotherapists. Questionnaire 01, including thirteen questions on functional activities of daily life which are potentially related to functional areas of Neck Disability Index (NDI). Questionnaire 02 was based on 1987 version of Nordic musculoskeletal questionnaire. Results: Participation of 80 physical therapists in the study.75% was directly involved with patient handling and 25% were teachers. A total of 35% therapists reported 7 days symptoms prevalence with a higher prevalence in cervical (77.1%), lower back (68.6%) and upper back (51.4%).Similarly 65% workers showed previous 12 month symptoms with higher prevalence in neck (72.3%). Gender prevalence of 7days and 12 months was high in female therapist. Conclusion: It has been concluded that 12 month prevalence of musculoskeletal discomfort was 65%, whereas 7 days was 35% and level of functional limitation from activities was insignificant. Keywords: Epidemiology, musculoskeletal discomfort, Severity, Physical therapy,

Deep Cervical Muscle Exercise Versus Soft Tissue Mobilization In Non-Specific Neck Pain

Background: Neck pain is a common health problem in the working population. When studied by the International Classification of Functioning, Disability and Health (ICF), the problems that arise in non-specific neck pain include: neck pain, limited joint motion, and decreased functional ability in carrying out daily activities. The aim of this study was to compare the effectiveness of combination ultrasound therapy (UST) and deep cervical muscle exercise (DCME) versus combination ultrasound therapy (UST) and soft tissue mobilization (STM) on non-specific neck pain. Methods: This research was experimental with a randomized pre-test and post-test control group design, in which the study participants were divided into two groups randomly. The study participants were 20 people who were divided into the control group (n = 10) who were given the combined intervention of UST and DCME while the treatment group (n = 10) were given the combined intervention of UST and STM. Therapeutic evaluation measurement tools include: pain scale in the form of numeric rating scale and neck disability in the form of neck disability index. The research was carried out in the independent physiotherapy practice in Denpasar and Badung. The intervention was given 3 times in 3 weeks. Results: The results showed a decrease in neck pain and disability in each intervention group (p <0.05). However, there were no significant differences when compared between groups. Conclusion: Based on these results, it can be concluded that the combination of UST and DCME has the same results as the combination of UST and STM in reducing neck pain and disability in non-specific neck pain.

Scapular Dyskinesis in Elite Boxers with Neck Disability and Shoulder Malfunction

Background and Objectives: Neck and shoulder injuries commonly occur during boxing, and scapular dyskinesis is related to those injuries. This study investigated scapular dyskinesis with neck disability and shoulder malfunction in elite boxers. Materials and Methods: Seventy-two elite boxers participated in this study. Scapular dyskinesis was evaluated as normal, subtle, and obvious. Neck disability index (NDI), shoulder internal (IR), and external (ER) range of motion (ROM), isometric strength of IR and ER, and pectoralis minor length were measured and compared with the severity of scapular dyskinesis. Results: Thirty-eight boxers (52.7%) showed scapular dyskinesis. NDI score was significantly different (normal = 3.89 ± 3.08, obvious = 7.36 ± 4.95, p = 0.025). Isometric IR strength was significantly different (normal = 10.48 ± 2.86, obvious = 8.46 ± 1.74, p = 0.01). The length of the pectoralis minor was significantly different (normal = 10.17 ± 0.67, subtle = 9.87 ± 0.79, obvious = 9.47 ± 0.85; p = 0.001), and the dominant and non-dominant arm IR ROM was significantly different (dominant = 57.43 ± 11.98, non-dominant = 64.62 ± 10.3, p = 0.001). Conclusions: The prevalence of scapular dyskinesis is high among elite boxers. Boxers with scapular dyskinesis presented shoulder malfunction as well as neck disability. Further investigation is necessary to examine the relationship between scapular dyskinesis and neck disability in boxers.