1
|
Ragnarsdottir H, Peterson G, Gislason MK, Oddsdottir GL, Peolsson A. The effect of a neck-specific exercise program on cervical kinesthesia for patients with chronic whiplash-associated disorders: a case-control study. BMC Musculoskelet Disord 2024; 25:346. [PMID: 38693515 PMCID: PMC11064421 DOI: 10.1186/s12891-024-07427-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/09/2024] [Indexed: 05/03/2024] Open
Abstract
INTRODUCTION Cervical kinesthesia is an important part of movement control and of great importance for daily function. Previous research on kinesthesia in whiplash-associated disorders (WAD) has focused on grades I-II. More research is needed on WAD grade III. The aim of this study was to investigate cervical kinesthesia in individuals with WAD grades II-III before and after a neck-specific exercise intervention and compare them to healthy controls. METHODS A prospective, case-control study with a treatment arm (n = 30) and a healthy control arm (n = 30) was conducted in Sweden. The WAD group received a neck-specific exercise program for 12 weeks. The primary outcome to evaluate kinesthesia was neck movement control (the Fly test). Secondary outcomes were neck disability, dizziness and neck pain intensity before and after the Fly test. Outcomes were measured at baseline and post-treatment. The control arm underwent measurements at baseline except for the dizziness questionnaire. A linear mixed model was used to evaluate difference between groups (WAD and control) and over time, with difficulty level in the Fly test and gender as factors. RESULTS Between-group analysis showed statistically significant differences in three out of five kinesthetic metrics (p = 0.002 to 0.008), but not for the WAD-group follow-up versus healthy control baseline measurements. Results showed significant improvements for the WAD-group over time for three out of five kinaesthesia metrics (p < 0.001 to 0.008) and for neck disability (p < 0.001) and pain (p = 0.005), but not for dizziness (p = 0.70). CONCLUSIONS The exercise program shows promising results in improving kinesthesia and reducing neck pain and disability in the chronic WAD phase. Future research might benefit from focusing on adding kinesthetic exercises to the exercise protocol and evaluating its beneficial effects on dizziness or further improvement in kinesthesia. IMPACT STATEMENT Kinesthesia can be improved in chronic WAD patients without the use of specific kinesthetic exercises. TRIAL REGISTRATION ClinicalTrials.gov (NCT03664934), first registration approved 11/09/2018.
Collapse
Affiliation(s)
- Harpa Ragnarsdottir
- Research Centre of Movement Science, Department of Physiotherapy, University of Iceland, Stapi v/Hringbraut 31, Reykjavik, 101, IS, Iceland
- Elja Physiotherapy, Hafnafjordur, Iceland
| | - Gunnel Peterson
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Magnus K Gislason
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavik, Iceland
| | - Gudny L Oddsdottir
- Research Centre of Movement Science, Department of Physiotherapy, University of Iceland, Stapi v/Hringbraut 31, Reykjavik, 101, IS, Iceland
| | - Anneli Peolsson
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden.
- Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Clinical Medicine, Linköping University, Linköping, Sweden.
| |
Collapse
|
2
|
Guo Q, Zhang L, Han LL, Gui C, Chen G, Ling C, Wang W, Gao Q. Effects of Virtual Reality Therapy Combined With Conventional Rehabilitation on Pain, Kinematic Function, and Disability in Patients With Chronic Neck Pain: Randomized Controlled Trial. JMIR Serious Games 2024; 12:e42829. [PMID: 38656775 PMCID: PMC11079768 DOI: 10.2196/42829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/16/2023] [Accepted: 03/17/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Neck pain is a common condition that leads to neck motor dysfunction and subsequent disability, with a significant global health care burden. As a newly emerging tool, virtual reality (VR) technology has been employed to address pain and reduce disability among patients with neck pain. However, there is still a lack of high-quality studies evaluating the efficacy of VR therapy combined with conventional rehabilitation for patients with chronic neck pain, particularly in terms of kinematic function. OBJECTIVE This study aims to investigate the effect of VR therapy combined with conventional rehabilitation on pain, kinematic function, and disability in patients with chronic neck pain. METHODS We conducted an assessor-blinded, allocation-concealed randomized controlled trial. Sixty-four participants experiencing chronic neck pain were randomly allocated into the experimental group that underwent VR rehabilitation plus conventional rehabilitation or the control group receiving the same amount of conventional rehabilitation alone for 10 sessions over 4 weeks. Pain intensity, disability, kinematic function (cervical range of motion, proprioception, and mean and peak velocity), degree of satisfaction, and relief of symptoms were evaluated at 3 timepoints (baseline, postintervention, and at 3 months follow-up). A 2*3 mixed repeated measures analysis of variance was utilized for analyzing the difference across indicators, with a significant difference level of .05. RESULTS Both groups demonstrated significant improvements in pain, disability, and kinematic functions (P<.05) at postintervention and at 3-month follow-up. The experimental group showed superior therapeutic outcomes compared to the control group in pain reduction (mean difference from the baseline: 5.50 vs 1.81 at posttreatment; 5.21 vs 1.91 at the 3-month follow-up, respectively; P<.001), disability improvement (mean difference from baseline: 3.04 vs 0.50 at posttreatment; 3.20 vs 0.85 at the 3-month follow-up, respectively; P<.001), and enhanced kinematic functions (P<.05). Moreover, participants in the experimental group reported better satisfaction and relief of symptoms than the control group (P<.05), with better initiative for exercising during the follow-up period. However, there was no between-group difference of improvement in proprioception. No adverse events were reported or observed in our research. CONCLUSIONS The findings of our study support the efficacy of combining VR therapy with conventional rehabilitation in alleviating pain, enhancing kinematic function, and reducing disability of patients with chronic neck pain. Future research should focus on refining the therapeutic protocols and dosages for VR therapy as well as on optimizing its application in clinical settings for improved convenience and effectiveness. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000040132; http://www.chictr.org.cn/showproj.aspx?proj=64346.
Collapse
Affiliation(s)
- Qifan Guo
- West China Hospital, Sichuan University, Chengdu, China
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Liming Zhang
- West China Hospital, Sichuan University, Chengdu, China
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Leo Lianyi Han
- Biostatistics Group, State Key Laboratory of Genetic Engineering, Greater Bay Area Institute of Precision Medicine (Guangzhou), Fudan University, Guangzhou, China
| | - Chenfan Gui
- West China Hospital, Sichuan University, Chengdu, China
| | - Guanghui Chen
- Department of Traumatology and Orthopedics of Traditional Chinese Medicine, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Chunyan Ling
- Department of Acupuncture and Tuina, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Wei Wang
- Department of Acupuncture and Tuina, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Qiang Gao
- West China Hospital, Sichuan University, Chengdu, China
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
3
|
Pardos-Aguilella P, Ceballos-Laita L, Cabanillas-Barea S, Pérez-Guillén S, Ciuffreda G, Carrasco-Uribarren A. Is device guided training targeted to the craniocervical flexor and extensor muscles efficacious? A preliminary randomized controlled trial in a cervicogenic headache population. Musculoskelet Sci Pract 2024; 69:102900. [PMID: 38157759 DOI: 10.1016/j.msksp.2023.102900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/08/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Specific neck exercise is effective in the management of cervicogenic headache (CH). The Spinertial device was designed to facilitate craniocervical flexion and extension training, but its efficacy, judged on change in headache impact, has not been tested. OBJECTIVE To compare guided and progressive resisted specific neck exercise targeted to the craniocervical flexors and extensors (SNE-fe) performed with Spinertial device to progressive SNE-fe without the device in a cohort with CH. DESIGN Randomised controlled trial. METHODS Twenty-eight participants with CH were randomly allocated to the Spinertial group (SG) or SNE-fe exercise group without the device (EG). Both groups performed 12 sessions of SNE-fe over six-weeks. The primary outcome was headache impact (HIT-6). Secondary outcomes were the craniocervical flexion test (CCFT), upper cervical (UCS) and lower cervical range of movement, flexion rotation test (FRT) analysed as more or less restricted side (MRS, LRS), the self-reported global rating of change (GROC-scale) and satisfaction with the exercise program (PACES). Outcomes were measured at baseline, post-intervention (T1) and after 1-month (T2). RESULTS Significant between-groups differences were found favouring the SG for HIT-6 (T1 p = 0.010, d = 0.5; T2 p < 0.004, d = 0.4), CCFT, UCS ROM, FRT MRS, FRT LRS, PACES and GROC-scale (T1: all p < 0.01; T2: all p < 0.01). Effects sizes were large (>0.8) at T1 and T2. No between-groups differences were found for lower cervical ROM. CONCLUSION Training with the Spinertial was more effective than SNE without the device for improving the impact of headache, the endurance of deep neck flexors and UCS ROM in participants with CH.
Collapse
Affiliation(s)
| | - Luis Ceballos-Laita
- Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, University of Valladolid, 42004 Soria, Spain.
| | - Sara Cabanillas-Barea
- Faculty of Medicine and Health Sciences, International University of Catalonia, 08195 Sant Cugat del Vallés, Spain
| | - Silvia Pérez-Guillén
- Faculty of Medicine and Health Sciences, International University of Catalonia, 08195 Sant Cugat del Vallés, Spain
| | - Gianluca Ciuffreda
- Faculty of Medicine and Health Sciences, International University of Catalonia, 08195 Sant Cugat del Vallés, Spain
| | - Andoni Carrasco-Uribarren
- Faculty of Medicine and Health Sciences, International University of Catalonia, 08195 Sant Cugat del Vallés, Spain
| |
Collapse
|
4
|
Raja G P, Bhat S, Gangavelli R, Prabhu A, Stecco A, Pirri C, Jaganathan V, Fernández-de-Las-Peñas C. Effectiveness of Deep Cervical Fascial Manipulation ® and Sequential Yoga Poses on Pain and Function in Individuals with Mechanical Neck Pain: A Randomised Controlled Trial. Life (Basel) 2023; 13:2173. [PMID: 38004313 PMCID: PMC10672322 DOI: 10.3390/life13112173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/23/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND This study aimed to investigate the effect of fascial manipulation (FM) of the deep cervical fascia (DCF) and sequential yoga poses (SYP) on pain and function in individuals with mechanical neck pain (MNP). METHOD Following the predefined criteria, ninety-nine individuals with MNP were recruited, randomised, and assigned to either the intervention group (IG) (n = 51) or the control group (CG) (n = 48). Individuals in the IG received FM (4 sessions in 4 weeks) and the home-based SYP (4 weeks). The CG participants received their usual care (cervical mobilisation and thoracic manipulation (4 sessions in 4 weeks) along with unsupervised therapeutic exercises (4 weeks). The participants underwent baseline and weekly follow-up measurements of pain using a numerical pain rating scale (NPRS) and elbow extension range of motion (EEROM) during the upper limb neurodynamic test 1 (ULNT1). The baseline and the fourth session follow-up measurements of the patient-specific functional scale (PSFS) and fear-avoidance behavior Questionnaire (FABQ) were also taken. RESULTS A repeated-measures ANOVA was performed. There were statistically significant differences between the IG and CG on the NPRS third and fourth sessions, with mean differences (MD) of -1.009 (p < 0.05) and -1.701 (p < 0.001), respectively. Regarding EEROM, there was a 20.120° difference (p < 0.001) in the fourth session between the groups. The MD in FABQ was -5.036 (p < 0.001), but there were no significant differences in PSFS between the groups during the follow-up. CONCLUSION FM and SYP can aid in reducing pain and fear-avoidance behaviour and improve the function and extensibility of the upper quarter region.
Collapse
Affiliation(s)
- Prabu Raja G
- Department of Exercise and Sports Science, Manipal College of Health Professions, Manipal Academy of Higher Education (MAHE), Manipal 576104, India;
| | - Shyamasunder Bhat
- Department of Orthopedics, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal 576104, India
| | - Ranganath Gangavelli
- Department of Physiotherapy, GITAM School of Physiotherapy, GITAM University, Visakhapatnam 530045, India;
| | - Anupama Prabhu
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education (MAHE), Manipal 576104, India;
| | - Antonio Stecco
- Department of Rehabilitation Medicine, New York University, New York, NY 10012, USA;
| | - Carmelo Pirri
- Department of Neurosciences, Institute of Human Anatomy, University of Padua, 35121 Padova, Italy;
| | - Vennila Jaganathan
- Department of Statistics, Manipal College of Health Professions, Manipal Academy of Higher Education (MAHE), Manipal 576104, India;
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28008 Madrid, Spain;
| |
Collapse
|
5
|
Elsig S, Allet L, Bastiaenen CHG, de Bie R, Hilfiker R. Reliability and measurement error of sensorimotor tests in patients with neck pain: a systematic review. Arch Physiother 2023; 13:15. [PMID: 37582811 PMCID: PMC10428553 DOI: 10.1186/s40945-023-00170-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/18/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Neck pain is one of the leading causes of years lived with disability, and approximately half of people with neck pain experience recurrent episodes. Deficits in the sensorimotor system can persist even after pain relief, which may contribute to the chronic course of neck pain in some patients. Evaluation of sensorimotor capacities in patients with neck pain is therefore important. No consensus exists on how sensorimotor capacities of the neck should be assessed in physiotherapy. The aims of this systematic review are: (a) to provide an overview of tests used in physiotherapy for assessment of sensorimotor capacities in patients with neck pain; and (b) to provide information about reliability and measurement error of these tests, to enable physiotherapists to select appropriate tests. METHODS Medline, CINAHL, Embase and PsycINFO databases were searched for studies reporting data on the reliability and/or measurement error of sensorimotor tests in patients with neck pain. The results for reliability and measurement error were compared against the criteria for good measurement properties. The quality of evidence was assessed according to the modified GRADE method proposed by the COSMIN group. RESULTS A total of 206 tests for assessment of sensorimotor capacities of the neck were identified and categorized into 18 groups of tests. The included tests did not cover all aspects of the sensorimotor system; tests for the sensory and motor components were identified, but not for the central integration component. Furthermore, no data were found on reliability or measurement error for some tests that are used in practice, such as movement control tests, which apply to the motor component. Approximately half of the tests showed good reliability, and 12 were rated as having good (+) reliability. However, tests that evaluated complex movements, which are more difficult to standardize, were less reliable. Measurement error could not be evaluated because the minimal clinically important change was not available for all tests. CONCLUSION Overall, the quality of evidence is not yet high enough to enable clear recommendations about which tests to use to assess the sensorimotor capacities of the neck.
Collapse
Affiliation(s)
- Simone Elsig
- School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, HES-SO Valais-Wallis, Rathausstrasse 25, 3954, Valais, Leukerbad, Switzerland.
- Department of Epidemiology, Research Line Functioning, Participation and Rehabilitation, CAPHRI - Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200, Maastricht, the Netherlands.
- School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, HES-SO Valais-Wallis, Chemin de l'Agasse 5, Valais, Sion, Switzerland.
- The Sense Innovation & Research Center, Sion and Lausanne, Switzerland.
| | - Lara Allet
- School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, HES-SO Valais-Wallis, Chemin de l'Agasse 5, Valais, Sion, Switzerland
- The Sense Innovation & Research Center, Sion and Lausanne, Switzerland
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Caroline Henrice Germaine Bastiaenen
- Department of Epidemiology, Research Line Functioning, Participation and Rehabilitation, CAPHRI - Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200, Maastricht, the Netherlands
| | - Rob de Bie
- Department of Epidemiology, Research Line Functioning, Participation and Rehabilitation, CAPHRI - Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200, Maastricht, the Netherlands
| | - Roger Hilfiker
- School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, HES-SO Valais-Wallis, Rathausstrasse 25, 3954, Valais, Leukerbad, Switzerland
| |
Collapse
|
6
|
Ragnarsdóttir H, Briem K, Oddsdóttir GL. Effects of a Novel Web-Based Sensorimotor Exercise Program for Patients With Subacute Whiplash-Associated Disorders: Protocol for a Randomized Clinical Trial. Phys Ther 2023; 103:pzad063. [PMID: 37338163 DOI: 10.1093/ptj/pzad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 01/18/2023] [Accepted: 03/12/2023] [Indexed: 06/21/2023]
Abstract
INTRODUCTION Whiplash-associated disorder (WAD) often becomes a persistent problem and is one of the leading causes of disability in the world. It is a costly condition for individuals, for insurance companies, and for society. Guidelines for the management of WAD have not been updated since 2014, and the use of computer-based sensorimotor exercise programs in treatment for this patient group has not been well documented. The purpose of this randomized clinical trial is to explore the degree of association between self-reported and clinical outcome measures in WAD. METHODS Individuals (n = 180) with subacute WAD grades I and II will be randomized into 3 groups using block randomization. The 2 primary intervention groups (A and B) will receive physical therapy involving manual therapy and either a remote, novel, computer-based cervical kinesthetic exercise (CKE) program starting at visit 2 (Group A) or neck exercises provided by the corresponding physical therapist (Group B). These groups will be compared to a "treatment as usual" Group C. Movement control, proprioception, and cervical range of motion will be measured. Neck disability and pain intensity, general health, self-perceived handicap, and physical, emotional, and functional difficulties due to dizziness will be measured using questionnaires. The short-term effects will be measured 10 to 12 weeks after the baseline measurements, and the long-term effects will be measured 6 to 12 months after the baseline measurements. IMPACT The successful completion of this trial will help guide clinicians in the selection of outcome measures for patients with subacute WAD in the assessment of the short- and long-term effectiveness of treatment combining manual therapy with computer-based CKE compared with manual therapy and non-computer-based exercises. This trial will also demonstrate the potential of using a computer-based intervention to increase the exercise dose for this patient group and how this influences outcomes such as levels of pain and disability in the short and long term.
Collapse
Affiliation(s)
- Harpa Ragnarsdóttir
- Department of Physiotherapy, Research Centre of Movement Science, University of Iceland, Reykjavik, Iceland
- KIM Rehabilitation, Kópavogur, Iceland
| | - Kristín Briem
- Department of Physiotherapy, Research Centre of Movement Science, University of Iceland, Reykjavik, Iceland
| | - Guðný Lilja Oddsdóttir
- Department of Physiotherapy, Research Centre of Movement Science, University of Iceland, Reykjavik, Iceland
| |
Collapse
|
7
|
Daher A, Dar G. Stretching and muscle-performance exercises for chronic nonspecific neck pain: who may benefit most? Physiother Theory Pract 2023:1-14. [PMID: 37133358 DOI: 10.1080/09593985.2023.2207103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Although exercise is the mainstay of treatment for neck pain (NP), uncertainty remains over optimal decision-making concerning who may benefit most from such, particularly in the long term. OBJECTIVE To identify the subgroup of patients with nonspecific NP most likely to benefit from stretching and muscle-performance exercises. METHODS This was a secondary analysis of treatment outcomes of 70 patients (10 of whom dropped out) with a primary complaint of nonspecific NP in one treatment arm of a prospective, randomized, controlled trial. All patients performed the exercises, twice weekly for 6 weeks, and a home exercise program. Blinded outcome measurements were collected at baseline, after the 6-week program, and at a 6-month follow-up. Patients rated their perceived recovery on a 15-point global rating of change scale; a rating of "quite a bit better" (+5) or higher was defined as a successful outcome. Clinical predictor variables were developed via logistic regression analysis to classify patients with NP that may benefit from exercise-based treatment. RESULTS NP duration since onset≤6 months, no cervicogenic headache, and shoulder protraction were independent predictor variables. The pretest probability of success was 47% after the 6-week intervention and 40% at the 6-month follow-up. The corresponding posttest probabilities of success for participants with all three variables were 86% and 71%, respectively; such participants were likely to recover. CONCLUSION The clinical predictor variables developed in this study may identify patients with nonspecific NP likely to benefit most from stretching and muscle-performance exercises in the short and long terms.
Collapse
Affiliation(s)
- Amira Daher
- Department of Physical Therapy, Faculty of Health Studies, Zefat Academic College, Safed, Israel
- Department of Health Systems Administration, Max Stern Academic College of Emek Yezreel, Emek Yezreel, Israel
| | - Gali Dar
- Department of Physical Therapy, Faculty of Social Welfare and Health Studies, University of Haifa, Mount Carmel, Israel
- Physical Therapy Clinic, The Ribstein Center for Sport Medicine Sciences and Research, Wingate Institute, Netanya, Israel
| |
Collapse
|
8
|
Anarte-Lazo E, Rodriguez-Blanco C, Falla D, Bernal-Utrera C. Physical testing in patients with acute whiplash-associated disorders: A within session test-retest reliability study. Musculoskelet Sci Pract 2023; 64:102738. [PMID: 36870148 DOI: 10.1016/j.msksp.2023.102738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/18/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND People with whiplash-associated disorders (WAD) commonly present with a variety of physical impairments. However, the reliability of physical tests has not been established for patients with acute WAD. OBJECTIVE To assess test-retest reliability of different physical tests in acute WAD. DESIGN Intra-rater test-retest reliability. METHODS Patients with acute WAD were recruited. Physical tests were used to evaluate articular, muscular and neural systems in two blocks of measurements separated by 10 min. Bland-Altman plots were performed to assess intrarater agreement, which included calculation of the mean difference (d) between rates, the 95% CI for d, the standard deviation of the differences and the 95% limits of agreement. Reliability was calculated via the standard error of measurement, the minimal detectable change, percent of agreement, the intraclass-correlation coefficient, and kappa coefficient. RESULTS 47 patients participated. Test-retest reliability was excellent or good for almost all measures, except for extension ROM, ULTT for the radial nerve, and active cervical extension and upper cervical rotation performed in 4-point kneeling, which presented moderate reliability. Systematic bias was found in cervical ROM in flexion, left and right lateral-flexion, left and right rotation; left ULTT for radial nerve; right trapezius, suboccipitalis and temporalis muscles, left temporalis; C3, both sides of C1-C2, left C3-C4. CONCLUSION The majority of physical tests achieved good or excellent test-retest intra-rater reliability when tested in patients with acute WAD. Findings must be considered with caution for those tests which demonstrated systematic bias. Additional research is warranted to evaluate inter-rater reliability.
Collapse
Affiliation(s)
- E Anarte-Lazo
- Doctoral Program in Health Sciences, University of Seville, Seville, Spain; Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - C Rodriguez-Blanco
- Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain.
| | - D Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - C Bernal-Utrera
- Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| |
Collapse
|
9
|
Motor alterations in the kinetic chain in individuals with chronic shoulder pain. Gait Posture 2022; 93:183-190. [PMID: 35182984 DOI: 10.1016/j.gaitpost.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 02/06/2022] [Accepted: 02/12/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Shoulder pain may be related to biomechanical dysfunctions in the kinetic chain. OBJECTIVE To compare the mobility and muscular endurance of thoracolumbar spine and hip, and the neuromuscular control of the lower extremity of individuals with and without shoulder pain and to determine the discriminative capacity between groups of these variables. DESIGN A cross-sectional study. METHOD One hundred and two individuals with and without shoulder pain were evaluated to range of motion (ROM) of the thoracolumbar spine and hips, the muscular endurance time of the thoracolumbar spine and hips muscles, and the neuromuscular control of the lower extremity, by the Star Excursion Balance Test (SEBT). RESULTS Individuals with shoulder pain presented lower ROM and muscular endurance time in all tests evaluated (p < 0.01-p = 0.03), greater perception of pain during all ROM and muscle endurance (p < 0.01-p = 0.04) evaluations, and less neuromuscular control of the lower extremity in the compound reach (p < 0.01-p = 0.01), anterior and posteromedial (p < 0.01-p = 0.04) directions of the SEBT on both sides. The anterior reach direction of the SEBT of the contralateral limb to the shoulder pain (AUC=0.80, cut-off point=47.7%) presented excellent capacity to discriminate individuals with shoulder pain, while the other variables showed between acceptable and small capacity (AUC=0.58-0.76). CONCLUSION Individuals with chronic shoulder pain presented alterations in joint mobility, muscular endurance time of the thoracolumbar spine and hips and neuromuscular control of the lower extremity. The anterior reach of the SEBT of the contralateral limb showed excellent discriminative capacity.
Collapse
|
10
|
Leonet-Tijero L, Corral-de-Toro J, Rodríguez-Sanz J, Hernández-Secorún M, Abenia-Benedí H, Lucha-López MO, Monti-Ballano S, Müller-Thyssen-Uriarte J, Tricás-Vidal H, Hidalgo-García C, Tricás-Moreno JM. Interexaminer Reliability and Validity of Quantity of Cervical Mobility during Online Dynamic Inspection. Diagnostics (Basel) 2022; 12:diagnostics12020546. [PMID: 35204635 PMCID: PMC8870754 DOI: 10.3390/diagnostics12020546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Physical therapists routinely measure range of motion (ROM) of cervical spine. The reliability of the cervical range of motion (CROM) device has been demonstrated in several studies, but current evidence on the validity and reliability of the visual inspection is contradictory. The aim is to assess the validity and interexaminer reliability of the online visual inspection of active cervical ROM in physiotherapy students. Methods: Flexion, extension, both lateral flexions and rotations of a single participant were measured using CROM. Online visual inspection of 18 physiotherapy students against CROM was registered. Results: The validity, against CROM, of the online visual inspection of the active ROM ranged from good to excellent (Intraclass Correlation Coefficient (ICC) 0.83–0.97). Interexaminer reliability of the online visual inspection had favorable outcomes in all cervical movements in the three physiotherapy courses (ICC 0.70–0.96), with the visual inspection of the rotations being the most reliable (ICC 0.93–0.97). Interexaminer reliability of the classification of mobility was poor to good (Kappa 0.03–0.90). Conclusions: The interexaminer reliability and validity of the quantification of active cervical movement during online visual inspection was shown to be good to excellent for flexion-extension and lateral flexions and excellent for rotations.
Collapse
Affiliation(s)
- Leire Leonet-Tijero
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
| | - Jaime Corral-de-Toro
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
| | - Jacobo Rodríguez-Sanz
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, 08195 Barcelona, Spain;
- ACTIUM Functional Anatomy Group, 08028 Barcelona, Spain
| | - Mar Hernández-Secorún
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
| | - Hugo Abenia-Benedí
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
| | - María Orosia Lucha-López
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
- Correspondence: (M.O.L.-L.); (C.H.-G.); Tel.: +34-976761760 (M.O.L.-L.); +34-976764430 (C.H.-G.)
| | - Sofía Monti-Ballano
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
| | - Julián Müller-Thyssen-Uriarte
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
| | - Héctor Tricás-Vidal
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
| | - César Hidalgo-García
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
- Correspondence: (M.O.L.-L.); (C.H.-G.); Tel.: +34-976761760 (M.O.L.-L.); +34-976764430 (C.H.-G.)
| | - José Miguel Tricás-Moreno
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
| |
Collapse
|
11
|
Voulgarakis P, Iakovidis P, Lytras D, Chatziprodromidou IP, Kottaras A, Apostolou T. Effects of Joint Mobilization Versus Acupuncture on Pain and Functional Ability in People with Chronic Neck Pain: A Randomized Controlled Trial of Comparative Effectiveness. J Acupunct Meridian Stud 2021; 14:231-237. [DOI: 10.51507/j.jams.2021.14.6.231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/30/2021] [Accepted: 11/15/2021] [Indexed: 12/12/2022] Open
Affiliation(s)
- Petros Voulgarakis
- Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Paris Iakovidis
- Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Dimitrios Lytras
- Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Ioanna P. Chatziprodromidou
- Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Anastasios Kottaras
- Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Thomas Apostolou
- Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Thessaloniki, Greece
| |
Collapse
|
12
|
Mousavi-Khatir SR, Fernández-de-Las-Peñas C, Saadat P, Javanshir K, Zohrevand A. The Effect of Adding Dry Needling to Physical Therapy in the Treatment of Cervicogenic Headache: A Randomized Controlled Trial. PAIN MEDICINE 2021; 23:579-589. [PMID: 34687308 DOI: 10.1093/pm/pnab312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 10/03/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To compare the long-term effect of adding real or sham dry needling with conventional physiotherapy in cervicogenic headache. DESIGN A randomized controlled trial. SETTING Physiotherapy Clinic, Rouhani Hospital of Babol University of Medical Sciences, Iran. SUBJECTS Sixty-nine patients with cervicogenic headache. METHODS Patients were randomly assigned into a control group (n = 23) receiving conventional physical therapy; a dry needling group (n = 23) receiving conventional physical therapy and dry needling on the cervical muscles; placebo needling group (n = 23) receiving conventional physical therapy and superficial dry needling at a point away from the trigger point. The primary outcome was the headache intensity and frequency. Neck disability, deep cervical flexor performance and range of motion were secondary outcomes. Outcomes were assessed immediately after treatment and one, three and six months later. RESULTS Sixty-five patients were finally included in the analysis. Headache intensity and neck disability decreased significantly more in the dry needling compared to sham and control groups after treatment and during all follow-ups. The frequency of headaches also reduced more in the dry needling than in control and sham groups, but it did not reach statistical significance. Higher cervical range of motion and enhancement of deep cervical flexors performance was also observed in the dry needling compared to sham and control groups. CONCLUSION Dry needling has a positive effect on pain and disability reduction, cervical range of motion and deep cervical flexor muscles performance in patients with cervicogenic headache and active trigger points, although the clinical relevance of the results was small.
Collapse
Affiliation(s)
- Seyedeh Roghayeh Mousavi-Khatir
- Assistant Professor of Physiotherapy (PhD), Department of Physiotherapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, Iran
| | - César Fernández-de-Las-Peñas
- Professor of Physiotherapy (PhD), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain
| | - Payam Saadat
- Associate Professor of Neurology, Department of Psychiatry, School of Medicine, Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Khodabakhsh Javanshir
- Physiotherapist, PhD, Associate professor (Corresponding Author), Mobility Impairment Research Center, Physiotherapy Department,, Babol University of Medical Sciences
| | - Amirhossein Zohrevand
- Assistant Professor of Neurosurgery, Department of Surgery, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| |
Collapse
|
13
|
Anandkumar S, Manivasagam M. Physical therapist guided active intervention of chronic temporomandibular disorder presenting as ear pain: A case report. Physiother Theory Pract 2021; 38:3146-3158. [PMID: 34152897 DOI: 10.1080/09593985.2021.1938307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This case report describes the successful physical therapy management of a 40-year-old female who presented with left ear pain referred from the temporomandibular joint. Diagnosis was primarily based on clinical examination findings and ruling out of red flags. Guidance was given on active self-care approaches consisting of pain neuroscience education designed with individualized pain curriculum, exercise therapy, manual therapy, and breathing exercises for a period of sixweeks. Clinically meaningful improvements were obtained in the outcome measures of Numeric Pain Rating Scale (NPRS), Patient-Specific Functional Scale (PSFS), and Global Rating of Change (GROC) scale and progress in Pain-Self Efficacy Questionnaire (PSEQ) and Tampa Scale for Kinesiophobia (TSK) scores. Positive changes were achieved with functional activities (chewing, eating, yawing, brushing teeth and physical intimacy), and the patient was pain-free on discharge, which was maintained at a six-month follow-up.
Collapse
Affiliation(s)
- Sudarshan Anandkumar
- Synergy Rehab Clayton Heights Physiotherapy and Sports Injury Clinic, Surrey, British Columbia, Canada
| | | |
Collapse
|
14
|
Hariharan KV, Timko MG, Bise CG, Sundaram M, Schneider MJ. Inter-examinerreliability study of physical examination procedures to assess the cervical spine. Chiropr Man Therap 2021; 29:20. [PMID: 34127016 PMCID: PMC8201716 DOI: 10.1186/s12998-021-00377-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 05/25/2021] [Indexed: 12/19/2022] Open
Abstract
Objective The objective of this study was to establish the level of inter-examiner reliability for six common cervical manual and physical examination procedures used to assess the cervical spine. Materials: Reliability study that used a convenience sample of 51 patients between the ages of 16–70 years presenting with a chief complaint of neck pain. Two physical therapists independently performed the same series of cervical physical examination procedures on each of the participant. The clinicians were blinded to each other’s findings and the clinical status of the patient. Kappa coefficients (κ) were calculated for levels of agreement between the clinicians for each procedure. Results When assessing for asymmetrical motion, excellent levels of reliability (κ range: 0.88–0.96) were observed for the Bilateral Modified Lateral Shear (asymmetry criterion), Bilateral C2 Spinous Kick (asymmetry criterion) and Flexion-Rotation Tests. When pain provocation was used as the indicator of a positive test during palpation of the cervical facet joints, moderate to substantial levels of reliability (κ range: 0.53–0.76) were observed. When patients were instructed not to provide feedback to the clinicians about pain provocation during facet joint palpation and clinicians relied solely on their qualitative assessment of segmental mobility, the level of reliability was lower (κ range: 0.45–0.53). Due to 100 % prevalence of negative findings, Kappa values could not be calculated for the Sharp-Purser test or the Unilateral C2 Spinous Kick Test. Conclusions Most physical examination procedures examined in this study demonstrated moderate to excellent levels of inter-examiner reliability. Palpation for segmental mobility without pain provocation demonstrated a lower level of reliability compared to palpation for pain provocation. Correlation with clinical findings is necessary to establish validity and the applicability of these procedures in clinical practice.
Collapse
Affiliation(s)
- Karthik V Hariharan
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael G Timko
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA.,Division of Physical Therapy, West Virginia University, Morgantown, WV, USA
| | - Christopher G Bise
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Meenakshi Sundaram
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael J Schneider
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA. .,Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA.
| |
Collapse
|
15
|
A comparison of kinesio taping and classical massage in addition to cervical stabilization exercise in patients with chronic neck pain. Complement Ther Clin Pract 2021; 43:101381. [PMID: 33831805 DOI: 10.1016/j.ctcp.2021.101381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 02/24/2021] [Accepted: 03/29/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND PURPOSE Studies comparing the effectiveness of kinesio taping (KT) and classical massage (CM) in chronic neck pain (CNP) are scarce. This study aimed to compare the effects of KT and CM in addition to cervical stabilization exercise (CSE) in patients with CNP. MATERIALS AND METHODS Patients were randomly allocated to KT + CSE and CM + CSE groups. Disability with the Neck Disability Index (NDI), pain with the Visual Analog Scale, cervical range of motion with a goniometer, and quality of life (QoL) with the 36-Item Short-Form (SF-36) were assessed baseline and after a 4-week treatment. RESULTS Improvement was observed in NDI and physical component scores of SF-36 in favor of the KT + CSE group and in rotation movements in favor of the CM + CSE group (p < 0.05). CONCLUSION In CNP, KT + CSE was superior in improving disability and QoL compared to CM + CSE, whereas CM + CSE was superior in increasing rotation movements compared to KT + CSE.
Collapse
|
16
|
Dry Needling Adds No Benefit to the Treatment of Neck Pain: A Sham-Controlled Randomized Clinical Trial With 1-Year Follow-up. J Orthop Sports Phys Ther 2021; 51:37-45. [PMID: 33383999 DOI: 10.2519/jospt.2021.9864] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To examine the short- and long-term effectiveness of dry needling on disability, pain, and patient-perceived improvements in patients with mechanical neck pain when added to a multimodal treatment program that includes manual therapy and exercise. DESIGN Randomized controlled trial. METHODS Seventy-seven adults (mean ± SD age, 46.68 ± 14.18 years; 79% female) who were referred to physical therapy with acute, subacute, or chronic mechanical neck pain were randomly allocated to receive 7 multimodal treatment sessions over 4 weeks of (1) dry needling, manual therapy, and exercise (needling group); or (2) sham dry needling, manual therapy, and exercise (sham needling group). The primary outcome of disability (Neck Disability Index score) and secondary outcomes of pain (current and 24-hour average) and patient-perceived improvement were assessed at baseline and follow-ups of 4 weeks, 6 months, and 1 year by blinded assessors. Between-group differences were analyzed with a 2-way, repeated-measures analysis of variance. Global rating of change was analyzed with a Mann-Whitney U test. RESULTS There were no group-by-time interactions for disability (Neck Disability Index: F2.37,177.47 = 0.42, P = .69), current pain (visual analog scale: F2.84,213.16 = 1.04, P = .37), or average pain over 24 hours (F2.64,198.02 = 0.01, P = .10). There were no between-group differences for global rating of change at any time point (P≥.65). Both groups improved over time for all variables (Neck Disability Index: F2.37,177.47 = 124.70, P<.001; current pain: F2.84,213.16 = 64.28, P<.001; and average pain over 24 hours: F2.64,198.02 = 76.69, P<.001). CONCLUSION There were no differences in outcomes between trigger point dry needling and sham dry needling when added to a multimodal treatment program for neck pain. Dry needling should not be part of a first-line approach to managing neck pain. J Orthop Sports Phys Ther 2021;51(1):37-45. doi:10.2519/jospt.2021.9864.
Collapse
|
17
|
Lerner-Lentz A, O'Halloran B, Donaldson M, Cleland JA. Pragmatic application of manipulation versus mobilization to the upper segments of the cervical spine plus exercise for treatment of cervicogenic headache: a randomized clinical trial. J Man Manip Ther 2020; 29:267-275. [PMID: 33148134 DOI: 10.1080/10669817.2020.1834322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The effectiveness of manipulation versus mobilization for the management of spinal conditions, including cervicogenic headache, is conflicting. However, a pragmatic approach comparing manipulation to mobilization has not been examined in a patient population with cervicogenic headache. OBJECTIVES To evaluate the effectiveness of manipulation compared to mobilization applied in a pragmatic fashion for patients with cervicogenic headache. METHODS Forty-five (26 females) patients with cervicogenic headache (mean age 47.8 ± SD 16.9 years) were randomly assigned to receive either pragmatically selected manipulation or mobilization. Outcomes were measured at baseline, the second visit, discharge, and 1-month follow-up and included the Neck Disability Index (NDI), Numeric Pain Rating Scale (NPRS), the Headache Impact Test (HIT-6), the Global Rating of Change (GRC), the Patient Acceptable Symptoms Scale (PASS). The primary aim (effects of treatment on disability and pain were examined with a mixed-model analysis of variance (ANOVA), with treatment group (manipulation versus mobilization) as the between subjects variable and time (baseline, 48 hours, discharge and follow-up) as the within subjects variable. RESULTS The interaction for the mixed model ANOVA was not statistically significant for NDI (p = 0.91), NPRS (p = 0.81), or HIT (p = 0.89). There was no significant difference between groups for the GRC or PASS. DISCUSSION AND CONCLUSION The results suggest that manipulation has similar effects on disability, pain, GRC, and cervical range of motion as mobilization when applied in a pragmatic fashion for patients with cervicogenic headaches. CLINICALTRIALS.GOV NCT03919630.
Collapse
Affiliation(s)
- Addison Lerner-Lentz
- Clinician and Researcher for Pain Relief and Physical Therapy, Havertown, PA, USA
| | - Bryan O'Halloran
- Director of Physical Therapy for Pain Relief and Physical Therapy, Havertown, PA, USA
| | - Megan Donaldson
- Program Director for the Doctor of Physical Therapy Program, Tufts University School of Medicine, Boston Mass
| | - Joshua A Cleland
- Director of Research and Faculty Development, Tufts University School of Medicine, Boston, Mass
| |
Collapse
|
18
|
Takatalo J, Ylinen J, Pienimäki T, Häkkinen A. Intra- and inter-rater reliability of thoracic spine mobility and posture assessments in subjects with thoracic spine pain. BMC Musculoskelet Disord 2020; 21:529. [PMID: 32778081 PMCID: PMC7418198 DOI: 10.1186/s12891-020-03551-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 07/31/2020] [Indexed: 11/17/2022] Open
Abstract
Background The thoracic spine (TS) has been neglected in the study of the spine despite its essential role in the stability and posture of the entire spinal complex. Therefore, there is an inevitable need to investigate the reproducibility of different thoracic spinal posture measures used in subjects with TS pain. Methods Thirty-two subjects (16 females and 16 males, mean age 39 years) were evaluated by two physiotherapists on the same day to gauge inter-rater reliability and on two consecutive days to gauge intra-rater reliability. TS posture was assessed by observation, and thoracic spine mobility was measured by manual assessment of segmental flexion and extension mobility in a seated position. Additionally, posterior-to-anterior accessory mobility in a prone position was assessed manually. Moreover, cervicothoracic flexion in a seated position, thoracic posture, and thoracic flexion and extension mobility in a standing position were assessed with a tape measure, and flexion and extension mobility in a seated position and TS posture in seated and standing positions were measured with an inclinometer. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), mean difference (MD), Bland-Altman (B&A) plot features and coefficient of repeatability (CR) were calculated. Results The mean and standard deviation (SD) of the duration of TS pain was 22 (SD 45) months, with the intensity of pain being rated at 27 (SD 21) mm on a visual analogue scale (VAS). Intra-rater reliability was very strong (ICC ≥ 0.80) for the evaluation of seated and standing upper TS posture, standing whole TS posture and seated lower TS posture with an inclinometer. Moreover, TS posture evaluation with a measuring tape, posture inspection in a seated position, and manual assessment of segmental extension were found to have very strong intra-rater reliability. Inter-rater reliability was very strong for inclinometer measurements of standing and seated upper TS posture as well as standing whole TS posture. Conclusion Intra-rater reliability was higher than inter-rater reliability in most of the evaluated measurements. Overall, posture measurements with an inclinometer were more reliable than mobility measurements with the same instrument. The manual assessments can be used reliably when same evaluator performs the examination. Trial registration Clinical Trials, NCT01884818. Registered 24 June 2013, https://clinicaltrials.gov/ct2/show/NCT01884818?cond=thoracic+spine&cntry=FI&rank=1
Collapse
Affiliation(s)
- Jani Takatalo
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyväskylä, Finland. .,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
| | - Jari Ylinen
- Central Finland Central Hospital, Jyväskylä, Finland
| | - Tuomo Pienimäki
- The Social Insurance Institution of Finland, Helsinki, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyväskylä, Finland.,Central Finland Central Hospital, Jyväskylä, Finland
| |
Collapse
|
19
|
Reliability of an Integrated Inertial Sensor for the Continuous Measurement of Active Cervical Range of Motion in a Group of Younger and Elderly Individuals. J Funct Morphol Kinesiol 2020; 5:jfmk5030058. [PMID: 33467273 PMCID: PMC7739228 DOI: 10.3390/jfmk5030058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 12/27/2022] Open
Abstract
The aim of this study was to evaluate the test-retest reliability of an integrated inertial sensor (IIS) for cervical range of motion assessment. An integrated inertial sensor was placed on the forehead center of thirty older adults (OA) and thirty younger adults (YA). Participants had to perform three continuous rotations, lateral bandings and flexion-extensions with their head. Test-retest reliability was assessed after 7 days. YA showed moderate to good agreement for rotation (0.54-0.82), lateral bending (0.74-0.8), and flexion-extension (0.74-0.81) movements and poor agreement for zero point (ZP). OA showed moderate to good agreement for rotation (0.65-0.86), good to excellent agreement in lateral bending (0.79-0.92), and poor to moderate agreement for flexion-extension (0.37-0.72). Zero point showed poor to moderate agreement. In conclusion, we can affirm that this IIS is a reliable device for cervical range of motion assessment in young and older adults; on the contrary, the ZP seems to be unreliable and the addition of an external reference point could help the subject to solve this shortcoming and reduce possible biases.
Collapse
|
20
|
Liss CM, Sanni AA, McCully KK. Endurance of the Dorsal and Ventral Muscles in the Neck. J Funct Morphol Kinesiol 2020; 5:E47. [PMID: 33467263 PMCID: PMC7739275 DOI: 10.3390/jfmk5030047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/04/2020] [Accepted: 07/06/2020] [Indexed: 11/16/2022] Open
Abstract
Endurance of the muscles of the neck are rarely studied. This study measured the endurance index (EI) of the sternocleidomastoid (SCM) and upper trapezius muscles of the neck (trap). The vastus lateralis (VL) was used for comparison. Skeletal muscle endurance of twelve healthy subjects, age 19-22 years, were tested on their SCM and trap in random order on one day, VL was tested on a separate day. Participants were tested in the supine position for the SCM and VL muscles and the prone position for the trap. Muscle contractions consisted of a 5 Hz twitch electrical stimulation for 5 min. Muscle acceleration (resultant vector) was measured using a triaxial accelerometer. EI was the ending acceleration as a percentage of the maximal acceleration. The endurance index (EI) for the SCM, trap, and VL was 42.3 ± 13.0%, 42.3 ± 20.2%, and 92.9 ± 11.0%, respectively. The EI of the VL was significantly higher than the EI of the SCM (t(2,22) = 10.33, p < 0.001) and the trap (t(2,22) = 7.625, p < 0.001). The EI was not different between the SCM and the trap muscle (t(2,22) = 0.004, p = 0.997). In conclusion, the neck muscles had much less endurance than the muscles in the leg and could make fatigued athletes more susceptible to concussions caused by head impacts.
Collapse
Affiliation(s)
| | - Adeola A. Sanni
- Department of Kinesiology, University of Georgia, Athens, GA 30602, USA; (C.M.L.); (K.K.M.)
| | | |
Collapse
|
21
|
Maissan F, Pool J, de Raaij E, Wittink H, Ostelo R. Treatment based classification systems for patients with non-specific neck pain. A systematic review. Musculoskelet Sci Pract 2020; 47:102133. [PMID: 32148328 DOI: 10.1016/j.msksp.2020.102133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 02/02/2020] [Accepted: 02/15/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We aimed to identify published classification systems with a targeted treatment approach (treatment-based classification systems (TBCSs)) for patients with non-specific neck pain, and assess their quality and effectiveness. DESIGN Systematic review. DATA SOURCES MEDLINE, CINAHL, EMBASE, PEDro and the grey literature were systematically searched from inception to December 2019. STUDY APPRAISAL AND SYNTHESIS The main selection criterium was a TBCS for patients with non-specific neck pain with physiotherapeutic interventions. For data extraction of descriptive data and quality assessment we used the framework developed by Buchbinder et al. We considered as score of ≤3 as low quality, a score between 3 and 5 as moderate quality and a score ≥5 as good quality. To assess the risk of bias of studies concerning the effectiveness of TBCSs (only randomized clinical trials (RCTs) were included) we used the PEDro scale. We considered a score of ≥ six points on this scale as low risk of bias. RESULTS Out of 7664 initial references we included 13 studies. The overall quality of the TBCSs ranged from low to moderate. We found two RCTs, both with low risk of bias, evaluating the effectiveness of two TBCSs compared to alternative treatments. The results showed that both TBCSs were not superior to alternative treatments. CONCLUSION Existing TBCSs are, at best, of moderate quality. In addition, TBCSs were not shown to be more effective than alternatives. Therefore using these TBCSs in daily practice is not recommended.
Collapse
Affiliation(s)
- Francois Maissan
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands; Department of Health Sciences, VU University, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Amsterdam UMC, Amsterdam, Amsterdam Movement Sciences, the Netherlands.
| | - Jan Pool
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - Edwin de Raaij
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands; Department of Health Sciences, VU University, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Amsterdam UMC, Amsterdam, Amsterdam Movement Sciences, the Netherlands
| | - Harriet Wittink
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - Raymond Ostelo
- Department of Health Sciences, VU University, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Amsterdam UMC, Amsterdam, Amsterdam Movement Sciences, the Netherlands
| |
Collapse
|
22
|
Wang X, Lindstroem R, Plocharski M, Østergaard LR, Graven-Nielsen T. Repeatability of Cervical Joint Flexion and Extension Within and Between Days. J Manipulative Physiol Ther 2019; 41:10-18. [PMID: 29366488 DOI: 10.1016/j.jmpt.2017.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 08/24/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate within- and between-day repeatability of free and unrestricted healthy cervical flexion and extension motion when assessing dynamic cervical spine motion. METHODS Fluoroscopy videos of 2 repeated cervical flexion and 2 repeated extension motions were examined for within-day repeatability (20-second interval) for 18 participants (6 females) and between-day repeatability (1-week interval) for 15 participants (6 females). The dynamic cervical motions were free and unrestricted from neutral to end range. The flexion videos and extension videos were evenly divided into 10% epochs of the C0-to-C7 range of motion. Within-day and between-day repeatability of joint motion angles (all 7 joints and epochs, respectively) was tested in a repeated-measures analysis of variance. Joint motion angle differences between repetitions were calculated for each epoch and joint (7 joints), and these joint motion angle differences between within-day and between-day repetitions were tested in mixed-model analysis of variance. RESULTS For all joints and epochs, respectively, no significant differences were found in joint motion angle between within-day or between-day repetitions. There were no significant effects of joint motion angle differences between within-day and between-day repetitions. The average within-day joint motion angle differences across all joints and epochs were 0.00° ± 2.98° and 0.00° ± 3.05° for flexion and extension, respectively. The average between-day joint motion angle differences were 0.02° ± 2.56° and 0.05° ± 2.40° for flexion and extension, respectively. CONCLUSIONS This is the first study to report the within-day and between-day joint motion angle differences of repeated cervical flexion and extension. This study supports the idea that cervical joints repeat their motion accurately.
Collapse
Affiliation(s)
- Xu Wang
- SMI, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark; Department of Orthopedics, Second Hospital of Jilin University, Changchun, China
| | - René Lindstroem
- SMI, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Maciej Plocharski
- Medical Informatics Group, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Lasse Riis Østergaard
- Medical Informatics Group, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain, SMI, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
| |
Collapse
|
23
|
Fazli F, Farahmand B, Azadinia F, Amiri A. The Effect of Ergonomic Latex Pillow on Head and Neck Posture and Muscle Endurance in Patients With Cervical Spondylosis: A Randomized Controlled Trial. J Chiropr Med 2019; 18:155-162. [PMID: 32874156 DOI: 10.1016/j.jcm.2019.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 11/26/2018] [Accepted: 02/10/2019] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES Cervical pillows have frequently been reported to attenuate the symptoms of pain and disability. Although the main role of pillows is to optimize head and neck posture and relax the neck muscles, limited studies have examined the effectiveness of pillows from aspects beyond subjective outcome measures, especially their effect on head and neck posture and muscle performance. This study examines the effect of ergonomic latex pillow on the craniovertebral (CV) angle and cervical flexor and extensor muscle endurance in patients with cervical spondylosis. METHODS This parallel-group, randomized, controlled trial was conducted from January to June 2017. The patients with cervical spondylosis were randomly allocated to the experimental and control groups, who both received identical standard physiotherapy 3 × a week for 4 weeks. The experimental group received an ergonomic latex pillow, but the control group was asked to continue sleeping on their usual pillow. The CV angle and flexor and extensor muscle endurance were measured before and after the intervention. The independent-sample t test was used to compare changes in the CV angle, whereas the Mann-Whitney test was used to compare changes in flexor and extensor muscle endurance between the groups, respectively. RESULTS The experimental group showed significant changes in the CV angle and extensor muscle endurance. A significant increase was observed in extensor muscle endurance in the experimental group compared with the control group. CONCLUSION The ergonomic latex pillow may affect neck extensor muscle endurance and CV angle in patients with cervical spondylosis, although further studies are needed before any recommendations.
Collapse
Affiliation(s)
- Fatemeh Fazli
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Isfahan, Esfahan, Iran
| | - Behshid Farahmand
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Tehran, Iran
| | - Fatemeh Azadinia
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Tehran, Iran
| | - Ali Amiri
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Tehran, Iran
| |
Collapse
|
24
|
Lemeunier N, Suri-Chilana M, Welsh P, Shearer HM, Nordin M, Wong JJ, Torres P, Oolup-da Silva S, D’Silva C, Jeoun EB, Stern P, Yu H, Murnaghan K, Sutton D, Côté P. Reliability and validity of clinical tests to assess the function of the cervical spine in adults with neck pain and its associated disorders: part 5. A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) collaboration. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2019. [DOI: 10.1080/21679169.2019.1626906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Nadège Lemeunier
- Department of Research, Institut Franco-Européen de Chiropraxie (IFEC), Toulouse, France
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Canada
| | - Minisha Suri-Chilana
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Patrick Welsh
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Heather M. Shearer
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Margareta Nordin
- Department of Orthopedic Surgery, Occupational and Industrial Orthopedic Centre (OIOC), New York, NY, USA
| | - Jessica J. Wong
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Paola Torres
- Rehabilitation Centre, San Cristobal Clinic, Santiago, Chile
| | - Sophia Oolup-da Silva
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Chelsea D’Silva
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Eun Been Jeoun
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Paula Stern
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Hainan Yu
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Kent Murnaghan
- Librarian, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Deborah Sutton
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College, Toronto, Canada
| |
Collapse
|
25
|
Martellucci S, Attanasio G, Ralli M, Marcelli V, de Vincentiis M, Greco A, Gallo A. Does cervical range of motion affect the outcomes of canalith repositioning procedures for posterior canal benign positional paroxysmal vertigo? Am J Otolaryngol 2019; 40:494-498. [PMID: 30967256 DOI: 10.1016/j.amjoto.2019.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/27/2019] [Accepted: 04/02/2019] [Indexed: 01/01/2023]
Abstract
PURPOSE Canalith repositioning procedure (CRP) for posterior canal benign positional paroxysmal vertigo (BPPV), also known as Epley maneuver, is a common procedure for the treatment of BPPV. This maneuver entails flexion, extension and rotation of the patient's neck. This study aims to investigate the impact of cervical range of motion (C-ROM) on CRP efficacy. MATERIALS AND METHODS The study included 47 patients with posterior canal BPPV treated by CRP. The procedure was considered successful if vertigo and nystagmus disappeared at the post-treatment evaluation. If CRP resulted ineffective, it was repeated up to three times per session. C-ROM was measured at BPPV diagnosis before treatment. Patients were followed up for 30 days. RESULTS The first CRP was successful in 29 patients (61.7%), while it was ineffective in 18 patients (38.3%) requiring multiple repositioning maneuvers. Patients who needed two or more CRP showed lower C-ROM in extension (p = .003) and flexion (p = .042), and earlier recurrences (p = .006). Univariate regression analysis showed that lower cervical extension was significantly associated with the failure of the first CRP (OR: 0.899, 95% CI 0.831-0.973, p = .008). CONCLUSIONS Our data suggest that a reduced C-ROM can require multiple CRPs to successfully treat BPPV and increase the risk of early recurrences.
Collapse
|
26
|
Immediate and Short-term Effects of Thoracic Spine Manipulation in Patients With Cervical Radiculopathy: A Randomized Controlled Trial. J Orthop Sports Phys Ther 2019; 49:299-309. [PMID: 31021691 DOI: 10.2519/jospt.2019.8150] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Thoracic spine thrust manipulation has been shown to improve patient-rated outcomes for individuals with neck pain. However, there is limited evidence of its effectiveness in patients with cervical radiculopathy. OBJECTIVES To compare the immediate and short-term effects of thoracic manipulation to those of a sham thoracic manipulation in patients with cervical radiculopathy. METHODS In this multicenter randomized controlled trial, participants with cervical radiculopathy were randomized to receive either manipulation (n = 22) or sham manipulation (n = 21) of the thoracic spine. Outcomes were measured at baseline, immediately after treatment, and at a follow-up 48 to 72 hours after manipulation. A repeated-measures analysis of variance was used to analyze neck and upper extremity pain (numeric pain-rating scale), disability (Neck Disability Index), cervical range of motion (ROM), and endurance (deep neck flexor endurance test). The chi-square test was used to analyze changes in neck and upper extremity pain, centralization of symptoms, and beliefs about receiving the active manipulation treatment using a global rating of change scale. RESULTS Neck and upper extremity pain, cervical ROM, disability, and deep neck flexor endurance all showed significant interactions between group and time (P<.01). Immediately after treatment and at the 48-to-72-hour follow-up, the manipulation group had lower neck pain (P<.01), better cervical ROM (P<.01), lower disability (P<.01), and better deep neck flexor endurance (P = .02) compared to the sham manipulation group. The manipulation group had moderate to large effect-size changes over time. No between-group differences for upper extremity pain were found immediately following the intervention (P = .34) and at 48 to 72 hours after the intervention (P = .18). At 48 to 72 hours after treatment, a greater proportion of participants in the manipulation group reported improvement (global rating of change scale score of 4 or greater) in neck and upper extremity symptoms (P<.01), centralization of symptoms (P<.01), and beliefs about receiving an active manipulation (P = .01) compared to the sham manipulation group. CONCLUSION One session of thoracic manipulation resulted in improvements in pain, disability, cervical ROM, and deep neck flexor endurance in patients with cervical radiculopathy. Patients treated with manipulation were more likely to report at least moderate change in their neck and upper extremity symptoms up to 48 to 72 hours following treatment. LEVEL OF EVIDENCE Therapy, level 2. J Orthop Sports Phys Ther 2019;49(5):299-309. doi:10.2519/jospt.2019.8150.
Collapse
|
27
|
Yarznbowicz R, Tao M. Directional preference constructs for patients' neck pain in the absence of centralization. J Man Manip Ther 2019; 27:229-236. [PMID: 30935329 DOI: 10.1080/10669817.2019.1568660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Objectives: We conducted a secondary analysis of a prospective, observational cohort study to (1) report the prevalence of Directional Preference (DP) constructs at first examination for patients with cervical spine challenges, and (2) determine the association between DP constructs and clinical outcomes at discharge from physical therapy. Methods: We analyzed data collected from 718 consecutive patients who presented to outpatient, private practice clinics with primary complaints of non-specific neck pain; 200 patients met the inclusion criteria and completed first examination and discharge data. Statistical analysis determined the association between DP constructs at first examination and clinical outcomes at discharge. Results: The findings in this investigation were that (1) the most prevalent DP constructs at first examination were related to ROM and pain intensity including Patient Reported Improvement in ROM (79.5%), Increase in Spine ROM (32.5%), and Pain Intensity Change (15.0%), (2) all DP groups improved and met the MCID for disability and pain intensity change at discharge except for the group that did not exhibit Increase in Spine ROM for pain intensity, (3) no clinically significant differences in pain intensity or disability existed between DP groups at discharge, and (4) 28.5% and 6.5% of patients exhibited a relative increase in cervical spine extension and flexion ROM, respectively, post-repeated movement testing on the first examination. Discussion: The most prevalent DP constructs at first examination were related to ROM and pain intensity, and each was associated with a comparable clinical trajectory in terms of pain and disability outcomes at discharge. The findings of this study help Mechanical Diagnosis and Therapy (MDT) providers understand the common DP constructs encountered in routine clinical practice and their relation to pain and disability outcomes for patients with cervical spine challenges. Level of Evidence: 2b.
Collapse
Affiliation(s)
- Richard Yarznbowicz
- a Center for Orthopedic and Sports Physical Therapy , Tallahassee , FL , USA
| | - Minjing Tao
- b Department of Statistics, Florida State University , Tallahassee , FL , USA
| |
Collapse
|
28
|
Zafar H, Alghadir AH, Iqbal ZA. Effect of jaw functional status on neck muscle endurance. Arch Oral Biol 2019; 101:30-33. [PMID: 30875591 DOI: 10.1016/j.archoralbio.2019.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/19/2019] [Accepted: 03/01/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate the effect of resting jaw and maximum voluntary clenching on neck flexor and extensor muscle endurance. DESIGN Neck flexor and extensor endurance was measured in a college health clinic in 85 male college students in two test positions: resting jaw (control) and maximum voluntary clenching. RESULTS Mean neck flexor muscle endurance values during resting jaw and maximum voluntary clenching were 70.06 SD 28.24, and 60.03 SD 16.5, seconds respectively. Mean neck extensor muscle endurance values during resting jaw and maximum voluntary clenching were 105.54 SD 29.9, and 98.32 SD 24.54, respectively. Both values were significantly lower while maximum voluntary clenching as compared to resting jaw position (p < 0.05). CONCLUSION Modification of jaw position can affect neck muscle endurance. Results of this study further supports sensory-motor relation between jaw and neck region.
Collapse
Affiliation(s)
- Hamayun Zafar
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umea University, Umea, Sweden
| | - Ahmad H Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Zaheen A Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| |
Collapse
|
29
|
Ramirez MM, Brennan GP. Using the value-based care paradigm to compare physical therapy access to care models in cervical spine radiculopathy: a case report. Physiother Theory Pract 2019; 36:1476-1484. [PMID: 30776939 DOI: 10.1080/09593985.2019.1579878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: The efficiency and effectiveness of multiple physical therapy care delivery models can be measured using the value-based care paradigm. Entering physical therapy through direct access can decrease health-care utilization and improve patient outcomes. Limited evidence exists which compares direct access physical therapy to referral using the value-based care paradigm specific to cervical spine radiculopathy. Case Description: The patient was a 39-year-old woman who presented to physical therapy through physician referral with the diagnoses of acute cervical radiculopathy. The patient was evaluated, provided guideline adherent treatment and discharged with a home exercise program. Sixteen months from being discharged, the same patient returned through direct access due to an acute onset of cervical spine symptoms and was evaluated and provided treatment that same morning. Outcomes: Direct access physical therapy saved the patient and third-party payer $434.30 and $3264.75 respectively. A 5×'s higher efficiency per visit and a 6.2×'s higher value in reducing disability was demonstrated when the patient accessed physical therapy directly. Physician referral and direct access entry pathways demonstrated neck disability index improvements of 6% and 16%, respectively. Discussion: This case report describes a clinical example of previous research that demonstrates improved cost efficiency, outcomes, and increased value with a patient who presented to physical therapy with cervical radiculopathy through two different access to care models. The results of this case demonstrate a clinical example of the use of the value-based care paradigm in comparing value and efficiency of two access to care models in a patient with cervical radiculopathy without other neurological deficits.
Collapse
Affiliation(s)
- Michelle M Ramirez
- Department of Sports Medicine and Rehabilitation, AdventHealth Orlando-Adventist Health System , Orlando, FL, USA
| | | |
Collapse
|
30
|
Aimi M, Schmit EFD, Ribeiro RP, Candotti CT. Posture, muscle endurance and ROM in individuals with and without neck pain. FISIOTERAPIA EM MOVIMENTO 2019. [DOI: 10.1590/1980-5918.032.ao20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Factors such as postural changes, reduced neck muscle endurance and reduced range of motion (ROM) are common characteristics attributed to people with neck pain. Objective: (a) Identify differences in postural, muscular endurance and ROM characteristics between individuals with and without neck pain and (b) relate the presence and intensity of neck pain with the characteristics of static posture, muscular endurance and cervical ROM. Method: A cross-sectional study with 60 subjects equally divided into two groups with respect to the presence of neck pain carrying out the following evaluations: (1) static postural evaluation by digital photogrammetry; (2) the neck flexor endurance test; and (3) evaluation of cervical ROM using a fleximeter. The data were analyzed with independent t-tests, the Mann-Whitney U test, and the Spearman and Tau of Kendall correlation tests (α < 0.05). Results: There were no statistical differences between individuals with and without neck pain regarding the postural, muscle endurance and cervical ROM characteristics. No statistically significant correlations were found between pain and posture, muscle endurance and cervical ROM. Conclusion: Individuals with neck pain do not appear to present differences in their postural, neck flexor muscle endurance or cervical ROM characteristics when compared to individuals without neck pain, and neck pain appears to be unrelated to these variables.
Collapse
Affiliation(s)
- Mateus Aimi
- Universidade Federal do Rio Grande do Sul, Brazil
| | | | | | | |
Collapse
|
31
|
Lemeunier N, Jeoun EB, Suri M, Tuff T, Shearer H, Mior S, Wong JJ, da Silva-Oolup S, Torres P, D'Silva C, Stern P, Yu H, Millan M, Sutton D, Murnaghan K, Cȏté P. Reliability and validity of clinical tests to assess posture, pain location, and cervical spine mobility in adults with neck pain and its associated disorders: Part 4. A systematic review from the cervical assessment and diagnosis research evaluation (CADRE) collaboration. Musculoskelet Sci Pract 2018; 38:128-147. [PMID: 30455032 DOI: 10.1016/j.msksp.2018.09.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/21/2018] [Accepted: 09/25/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the reliability and validity of clinical tests to assess posture, pain location, and cervical spine mobility in adults with grades I-IV neck pain and associated disorders (NAD). METHODS We systematically searched electronic databases to update the systematic review of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Eligible reliability and validity studies were critically appraised using modified versions of the QAREL and QUADAS-2 instruments, respectively. Evidence from low risk of bias studies were synthesized following best evidence synthesis principles. RESULTS We screened 14302 articles, critically appraised 46 studies, and found 32 low risk of bias articles (14 reliability and 18 validity studies). We found preliminary evidence of: 1) reliability of visual inspection, aided with devices (CROM and digital caliper) to assess head posture; 2) reliability and validity of soft tissue palpation to locate tender/trigger points in muscles; 3) reliability and validity of joint motion palpation to assess stiffness and pain provocation in combination; and 4) range of motion tests using visual estimation (in cervical extension only) or devices (digital caliper, goniometer, inclinometer) to assess cervical mobility. CONCLUSIONS We found little evidence to support the reliability and validity of clinical tests to assess head posture, pain location and cervical mobility in adults with NAD grades I-III. More advanced validity studies are needed to inform the clinical utility of tests used to evaluate patients with NAD.
Collapse
Affiliation(s)
- N Lemeunier
- Institut Franco-Européen de Chiropraxie, 72 chemin de la Flambère, 31300, Toulouse, France; UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada.
| | - E B Jeoun
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - M Suri
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - T Tuff
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - H Shearer
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - S Mior
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - J J Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - S da Silva-Oolup
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - P Torres
- Rehabilitation Centre, San Cristobal Clinic, Santiago Spine Group, Santiago, Chile
| | - C D'Silva
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, L1H 7K4, Canada
| | - P Stern
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - H Yu
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada
| | - M Millan
- Cabinet d'expertise médicale, Castres, France
| | - D Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada
| | - K Murnaghan
- Librarian, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - P Cȏté
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, L1H 7K4, Canada
| |
Collapse
|
32
|
Dewitte V, De Pauw R, Danneels L, Bouche K, Roets A, Cagnie B. The interrater reliability of a pain mechanisms-based classification for patients with nonspecific neck pain. Braz J Phys Ther 2018; 23:437-447. [PMID: 30389348 DOI: 10.1016/j.bjpt.2018.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/12/2018] [Accepted: 10/16/2018] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To examine the interrater reliability and agreement of a pain mechanisms-based classification for patients with nonspecific neck pain (NSNP). METHODS Design - Observational, cross-sectional reliability study with a simultaneous examiner design. SETTING University hospital-based outpatient physical therapy clinic. PARTICIPANTS A random sample of 48 patients, aged between 18 and 75 years old, with a primary complaint of neck pain was included. INTERVENTIONS Subjects underwent a standardized subjective and clinical examination, performed by 1 experienced physical therapist. Two assessors independently classified the participants' NSNP on 3 main outcome measures. MAIN OUTCOME MEASURES The Cohen kappa, percent agreement, and 95% confidence intervals (CIs) were calculated to determine the interrater reliability for (1) the predominant pain mechanism; (2) the predominant pain pattern; and (3) the predominant dysfunction pattern (DP). RESULTS There was almost perfect agreement between the 2 physical therapists' judgements on the predominant pain mechanism, kappa=.84 (95% CI, .65-1.00), p<.001. There was substantial agreement between the raters' judgements on the predominant pain pattern and predominant DP with respectively kappa=.61 (95% CI, .42-.80); and kappa=.62 (95% CI, .44-.79), p<.001. CONCLUSION(S) The proposed classification exhibits substantial to almost perfect interrater reliability. Further validity testing in larger neck pain populations is required before the information is used in clinical settings. CLINICAL TRIAL REGISTRATION NUMBER NCT03147508 (https://clinicaltrials.gov/ct2/show/NCT03147508).
Collapse
Affiliation(s)
- Vincent Dewitte
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
| | - Robby De Pauw
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Katie Bouche
- Centre for Musculoskeletal and Neurological Rehabilitation, Ghent University Hospital, Ghent, Belgium
| | - Arne Roets
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Barbara Cagnie
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| |
Collapse
|
33
|
Escaloni J, Butts R, Dunning J. The use of dry needling as a diagnostic tool and clinical treatment for cervicogenic dizziness: a narrative review & case series. J Bodyw Mov Ther 2018; 22:947-955. [DOI: 10.1016/j.jbmt.2018.02.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 01/21/2018] [Accepted: 02/08/2018] [Indexed: 12/20/2022]
|
34
|
Ghamkhar L, Kahlaee AH. Is forward head posture relevant to cervical muscles performance and neck pain? A case-control study. Braz J Phys Ther 2018; 23:346-354. [PMID: 30145129 DOI: 10.1016/j.bjpt.2018.08.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/04/2018] [Accepted: 08/07/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Forward head posture (FHP) and muscular dysfunction are likely contributing factors to chronic neck pain (CNP) but there are inconsistent findings on the relevance of these factors to clinical CNP characteristics. OBJECTIVE To compare FHP, cervical muscles size and endurance between CNP and asymptomatic participants and to investigate their association with pain and disability and relative involvement of deep/superficial and flexor/extensor muscles. METHODS Thirty-two patients with CNP and 35 asymptomatic participants were included in this case-control study. FHP in standing, extensor and flexor muscles endurance and dimensions were assessed using digital photography, clinical tests and ultrasonographic imaging, respectively. The visual analog scale and neck disability index were also used to evaluate CNP patients' clinical characteristics. RESULTS Deep flexor (mean difference=0.06, 95% CI=0.02-0.11) and extensor muscles size (mean difference=0.07, 95% CI=0.01-0.12) were found to be significantly smaller in CNP patients. CNP patients also demonstrated lower levels of flexor (mean difference=14.68, 95% CI=3.65-25.72) and global extensor endurance capacity. FHP was neither different between the groups nor correlated with any of the dependent variables. Neither FHP nor endurance was correlated with pain/disability. Extensor endurance in both groups and flexor endurance in the asymptomatic group showed significant correlations with muscles size. CONCLUSIONS FHP was found neither different between groups nor correlated with muscle performance or CNP clinical characteristics. While cervical endurance was found lower in CNP patients, it did not show any association with pain/disability. The muscular size-endurance relationship seems to become more complex in the presence of NP. While deep muscles seem to be differentially affected in the presence of CNP, the alterations do not seem to be uniform in the flexor and extensor groups.
Collapse
Affiliation(s)
- Leila Ghamkhar
- Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Amir Hossein Kahlaee
- Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| |
Collapse
|
35
|
Andrews DP, Odland-Wolf KB, May J, Baker R, Nasypany A, Dinkins EM. Immediate and short-term effects of mulligan concept positional sustained natural apophyseal glides on an athletic young-adult population classified with mechanical neck pain: an exploratory investigation. J Man Manip Ther 2018; 26:203-211. [PMID: 30083043 PMCID: PMC6071273 DOI: 10.1080/10669817.2018.1460965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Objectives: Mechanical neck pain (MNP) is common in the athletic population. While symptoms may present at the cervical spine for patients complaining of MNP, thoracic spinal alignment or dysfunction may influence cervical positioning and overall cervical function. Clinicians often employ cervical high-velocity low-amplitude (HVLA) thrust manipulations to treat MNP, albeit with a small level of inherent risk. Mulligan Concept positional sustained natural apophyseal glides (SNAGs) directed at the cervicothoracic region are emerging to treat patients with cervical pain and dysfunction, as evidence supporting an interdependent relationship between the thoracic and cervical spine grows. The purpose of this a priori study was to evaluate outcome measures of patients classified with MNP treated with the Mulligan Concept Positional SNAGs. Methods: Ten consecutive young-adult patients, ages ranging from 15 to 18 years (mean = 16.5 ± 1.78), classified with MNP were treated utilizing Mulligan Concept Positional SNAGs. The Numeric Rating Scale (NRS), Patient-Specific Functional Scale (PSFS), Neck Disability Index (NDI), Disablement in the Physically Active (DPAS), and Fear-Avoidance Based Questionnaire-Physical Activity (FABQPA) were collected for inclusion criteria and to identify patient-reported pain and dysfunction. Results: Patients reported decreases in pain on the NRS [5.4 to .16, p = .001], increases in function on the PSFS [5.2 to 10, p = .001], and increases in cervical range of motion (CROM) [ext p = .003, flex p = .009, left rot p = .001, right rot p = .002] immediately post-treatment and between treatments. Discussion: Positional SNAGs directed at the cervicothoracic region may address a variety of patient reported symptoms for MNP, and the number of treatment sessions needed for symptom resolution may be closer to a single session rather than multiple treatments. Level of Evidence: 4.
Collapse
Affiliation(s)
| | | | - James May
- College of Education, Movement Sciences, University of Idaho, Moscow, ID, USA
| | - Russell Baker
- College of Education, Movement Sciences, University of Idaho, Moscow, ID, USA
| | - Alan Nasypany
- College of Education, Movement Sciences, University of Idaho, Moscow, ID, USA
| | | |
Collapse
|
36
|
Williams G, Sarig-Bahat H, Williams K, Tyrrell R, Treleaven J. Cervical kinematics in patients with vestibular pathology vs. patients with neck pain: A pilot study. J Vestib Res 2018; 27:137-145. [PMID: 29064829 DOI: 10.3233/ves-170615] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Research has consistently shown cervical kinematic impairments in subjects with persistent neck pain (NP). It could be reasoned that those with vestibular pathology (VP) may also have altered kinematics since vestibular stimulation via head movement can cause dizziness and visual disturbances. However, this has not been examined to date. This pilot study investigated changes in cervical kinematics between asymptomatic control, NP and VP subjects using a Virtual Reality (VR) system. It was hypothesised that there would be altered kinematics in VP subjects, which might be associated with dizziness and visual symptoms. DESIGN Pilot cross sectional observational study. PARTICIPANTS Twenty control, 14 VP and 20 NP subjects. INTERVENTION Not applicable. MAIN OUTCOME MEASURES Measures included questionnaires (neck disability index, pain on movement, dizziness and pain intensity, visual disturbances) and cervical kinematics (range, peak and mean velocity, smoothness, symmetry, and accuracy of cervical motion) using a virtual reality system. RESULTS Results revealed significantly decreased mean velocity and symmetry of motion in both planes in those with NP but no differences in accuracy or range of motion. No significant differences were seen between VP subjects and asymptomatic controls. However, correlation analysis showed some moderate correlations between dizziness to selected kinematics in both the NP and the VP groups. CONCLUSIONS These results support that cervical kinematics are altered in NP patients, with velocity most affected. There is potential for VP subjects to also have altered kinematics, especially those who experience dizziness. More research is required.
Collapse
Affiliation(s)
- Grace Williams
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Hilla Sarig-Bahat
- Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Katrina Williams
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Ryan Tyrrell
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Julia Treleaven
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| |
Collapse
|
37
|
Amiri Arimi S, Ghamkhar L, Kahlaee AH. The Relevance of Proprioception to Chronic Neck Pain: A Correlational Analysis of Flexor Muscle Size and Endurance, Clinical Neck Pain Characteristics, and Proprioception. PAIN MEDICINE 2018; 19:2077-2088. [DOI: 10.1093/pm/pnx331] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Somayeh Amiri Arimi
- Clinical Research Development Center, Rofeideh Rehabilitation Hospital, Tehran, Iran
- Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Leila Ghamkhar
- Clinical Research Development Center, Rofeideh Rehabilitation Hospital, Tehran, Iran
- Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Amir H Kahlaee
- Clinical Research Development Center, Rofeideh Rehabilitation Hospital, Tehran, Iran
- Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| |
Collapse
|
38
|
Gattie ER, Cleland JA, Snodgrass SJ. Dry Needling for Patients With Neck Pain: Protocol of a Randomized Clinical Trial. JMIR Res Protoc 2017; 6:e227. [PMID: 29167092 PMCID: PMC5719229 DOI: 10.2196/resprot.7980] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 08/21/2017] [Accepted: 08/21/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Neck pain is a costly and common problem. Current treatments are not adequately effective for a large proportion of patients who continue to experience recurrent pain. Therefore, new treatment strategies should be investigated in an attempt to reduce the disability and high costs associated with neck pain. Dry needling is a technique in which a fine needle is used to penetrate the skin, subcutaneous tissues, and muscle with the intent to mechanically disrupt tissue without the use of an anesthetic. Dry needling is emerging as a treatment modality that is widely used clinically to address a variety of musculoskeletal conditions. Recent studies of dry needling in mechanical neck pain suggest potential benefits, but do not utilize methods typical to clinical practice and lack long-term follow-up. Therefore, a clinical trial with realistic treatment time frames and methods consistent with clinical practice is needed to examine the effectiveness of dry needling on reducing pain and enhancing function in patients presenting to physical therapy with mechanical neck pain. OBJECTIVE The aim of this trial will be to examine the short- and long-term effectiveness of dry needling delivered by a physical therapist on pain, disability, and patient-perceived improvements in patients with mechanical neck pain. METHODS We will conduct a randomized, double-blind, placebo-controlled trial in accordance with the CONSORT guidelines. A total of 76 patients over the age of 18 with acute or chronic mechanical neck pain resulting from postural dysfunction, trauma, or insidious onset who are referred to physical therapy will be enrolled after meeting the eligibility criteria. Subjects will be excluded if they have previous history of surgery, whiplash in the last 6 weeks, nerve root compression, red flags, or contraindications to dry needling or manual therapy. Participants will be randomized to receive (1) dry needling, manual therapy, and exercise or (2) sham dry needling, manual therapy, and exercise. Participants will receive seven physical therapy treatments lasting 45 minutes each over a maximum of 4 weeks. The primary outcome will be disability as measured by the Neck Disability Index. Secondary outcomes include the following: pain, patient-perceived improvement, patient expectations, and successful blinding to the needling intervention. Outcome measures will be assessed at 4 weeks, 6 months, and 12 months by an assessor who is blind to the group allocation of the participants to determine the short- and long-term treatment effects. We will examine the primary aim with a two-way, repeated-measures analysis of variance with treatment group as the between-subjects variable and time as the within-subjects variable. The hypothesis of interest will be the two-way group by time interaction. An a priori alpha level of .05 will be used for all analyses. RESULTS Recruitment is currently underway and is expected to be completed by the end of 2017. Data collection for long-term outcomes will occur throughout 2017 and 2018. Data analysis, preparation, and publication submission is expected to occur throughout the final three quarters of 2018. CONCLUSIONS The successful completion of this trial will provide evidence to demonstrate whether dry needling is effective for the management of mechanical neck pain when used in a combined treatment approach, as is the common clinical practice. TRIAL REGISTRATION ClinicalTrials.gov NCT02731014; https://clinicaltrials.gov/ct2/show/NCT02731014 (Archived by WebCite at http://www.webcitation.org/6ujZgbhsq).
Collapse
Affiliation(s)
| | - Joshua A Cleland
- Physical Therapy Program, Franklin Pierce University, Manchester, NH, United States
| | | |
Collapse
|
39
|
Jonsson A, Rasmussen-Barr E. Intra- and inter-rater reliability of movement and palpation tests in patients with neck pain: A systematic review. Physiother Theory Pract 2017; 34:165-180. [PMID: 29111857 DOI: 10.1080/09593985.2017.1390806] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Neck pain is common and often becomes chronic. Various clinical tests of the cervical spine are used to direct and evaluate treatment. This systematic review aimed to identify studies examining the intra- and/or interrater reliability of tests used in clinical examination of patients with neck pain. A database search up to April 2016 was conducted in PubMed, CINAHL, and AMED. The Quality Appraisal of Reliability Studies Checklist (QAREL) was used to assess risk of bias. Eleven studies were included, comprising tests of active and passive movement and pain evaluating participants with ongoing neck pain. One study was assessed with a low risk of bias, three with medium risk, while the rest were assessed with high risk of bias. The results showed differing reliabilities for the included tests ranging from poor to almost perfect. In conclusion, active movement and pain for pain or mobility overall presented acceptable to very good reliability (Kappa >0.40); while passive intervertebral tests had lower Kappa values, suggesting poor reliability. It may be a coincidence that the studies indicating very good reliability tended to be of higher quality (low to moderate risk of bias), while studies finding poor reliability tended to be of lower quality (high risk of bias). Regardless, the current recommendation from this review would suggest the clinical use of tests with acceptable reliability and avoiding the use of tests that have been shown to not be reliable. Finally, it is critical that all future reliability studies are of higher quality with low risk of bias.
Collapse
Affiliation(s)
- Anders Jonsson
- a Department of Community Medicine and Rehabilitation/Physiotherapy , Umeå University , Umeå , Sweden
| | - Eva Rasmussen-Barr
- b Karolinska Institutet, Department of Neurobiology Care Scinces and society , Division of Physiotherapy , Huddinge , Sweden
| |
Collapse
|
40
|
Remote kinematic training for patients with chronic neck pain: a randomised controlled trial. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 27:1309-1323. [DOI: 10.1007/s00586-017-5323-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 09/04/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022]
|
41
|
Rondoni A, Rossettini G, Ristori D, Gallo F, Strobe M, Giaretta F, Battistin A, Testa M. Intrarater and Inter-rater Reliability of Active Cervical Range of Motion in Patients With Nonspecific Neck Pain Measured With Technological and Common Use Devices: A Systematic Review With Meta-regression. J Manipulative Physiol Ther 2017; 40:597-608. [PMID: 29187311 DOI: 10.1016/j.jmpt.2017.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 07/07/2017] [Accepted: 07/20/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The purpose of this systematic review was to compare intrarater and inter-rater reliability of active cervical range of motion (ACROM) measures obtained with technological devices to those assessed with low-cost devices in patients with nonspecific neck pain. As a secondary outcome, we investigated if ACROM reliability is influenced by the plane of the assessed movement. METHODS Medline, Scopus, Embase, the Cochrane Library, CINHAL, PEDro, and gray literature were searched until August 2016. Inclusion criteria were reliability design, population of adults with nonspecific neck pain, examiners of any level of experience, measures repeated at least twice, and statistical indexes on reliability. A device was considered inexpensive if it cost less than €500. The risk of bias of included studies was assessed by Quality Appraisal of Reliability Studies. RESULTS The search yielded 35 151 records. Nine studies met all eligibility criteria. Their Quality Appraisal of Reliability Studies mean score was 3.7 of 11. No significant effect of the type of device (inexpensive vs expensive) on intraclass correlation coefficient (ICC) was identified for intrarater (ICC = 0.93 vs 0.91; P > .99) and inter-rater reliability (ICC = 0.80 vs 0.87; P > .99). The plane of movement did not affect inter-rater reliability (P = .11). Significant influences were identified with intrarater reliability (P = .0001) of inexpensive devices, where intrarater reliability decreased (P = .01) in side bending, compared with flexion-extension. CONCLUSIONS The use of expensive devices to measure ACROM in adults with nonspecific neck pain does not seem to improve the reliability of the assessment. Side bending had a lower level of intrarater reliability.
Collapse
Affiliation(s)
- Angie Rondoni
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova-Campus of Savona, Savona, Italy
| | - Giacomo Rossettini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova-Campus of Savona, Savona, Italy
| | - Diego Ristori
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova-Campus of Savona, Savona, Italy
| | - Fabio Gallo
- Department of Health Sciences, University of Genova, Genova, Italy
| | - Marco Strobe
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova-Campus of Savona, Savona, Italy
| | | | | | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova-Campus of Savona, Savona, Italy.
| |
Collapse
|
42
|
Interrater Agreement of Manual Palpation for Identification of Myofascial Trigger Points. Clin J Pain 2017; 33:715-729. [DOI: 10.1097/ajp.0000000000000459] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
43
|
Within-Session and Between-Session Reliability, Construct Validity, and Comparison Between Individuals With and Without Neck Pain of Four Neck Muscle Tests. PM R 2017; 10:183-193. [DOI: 10.1016/j.pmrj.2017.06.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 06/16/2017] [Accepted: 06/30/2017] [Indexed: 11/22/2022]
|
44
|
Williams K, Tarmizi A, Treleaven J. Use of neck torsion as a specific test of neck related postural instability. Musculoskelet Sci Pract 2017; 29:115-119. [PMID: 28371703 DOI: 10.1016/j.msksp.2017.03.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/20/2017] [Accepted: 03/26/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Disturbed postural stability in neck pain (NP) is likely due to abnormal cervical afferent function. Several potential causes requires specific diagnostic tests. The neck torsion (head still body rotated) manoeuvre stimulates cervical but not vestibular receptors and identified abnormal cervical afferent input as the cause in patients with NP compared to healthy controls. Comparison between vestibular and NP subjects is now needed. AIMS To compare individuals with unilateral vestibular loss (UVL), persistent NP and asymptomatic controls. It was hypothesized that neck torsion will increase postural stability in NP compared to both the asymptomatic and UVL groups. METHODS Twenty UVL, 20 persistent NP and 20 asymptomatic control subjects underwent measurement of postural stability on a computerised force plate with eyes closed in comfortable stance under 5 conditions: neutral head, head rotated 45° (left and right) and neck torsion (left and right). Root mean square (rms) amplitude of sway was measured in the anterior posterior (AP) and medial lateral (ML) directions. Average torsion and torsion difference (average torsion - neutral neck) were calculated. RESULTS NP subjects had significantly greater (p < 0.05) AP sway with average torsion and torsion difference compared to both control and UVL. There were no significant differences between control and UVL and no between group differences for neutral neck, rotation or rotation difference. CONCLUSION The results of the study suggest that the torsion manouever may identify cervical afferent causes of disturbed postural stability. This is important for guiding assessment and management of balance disturbances in patients.
Collapse
Affiliation(s)
- Katrina Williams
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia
| | - Ahmad Tarmizi
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia
| | - Julia Treleaven
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia.
| |
Collapse
|
45
|
Kubas C, Chen YW, Echeverri S, McCann SL, Denhoed MJ, Walker CJ, Kennedy CN, Reid WD. Reliability and Validity of Cervical Range of Motion and Muscle Strength Testing. J Strength Cond Res 2017; 31:1087-1096. [PMID: 27467513 DOI: 10.1519/jsc.0000000000001578] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Kubas, C, Chen, Y-W, Echeverri, S, McCann, S, Denhoed, M, Walker, C, Kennedy, C, and Reid, WD. Reliability and validity of cervical range of motion and muscle strength testing. J Strength Cond Res 31(4): 1087-1096, 2017-Cervical range of motion (ROM) and strength are fundamental measures to assess treatment effectiveness. The JTECH wireless devices provide versatile means of quantifying these measurements. The purpose of this study was to determine intrarater and interrater reliabilities and concurrent validity of the JTECH wireless dual inclinometer and handheld dynamometer. This study included 20 healthy subjects (mean age = 28.7 ± 7.8 years). The directions of ROM movement measured were cervical flexion, extension, lateral flexion, and rotation. Isometric strength was measured for flexion, extension, and lateral flexion. Two testers measured cervical ROM and isometric strength for each subject using the JTECH devices during 2 or 3 sessions to determine reliability. The same ROM and muscle strength movements were measured using the CROM3 and MicroFET2, respectively, to assess concurrent validity. Reliability and validity were analyzed using intraclass correlation coefficient (ICC), along with SEM and minimal detectable change. The results of this study showed that the intrarater reliability of the JTECH inclinometer and dynamometer was moderate to excellent (ICCs (3,1) = 0.53-0.90 and 0.74-0.91, respectively). The interrater reliability of the JTECH inclinometer was moderate to excellent (ICCs (2,3) = 0.69-0.89), whereas the JTECH dynamometer showed excellent interrater reliability (ICCs (2,3) = 0.84-0.88). The JTECH inclinometer and dynamometer showed moderate to excellent concurrent validity (ICCs (3,2) = 0.65-0.91 and 0.91-0.96, respectively). With the ease of use, portability, and ability to record multiple measurements without stopping, these devices can be applied to clinical and research settings.
Collapse
Affiliation(s)
- Christian Kubas
- 1Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; and 2Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Grondin F, Hall T. Changes in cervical movement impairment and pain following orofacial treatment in patients with chronic arthralgic temporomandibular disorder with pain: A prospective case series. Physiother Theory Pract 2016; 33:52-61. [PMID: 27911133 DOI: 10.1080/09593985.2016.1247934] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to investigate the influence of isolated temporomandibular joint (TMJ) manual therapy on pain and range of motion (ROM) of the TMJ and cervical spine including flexion-rotation test (FRT) in people suffering chronic pain arising from chronic arthralgic temporomandibular disorder (TMD). An experienced clinician managed a case series of 12 patients with TMD (mean duration 28.6 months +/- 26.9). The intervention comprised four-weekly sessions of transverse medial accessory TMJ mobilization and advice. Patients were examined prior to and one-week following the intervention period. Outcome measures included jaw disability (JFLS-20), jaw pain measured by Visual Analogue Scale (VAS), maximal mouth opening ROM, cervical ROM including FRT, and pain during cervical movement. A paired t-test revealed significant improvement following the intervention in disability (p < 0.001), VAS pain score at rest (p < 0.001) and at maximum mouth opening (p < 0.001), jaw opening ROM (p < 0.001), FRT ROM to the left (p = 0.024) and right (p = 0.001). In contrast, no significant change was identified for total cervical ROM (p = 0.905). After the intervention, five patients (41.66%) had no pain at rest or at maximal mouth opening, and all had a negative FRT. The effect sizes indicate a moderate to strong, clinically significant effect for all variables apart from total cervical ROM. While a case series cannot identify a cause and effect relationship, these results provide preliminary evidence for the influence of TMJ manual therapy on measures of TMD including pain, as well as upper but not whole cervical movement and associated pain in patients with a diagnosis of TMJ arthralgia.
Collapse
Affiliation(s)
- Francis Grondin
- a Laboratory of Anatomy , Bordeaux University , Bordeaux Cedex, France
| | - Toby Hall
- b School of Physiotherapy and Exercise Science , Curtin University of Technology , Perth , WA , Australia
| |
Collapse
|
47
|
Costello M, Puentedura E'LJ, Cleland J, Ciccone CD. The immediate effects of soft tissue mobilization versus therapeutic ultrasound for patients with neck and arm pain with evidence of neural mechanosensitivity: a randomized clinical trial. J Man Manip Ther 2016; 24:128-40. [PMID: 27559283 DOI: 10.1179/2042618614y.0000000083] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
STUDY DESIGN Randomized clinical trial. OBJECTIVES To investigate the immediate effects of soft tissue mobilization (STM) versus therapeutic ultrasound (US) in patients with neck and arm pain who demonstrate neural mechanical sensitivity. BACKGROUND While experts have suggested that individuals with neck and arm pain associated with neural tissue mechanical sensitivity may benefit from STM, there has been little research to investigate this hypothesis. METHODS Twenty-three patients with neck and arm pain and a positive upper limb neurodynamic test (ULNT) were randomly assigned to receive STM or therapeutic US during a single session. Outcome measures were collected immediately before and after treatment, and at 2-4 day follow-up. Primary outcomes were the Global Rating of Change (GROC), range of motion (ROM) during the ULNT, and pain rating during the ULNT. Secondary measures included the Neck Disability Index (NDI), Patient-Specific Functional Scale (PSFS), Numeric Pain Rating Scale (NPRS), and active range of shoulder abduction motion combined with the wrist neutral or wrist extension. RESULTS A greater proportion of patients in the STM group reported a significant improvement on the GROC immediately after treatment (P = 0·003, STM = 75%, US = 9%), and at 2-4 day follow-up (P = 0·027, STM = 58%, US = 9%). Patients who received STM demonstrated greater improvements in ROM during ULNT (P = 0·026), PSFS (P = 0·007), and shoulder active ROM combined with wrist extension (P = 0·028). Improvements in Numeric Pain Rating Scale and pain during the ULNT were observed only in the STM group. There was no difference between groups for the NDI or shoulder abduction ROM with wrist neutral. CONCLUSION Patients with neck and arm pain demonstrated greater improvements in ULNT ROM, GROC, and PSFS, and pain following STM than after receiving therapeutic US. LEVEL OF EVIDENCE Therapy, level 1b.
Collapse
Affiliation(s)
- Michael Costello
- Orthopedic Physical Therapy Residency Program, Cayuga Medical Center, Ithaca, NY 14850, USA
| | | | - Josh Cleland
- Physical Therapy Program, Franklin Pierce University, Manchester, NH, USA
| | | |
Collapse
|
48
|
Petersen SM, Domino NA, Cook CE. Scapulothoracic muscle strength in individuals with neck pain. J Back Musculoskelet Rehabil 2016; 29:549-55. [PMID: 26836839 DOI: 10.3233/bmr-160656] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND People with neck pain often present with weakness in the scapulothoracic muscles. Few studies have examined lower trapezius (LT), middle trapezius (MT) and serratus anterior (SA) muscle strength in individuals with neck pain, nor compared strength to asymptomatic individuals. OBJECTIVES The aim of this study was to examine LT, MT and SA muscle strength in individuals with chronic neck pain. METHODS Descriptive cross sectional design. Twenty two individuals with chronic neck pain and 17 asymptomatic individuals were included. Participants were asked to complete a screening questionnaire, Neck Disability Index, and underwent manual muscle testing for the LT, MT, and SA muscles bilaterally. Data analyses included paired and comparative independent t-tests. RESULTS For individuals with neck pain, significant within subject differences in strength between sides for the LT (P< 0.01) and MT (P< 0.01) were present. In contrast, no within subject difference between sides for the asymptomatic group was found for any muscle. Individuals with neck pain were significantly weaker than asymptomatic individuals for the LT (p= 0.02), MT (p= 0.03), and SA (p= 0.01) on their side of neck pain, but not on their non-painful side. CONCLUSIONS Significant within subject differences were found between sides for the LT and MT while significant between group differences were identified for all three muscles tested.
Collapse
Affiliation(s)
| | - Nathan A Domino
- Physical Therapy Program, Des Moines University, Des Moines, IA, USA
| | - Chad E Cook
- Research Division of Physical Therapy, Duke Medical Center, Durham, NC, USA
| |
Collapse
|
49
|
Lourenço AS, Lameiras C, Silva AG. Neck Flexor and Extensor Muscle Endurance in Subclinical Neck Pain: Intrarater Reliability, Standard Error of Measurement, Minimal Detectable Change, and Comparison With Asymptomatic Participants in a University Student Population. J Manipulative Physiol Ther 2016; 39:427-433. [PMID: 27368756 DOI: 10.1016/j.jmpt.2016.05.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 07/13/2015] [Accepted: 08/27/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aims of this study were to assess intrarater reliability and to calculate the standard error of measurement (SEM) and minimal detectable change (MDC) for deep neck flexor and neck extensor muscle endurance tests, and compare the results between individuals with and without subclinical neck pain. METHODS Participants were students of the University of Aveiro reporting subclinical neck pain and asymptomatic participants matched for sex and age to the neck pain group. Data on endurance capacity of the deep neck flexors and neck extensors were collected by a blinded assessor using the deep neck flexor endurance test and the extensor endurance test, respectively. Intraclass correlation coefficients (ICCs), SEM, and MDC were calculated for measurements taken within a session by the same assessor. Differences between groups for endurance capacity were investigated using a Mann-Whitney U test. RESULTS The deep neck flexor endurance test (ICC = 0.71; SEM = 6.91 seconds; MDC = 19.15 seconds) and neck extensor endurance test (ICC = 0.73; SEM = 9.84 minutes; MDC = 2.34 minutes) are reliable. No significant differences were found between participants with and without neck pain for both tests of muscle endurance (P > .05). CONCLUSION The endurance capacity of the deep neck flexors and neck extensors can be reliably measured in participants with subclinical neck pain. However, the wide SEM and MDC might limit the sensitivity of these tests.
Collapse
Affiliation(s)
- Ana S Lourenço
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Carina Lameiras
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Anabela G Silva
- School of Health Sciences, University of Aveiro, Aveiro, Portugal.
| |
Collapse
|
50
|
Tsang SMH, Szeto GPY, Lee RYW. Relationship between neck acceleration and muscle activation in people with chronic neck pain: Implications for functional disability. Clin Biomech (Bristol, Avon) 2016; 35:27-36. [PMID: 27116562 DOI: 10.1016/j.clinbiomech.2016.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 04/05/2016] [Accepted: 04/12/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous study has found that people with chronic neck pain moved with a consistently compromised acceleration/deceleration at their cervical and thoracic spines. This study examined the strength of the association between the electromyographic activities and the acceleration/deceleration of the cervical and thoracic spine, and its correlation with the functional disabilities in individuals with neck pain. METHODS Time history of the cervical and thoracic acceleration/deceleration and EMG activity was acquired in thirty-four subjects with chronic neck pain and thirty-four age- and gender-matched asymptomatic subjects during active neck movements. The strength of the association between the electromyographic activity of spinal muscles and the cervical and thoracic acceleration/deceleration was determined using cross-correlation method. Relationship between the strength of this association and the severity of the functional disabilities in neck pain group was examined using correlation analysis. FINDINGS The strength of the association between cervical and thoracic acceleration/deceleration and electromyographic activities was significantly lower in neck pain group. Significant negative correlations were found between the functional disability level and the strength of this defined association in the symptomatic group. INTERPRETATION The compromised capability of the spinal muscles to produce acceleration/deceleration in the neck pain group may imply an impaired electromechanical coupling of these spinal muscles when performing neck movements. Significant negative correlation of the degree of functional disabilities suggests that the present approach can be used as an objective and specific evaluation of the dynamic performance of the spinal muscles and its relationship with the functional disabilities in neck pain subjects.
Collapse
Affiliation(s)
- Sharon M H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - Grace P Y Szeto
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - Raymond Y W Lee
- School of Applied Sciences, London South Bank University, United Kingdom.
| |
Collapse
|