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Sun Y, Xian Y, Lin H, Sun X. Enhancing the Management of Non-Specific Neck Pain through Gamification: Design and Efficacy of a Health Application. Bioengineering (Basel) 2024; 11:640. [PMID: 39061722 PMCID: PMC11273543 DOI: 10.3390/bioengineering11070640] [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: 05/27/2024] [Revised: 06/18/2024] [Accepted: 06/20/2024] [Indexed: 07/28/2024] Open
Abstract
Chronic non-specific neck pain (CNNP) poses a substantial health and economic burden in China. This study introduces a gamified motion-sensing health application framework to address the limitations of existing health applications. The gamified cervical spine somatic exercise application employs motion capture technology alongside the smartphone's built-in sensors to simulate accurate somatic interactions. Controlled experiments and data analyses demonstrated that the application significantly outperformed traditional text and video interventions in relieving participants' neck pain by increasing their average daily activity and compliance with the cervical spine exercise routine. The neck pain level of the participants is quantified by the Neck Disability Index (NDI). The results from the controlled experiments demonstrate that this gamified approach significantly decreases the Neck Disability Index (NDI) score from 1.54 to 1.24, highlighting its ability to alleviate neck pain and increase user compliance.
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Affiliation(s)
| | | | | | - Xing Sun
- Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China; (Y.S.); (Y.X.)
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2
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Fang J, Shi H, Wang W, Chen H, Yang M, Gao S, Yao H, Zhu L, Yan Y, Liu Z. Durable Effect of Acupuncture for Chronic Neck Pain: A Systematic Review and Meta-Analysis. Curr Pain Headache Rep 2024:10.1007/s11916-024-01267-x. [PMID: 38856887 DOI: 10.1007/s11916-024-01267-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVE Chronic neck pain, a prevalent health concern characterized by frequent recurrence, requires exploration of treatment modalities that provide sustained relief. This systematic review and meta-analysis aimed to evaluate the durable effects of acupuncture on chronic neck pain. METHODS We conducted a literature search up to March 2024 in six databases, including PubMed, Embase, and the Cochrane Library, encompassing both English and Chinese language publications. The main focus of evaluation included pain severity, functional disability, and quality of life, assessed at least 3 months post-acupuncture treatment. The risk of bias assessment was conducted using the Cochrane Risk of Bias 2.0 tool, and meta-analyses were performed where applicable. RESULTS Eighteen randomized controlled trials were included in the analysis. Acupuncture as an adjunct therapy could provide sustained pain relief at three (SMD: - 0.79; 95% CI - 1.13 to - 0.46; p < 0.01) and six (MD: - 18.13; 95% CI - 30.18 to - 6.07; p < 0.01) months post-treatment. Compared to sham acupuncture, acupuncture did not show a statistically significant difference in pain alleviation (MD: - 0.12; 95% CI - 0.06 to 0.36; p = 0.63). However, it significantly improved functional outcomes as evidenced by Northwick Park Neck Pain Questionnaire scores 3 months post-treatment (MD: - 6.06; 95% CI - 8.20 to - 3.92; p < 0.01). Although nine studies reported an 8.5%-13.8% probability of adverse events, these were mild and transitory adverse events. CONCLUSION Acupuncture as an adjunct therapy may provide post-treatment pain relief lasting at least 3 months for patients with chronic neck pain, although it is not superior to sham acupuncture, shows sustained efficacy in improving functional impairment for over 3 months, with a good safety profile.
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Affiliation(s)
- Jiufei Fang
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No.5 Beixiange St, Xicheng District, Beijing, 100053, China
| | - Hangyu Shi
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No.5 Beixiange St, Xicheng District, Beijing, 100053, China
- Graduate College, Beijing University of Chinese Medicine, Beijing, China
| | - Weiming Wang
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No.5 Beixiange St, Xicheng District, Beijing, 100053, China
| | - He Chen
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No.5 Beixiange St, Xicheng District, Beijing, 100053, China
| | - Min Yang
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No.5 Beixiange St, Xicheng District, Beijing, 100053, China
| | - Shuai Gao
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No.5 Beixiange St, Xicheng District, Beijing, 100053, China
| | - Hao Yao
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No.5 Beixiange St, Xicheng District, Beijing, 100053, China
- Graduate College, Beijing University of Chinese Medicine, Beijing, China
| | - Lili Zhu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No.5 Beixiange St, Xicheng District, Beijing, 100053, China
| | - Yan Yan
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No.5 Beixiange St, Xicheng District, Beijing, 100053, China
| | - Zhishun Liu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No.5 Beixiange St, Xicheng District, Beijing, 100053, China.
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Delgado-García P, Alcocer-Herrera JB, Urenda-Quezada A, Alonso-Martinez MD, Bautista-Mendoza MA, Romero-Antonio Y, Mora-Villalobos JC, Sander-Padilla JG, Rios-Brito KF, Rodríguez-Vazquez IC, González-Canudas J. A Randomized Control Trial of Dexketoprofen/Vitamin B (Thiamine, Pyridoxine and Cyanocobalamin) Fixed-Dose Combination in Post-Traumatic Grade I-II Cervical Sprains. Clin Drug Investig 2024; 44:413-424. [PMID: 38842764 PMCID: PMC11196333 DOI: 10.1007/s40261-024-01370-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Musculoskeletal disorders are an important cause of work absence. Clinical practice guidelines recommend nonsteroidal anti-inflammatory drugs (NSAIDs) for grade I-II cervical sprains. The combination of thiamine + pyridoxine + cyanocobalamin vitamins has been used, alone and in combination with NSAIDs, for pain and inflammation in musculoskeletal disorders. OBJECTIVE The objective of this study was to demonstrate the analgesic synergy of dexketoprofen, and the combination of vitamins thiamine + pyridoxine + cyanocobalamin in a fixed-dose combination (FDC) for the treatment of acute pain caused by grade I-II cervical sprains. METHODS We conducted a multicentre, prospective, randomized, double-blind, phase IIIb clinical study comparing two treatment groups: (1) dexketoprofen 25 mg/vitamin B (thiamine 100 mg, pyridoxine 50 mg and cyanocobalamin 0.50 mg) in an FDC (two or more active ingredients combined in a single dosage form) versus (2) dexketoprofen 25 mg monotherapy (single drug to treat a particular disease), one capsule or tablet orally, every 8 h for 7 days. Final mean, average change, and percentage change in pain perception (measured using a visual analogue scale [VAS]) were compared with baseline between groups. A p value < 0.05 was considered statistically significant. Analyses were conducted using SPSS software, v.29.0. RESULTS A statistically significant reduction in pain intensity was observed from the third day of treatment with the FDC compared with monotherapy (- 3.1 ± - 1.5 and - 2.6 ± - 1.1 cm, respectively) measured using the VAS (p = 0.011). Regarding the degree of disability, using the Northwick Park Neck Pain Questionnaire (NPQ), statistical difference was observed for the final measurement (7.5%, interquartile range [IQR] 2.5, 10.5; vs. 7.9%, IQR 5.0, 13.8; p = 0.028). A lower proportion of adverse events was reported when using the FDC. CONCLUSIONS The FDC of dexketoprofen/thiamine + pyridoxine + cyanocobalamin vitamins demonstrated superior efficacy and a better safety profile compared with dexketoprofen monotherapy for pain treatment in patients with grade I-II cervical sprains. CLINICAL TRIALS REGISTRATION NCT05001555, registered 29 July 2021 ( https://clinicaltrials.gov/study/NCT05001555 ).
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Affiliation(s)
| | | | | | | | | | - Yulia Romero-Antonio
- Research and Development Department of Laboratorios Silanes, S.A. de C.V., Av. De las Palmas No. 340, 3rd floor, Lomas de Chapultepec, Miguel Hidalgo, 11000, Mexico City, Mexico
| | - Julio C Mora-Villalobos
- Research and Development Department of Laboratorios Silanes, S.A. de C.V., Av. De las Palmas No. 340, 3rd floor, Lomas de Chapultepec, Miguel Hidalgo, 11000, Mexico City, Mexico
| | - José G Sander-Padilla
- Research and Development Department of Laboratorios Silanes, S.A. de C.V., Av. De las Palmas No. 340, 3rd floor, Lomas de Chapultepec, Miguel Hidalgo, 11000, Mexico City, Mexico
| | - Kevin F Rios-Brito
- Research and Development Department of Laboratorios Silanes, S.A. de C.V., Av. De las Palmas No. 340, 3rd floor, Lomas de Chapultepec, Miguel Hidalgo, 11000, Mexico City, Mexico
| | - Ileana C Rodríguez-Vazquez
- Research and Development Department of Laboratorios Silanes, S.A. de C.V., Av. De las Palmas No. 340, 3rd floor, Lomas de Chapultepec, Miguel Hidalgo, 11000, Mexico City, Mexico
| | - Jorge González-Canudas
- Research and Development Department of Laboratorios Silanes, S.A. de C.V., Av. De las Palmas No. 340, 3rd floor, Lomas de Chapultepec, Miguel Hidalgo, 11000, Mexico City, Mexico.
- IMSS-Centro Médico Nacional Siglo XXI, Mexico City, Mexico.
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Altmis Kacar H, Ozkul C, Baran A, Guclu-Gunduz A. Effects of cervical stabilization training in patients with headache: A single-blinded randomized controlled trial. Eur J Pain 2024; 28:633-648. [PMID: 37970662 DOI: 10.1002/ejp.2208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/29/2023] [Accepted: 10/31/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND This study aimed to investigate the effects of Cervical Stabilization Training (CST) on the headache, neck pain and cervical musculoskeletal system in patients with headache compared to the control group. METHODS A total of 90 female patients with migraine, tension-type headache and cervicogenic headache (CGH) participated in this study. The patients were divided into the cervical stabilization training group (CSTG) and the control group (CG). The CSTG performed the CST three times a week for 8 weeks while the CG continued their ongoing medical treatment. The pain intensity was assessed by Visual Analogue Scale, forward head posture by craniovertebral angle measurement, the endurance of deep cervical flexor muscles by craniocervical flexion test and the endurance of cervical muscles by flexor and extensor endurance tests before and after 8 weeks. In addition, disability levels, health-related quality of life, sleep quality and mood were assessed by the Migraine Disability Assessment questionnaire, Neck Disability Index (NDI), Short Form 36 Quality of Life Scale, the Pittsburgh Sleep Quality Index and Beck Depression Scale, respectively. RESULTS Headache frequency, duration and intensity, neck pain intensity and forward head posture reduced while activation and performance of deep cervical flexor muscles, the endurance of cervical flexor and extensor muscles increased in the CSTG (p < 0.05). Furthermore, the disability levels, quality of life, sleep quality and mood also improved in the CSTG (p < 0.05). CONCLUSIONS This study suggests that CST reduces headaches and neck pain by improving the cervical musculoskeletal system in patients with headache. SIGNIFICANCE The CST improved the headache frequency, duration and intensity, neck pain intensity, cervical posture, activation of deep cervical flexor muscles and endurance of cervical muscles in patients with headache. In addition, improvements in the cervical musculoskeletal system contributed to a reduction in the intensity of headaches and neck pain. Therefore, CST may be preferred in the treatment of headaches, especially with coexisting neck pain.
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Affiliation(s)
- H Altmis Kacar
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Gazi University, Ankara, Turkey
| | - C Ozkul
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - A Baran
- Department of Neurology, Medical Park Hospital, Ankara, Turkey
| | - A Guclu-Gunduz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Olaiya OR, Abraha B, Gallo L, Hircock C, Huynh M, McRae M. Estimating the Minimal Clinically Important Difference on the Visual Analogue Scale for Carpometacarpal Thumb Joint Osteoarthritis. Hand (N Y) 2024:15589447241235344. [PMID: 38491834 DOI: 10.1177/15589447241235344] [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] [Indexed: 03/18/2024]
Abstract
BACKGROUND The minimal clinically important difference (MCID) is the smallest perceived treatment effect that patients deem clinically significant. There is currently no agreement on an appropriate MCID for the pain visual analogue scale (VAS) in the context of thumb osteoarthritis (OA). METHODS We approximated MCIDs using a distribution-based approach that pooled standard deviations (SDs) associated with baseline mean values of the pain VAS (0-100 mm). We extracted the data from randomized controlled trials (RCTs) included in a systematic review of adults with long-term OA of the thumb. We excluded RCTs that did not report baseline SD values. The MCIDs were derived at 0.4 and 0.5 SDs of the pooled SD and compared with previously published MCIDs for the pain VAS in OA. RESULTS A total of 403 patients were pooled from 7 RCTs for the analysis. The mean baseline VAS pain score was 5.6 cm. We derived an MCID of 0.72 cm at 0.4 SDs and 0.91 cm at 0.5 SDs using baseline SDs. We found that MCIDs derived from a distribution-based approach approximated published MCIDs for the VAS for pain for OA in the knee and hip. CONCLUSION The authors propose that a change of 0.7 to 0.9 cm on the VAS is clinically meaningful in the context of long-term OA of the thumb.
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Affiliation(s)
- Oluwatobi R Olaiya
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Beraki Abraha
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Lucas Gallo
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Caroline Hircock
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Minh Huynh
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Matthew McRae
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
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Jeon JJ, Jeon SH, Yang KJ, Choi H, Cho HY, Hahm SC. Self-stretching exercises with kinesio taping for management of chronic nonspecific neck pain in taxi drivers: A single-blind, randomized controlled trial. Complement Ther Med 2024; 80:103010. [PMID: 38104730 DOI: 10.1016/j.ctim.2023.103010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/05/2023] [Accepted: 12/13/2023] [Indexed: 12/19/2023] Open
Abstract
OBJECTIVES Taxi drivers experience chronic neck pain owing to their posture while driving. The aim of this study was to investigate the effect of self-stretching exercises with kinesio taping on pain, stress, pressure pain threshold (PPT), disability, cervical range of motion (CROM) in this population. DESIGN A single-blind, randomized controlled trial SETTING: Forty-three taxi drivers with nonspecific chronic nonspecific neck pain were randomly assigned to experimental (n = 22) and control (n = 21) groups. METHODS In the experimental group, self-stretching exercises were performed 3 times a day, 5 days per week, for 4 weeks, with kinesio taping applied while driving. In the control group, only kinesio taping was applied while driving for 4 weeks. Pain intensity, stress intensity, PPT, neck disability, and CROM were assessed pre-intervention, post-intervention, and at 4 weeks post-intervention. RESULTS Significant time and group interactions were observed in pain intensity at rest (p = 0.048) and while driving (p = 0.001). In the experimental group, the Pre - Post - Follow-up mean (95% CI) was 4.41 (4.14 to 4.68) - 3.82 (3.57 to 4.07) - 3.78 (3.55 to 3.99). In the control group, the Pre - Post - Follow-up mean (95% CI) was 4.29 (4.01 to 4.56) - 3.86 (3.60 to 4.11) - 4.05 (3.82 to 4.27) for pain at rest. In the experimental group, the Pre - Post - Follow-up mean (95% CI) was 4.91 (4.63 to 5.19) - 4.00 (3.76 to 4.24) - 3.69 (3.69 to 4.22), while in the control group, the Pre - Post - Follow-up mean (95% CI) was 4.81 (4.53 to 5.09) - 4.38 (4.13 to 4.63) - 4.57 (4.30 to 4.85) for pain while driving. PPT on the right (p = 0.029) and left (p < 0.001) sides, and neck disability (p = 0.001) also showed significant time and group interactions. NDI was not clinically significant based on the minimum clinically important difference. All CROM showed significant time and group interactions (flexion, p = 0.008; right lateral flexion, p = 0.009; left lateral flexion, p = 0.004; right rotation, p = 0.001; left rotation, p = 0.001), except for extension. CONCLUSION This study showed that self-stretching exercises with kinesio taping provided benefits over kinesio taping alone on pain intensity, PPT, disability, and CROM in taxi drivers with nonspecific chronic neck pain. CLINICAL TRIAL REGISTRATION This study registered with the Clinical Research Information Service (WHO International Clinical Trials Registry Platform) on September 22, 2020 (KCT0005406).
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Affiliation(s)
- Jae-Jung Jeon
- Graduate School of Integrative Medicine, CHA University, Seongnam, South Korea
| | - Sun-Hee Jeon
- Graduate School of Integrative Medicine, CHA University, Seongnam, South Korea
| | - Keun-Jung Yang
- Graduate School of Integrative Medicine, CHA University, Seongnam, South Korea
| | - Han Choi
- Graduate School of Art Therapy, CHA University, Seongnam, South Korea
| | - Hwi-Young Cho
- Department of Physical Therapy, Gachon University, Incheon, South Korea.
| | - Suk-Chan Hahm
- Graduate School of Integrative Medicine, CHA University, Seongnam, South Korea.
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Timurtaş E, Selçuk H, Uğur Canöz E, Inceer M, Batar S, Demirbüken İ, Polat MG. Synchronous and asynchronous telerehabilitation methods produce similar benefits in individuals with non-specific neck pain. Arch Orthop Trauma Surg 2024; 144:559-566. [PMID: 37812269 DOI: 10.1007/s00402-023-05083-7] [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: 10/18/2022] [Accepted: 09/18/2023] [Indexed: 10/10/2023]
Abstract
INTRODUCTION Evidence exists on clinical benefits of synchronous and asynchronous telerehabilitation for patients with non-specific neck pain (NSNP); however, limited studies are comparing synchronous and asynchronous telerehabilitation (TR) programs in this population. The aim of this study was to estimate the relative effectiveness of an 8-week synchronous or asynchronous TR in improving pain, functional disability, kinesiophobia, and mobility in patients with NSNP. MATERIALS AND METHODS This was a randomized, controlled clinical trial carried out on 60 individuals with NSNP. Participants were randomly assigned to synchronous TR group (n = 30) or asynchronous TR group (n = 30) that received the same exercise program for 8 weeks. Pain measured by Numeric Pain Rating Scale (NPRS), disability measured by Neck Disability Index (NDI), kinesiophobia measured by Tampa Scale of Kinesiophobia (TSK), and cervical range of motion were used as outcome measures. Assessments were performed at baseline, 4th week, 8th week, and 16th week. RESULTS The analysis showed a significant effect of time and significant interaction between group and time in NPRS, NDI, TSK, and cervical mobility scores (p < 0.05), yet the group effect was not significant (p > 0.05). There were no significant differences between the groups at all time points (p > 0.05) except for cervical right lateral flexion at 8th week (p = 0.036). CONCLUSION Telerehabilitation technologies are expanding at a rapid rate, and it is essential to understand the outcomes produced using these technologies in health conditions. This study showed that synchronous and asynchronous telerehabilitation produces similar results in patients with NSNP, supporting that either method can be used interchangeably.
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Affiliation(s)
- Eren Timurtaş
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Halit Selçuk
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Turkey.
| | - Ekin Uğur Canöz
- Department of Physiotherapy, Vocational School of Health Services, Fenerbahçe University, Istanbul, Turkey
| | - Mehmet Inceer
- Patient Centered Solutions, IQVIA, Montreal, QC, Canada
- Center for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Center, Montreal, QC, Canada
| | - Suat Batar
- Department of Orthopedics and Traumatology, Ümraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - İlkşan Demirbüken
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Mine Gülden Polat
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
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Sidiq M, Chahal A, Janakiraman B, Kashoo F, Kumar Kedia S, Kashyap N, Hirendra Rai R, Vyas N, Veeragoudhaman T, Vajrala KR, Yadav M, Zafar S, Jena S, Sharma M, Baranwal S, Alghadier M, Alhusayni A, Alzahrani A, Selvan Natarajan V. Effect of dynamic taping on neck pain, disability, and quality of life in patients with chronic non-specific neck pain: a randomized sham-control trial. PeerJ 2024; 12:e16799. [PMID: 38288463 PMCID: PMC10823991 DOI: 10.7717/peerj.16799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/24/2023] [Indexed: 02/01/2024] Open
Abstract
Background In 2020, 203 million people experienced neck pain, with a higher prevalence in women. By 2050, it is predicted that neck pain will affect 269 million people, representing a 32.5% increase. Physical rehabilitation is often employed for the treatment of chronic non-specific neck pain (CNSNP) and the associated functional loss. Taping is frequently used as an adjunct treatment alongside primary physical rehabilitation. Unlike kinesio tape (KT), the therapeutic benefits of dynamic tape (DT) have not been thoroughly explored and documented in non-athletic conditions. Therefore, the aim of this trial was to determine the effects of DT on pain, disability, and overall well-being in individuals experiencing CNSNP. Methods A prospective parallel-group active controlled trial was conducted at a single center, involving 136 patients with CNSNP, randomly allocated in a 1:1 ratio. The sham taping group (STC) received standard physiotherapy care (n = 67) alongside DT without tension, while the dynamic taping group (DTC) (n = 69) underwent standard cervical offloading technique with appropriate tension in addition to standard physiotherapy care. Demographic information and three patient-reported outcome measures (PROMs), namely the Neck Disability Index (NDI), Visual Analogue Scale (VAS), and the World Health Organization-Five Well-Being Index (WHO-5), were collected for each participant at three time points (baseline, four weeks post-taping, and four weeks follow-up). Results At baseline, no significant differences were observed between the STC and DTC for any outcome measure. Notably, all three PROMs exhibited a significant improvement from baseline to four weeks post-intervention, with moderate to small effect sizes (NDI ηp2 = 0.21, VAS ηp2 = 0.23, and WHO-55 ηp2 = 0.05). The WHO-5 scores for both groups demonstrated improvement from baseline through follow-up (p < 0.001). The NDI and VAS scores ameliorated from baseline to the four weeks post-taping period, with marginal improvements observed during the four weeks follow-up. Conclusion The incorporation of DT as an adjunct to standard physiotherapy care yielded enhancements in pain levels, functional disability, and well-being among patients with CNSNP when compared to the sham group. However, the sustainability of these improvements beyond the taping period lacks statistical significance and warrants further validation.
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Affiliation(s)
- Mohammad Sidiq
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Aksh Chahal
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Balamurugan Janakiraman
- Department of Physiotherapy, School of Allied Health Sciences, Madhav University, Abu Road, Sirohi, Rajasthan, India
- SRM College of Physiotherapy, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology (SRMIST), Kattankulathur, Tamil Nadu, India
| | - Faizan Kashoo
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Riyadh, Saudi Arabia
| | - Sharad Kumar Kedia
- Department of Physical Medicine & Rehabilitation, NIMS University Hospital, Jaipur, Rajasthan, India
| | - Neha Kashyap
- Physiotherapy, Maharishi Markandeshwar Deemed to Be University, Ambala, Haryana, India
| | - Richa Hirendra Rai
- Physiotherapy, Delhi Pharmaceutical Sciences and Research University, New Delhi, Delhi, India
| | - Neha Vyas
- Physiotherapy, University of Engineering and Management, Jaipur, Rajasthan, India
| | - T.S. Veeragoudhaman
- SRM College of Physiotherapy, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology (SRMIST), Kattankulathur, Tamil Nadu, India
| | - Krishna Reddy Vajrala
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Megha Yadav
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Shahiduz Zafar
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Sanghamitra Jena
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Monika Sharma
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Shashank Baranwal
- Nims College of Physiotherapy and Occupational Therapy, NIMS University, Jaipur, Rajasthan, India
| | - Mshari Alghadier
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, AR Riyadh Province, Saudi Arabia
| | - Abdullah Alhusayni
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, Shaqra University, Shaqra, West Province, Saudi Arabia
| | - Abdullah Alzahrani
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, Shaqra University, Shaqra, West Province, Saudi Arabia
| | - Vijay Selvan Natarajan
- Physiotherapy, KMCT College of Allied Medical Sciences, Manassery, Kozhikode, Kerala, India
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Yilmaz K, Yazicioglu FG, Akkoyun Sert O, Ozturk B, Armutlu K, Yuce H. The effects of basic body awareness therapy on balance in patients with chronic neck pain: a randomised crossover trial. Somatosens Mot Res 2023; 40:147-155. [PMID: 36815247 DOI: 10.1080/08990220.2023.2181327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 02/13/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE This study aimed to compare the effects of basic body awareness therapy (BBAT) and conventional treatments (CT) on balance in patients with chronic neck pain. METHODS Thirty-five patients with neck pain participated in this randomised two-period crossover trial. Patients were divided into A (BBAT/CT) (n = 17) and B (CT/BBAT) (n = 18) groups. Group A received BBAT twice a week for 6 weeks, whereas Group B received CT within the same parameters. After a 5-week washout period, the treatments received by the groups were changed. The primary outcome was balance, assessed via the sensory organisation test (SOT) using the computerised dynamic posturography device. The secondary outcome was pain assessed by the visual analogue scale. Assessments were performed before and after primary and secondary treatments. RESULTS In Group A, the SOT conditions 4, 5, 6; composites score; and visual and vestibular system scores increased after BBAT; however, only condition five scores and vestibular system scores increased (p < .05) in Group B, which started with CT. Within the groups, both treatments were effective for easing pain (p < .05). CONCLUSIONS Although patients who started the therapy with BBAT showed more improvement in balance, no differences were observed between the therapies.
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Affiliation(s)
- Kamil Yilmaz
- Department of Physiotherapy and Rehabilitation, School of Health Sciences, KTO Karatay University, Konya, Turkey
| | - Fatma Gul Yazicioglu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ozlem Akkoyun Sert
- Department of Physiotherapy and Rehabilitation, School of Health Sciences, KTO Karatay University, Konya, Turkey
| | - Burak Ozturk
- Department of Audiology, Faculty of Health Sciences, Izmir Bakircay University, İzmir, Turkey
| | - Kadriye Armutlu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Hamiyet Yuce
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Balıkesir, Turkey
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Chen L, Zhang Q, Huang Z, Da W, Liu S, Xue C, Ding C, Chen D, Fan T, Shi Q, Li X. Efficacy of Combining Traditional Chinese Manual Therapy (Tuina) and Specific Therapeutic Neck Exercise in Young Adults with Non-Specific Chronic Neck Pain: Study Protocol for a Randomized Controlled Trial. J Pain Res 2023; 16:3119-3131. [PMID: 37724170 PMCID: PMC10505386 DOI: 10.2147/jpr.s424812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/07/2023] [Indexed: 09/20/2023] Open
Abstract
Purpose Non-specific chronic neck pain (NSCNP) is an increasingly common musculoskeletal disease and an important issue in the global healthcare system. Some studies have shown that the combination of manual therapy and exercise is effective in treating NSCNP but still with several limitations. Traditional Chinese manual therapy (tuina) is a Chinese manual therapy that consists of soft tissue manipulation and spinal manipulation. This study aims to design a randomized controlled trial to assess the effect of a tuina combined with specific therapeutic neck exercise modified protocol for NSCNP patients. Patients and Methods This is a study protocol for a randomized, participant-, assessor- and analyst-blinded controlled trial. Eighty-eight eligible NSCNP patients will be randomly allocated into tuina combined with specific therapeutic neck exercise group (TSTE group) and tuina combined with sham therapeutic neck exercise group (TS group) in a ratio of 1:1. All participants will receive 8 treatment sessions applied in 4 weeks and then be followed up for another 12 weeks. Clinical data will be collected at baseline, during treatment phase (at the 2- and 4-week) and at the 8-, 12-, 16-week follow-ups. The primary outcome is the changes in neck pain intensity (visual analogue scale). The secondary outcomes include neck disability (Neck Disability Index), cervical range of motion (ROM), neck muscle endurance, cervical muscle cross-sectional area, cervical curvature and analgesic consumption. Adverse events will be collected and recorded throughout the study. Conclusion We will discuss whether our tuina combined with specific therapeutic neck exercise modified protocol is more effective at improving pericervical muscle endurance, ROM, cervical muscle cross-sectional area and cervical curvature than tuina alone, thereby decreases neck pain and disability in individuals with NSCNP more effectively. Trial Registration Chinese Clinical Trials Registry, ChiCTR2300067903. Registered on 31 January 2023.
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Affiliation(s)
- Lin Chen
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Qi Zhang
- Department of Traditional Chinese Medicine, Xuhui District Tianping Street Community Health Center, Shanghai, People’s Republic of China
| | - Zheng Huang
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Weiwei Da
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Shuang Liu
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Chunchun Xue
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Chao Ding
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Deta Chen
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Tianyou Fan
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Qi Shi
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Xiaofeng Li
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
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Zhang Y, Xi X, Huang Y. The anchor design of anchor-based method to determine the minimal clinically important difference: a systematic review. Health Qual Life Outcomes 2023; 21:74. [PMID: 37454099 DOI: 10.1186/s12955-023-02157-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Positive results for clinical outcomes should be not only statistically significant, but also clinically significant. The minimum clinically important difference (MCID) is used to define the minimum threshold of clinical significance. The anchor-based method is a classical method for ascertaining MCID. This study aimed to summarise the design of the anchors of the anchor-based method by reviewing the existing research and providing references and suggestions. METHOD This study was mainly based on literature research. We performed a systematic search using Web of Science, PubMed, CNKI, Wanfang, and VIP databases. Two reviewers independently screened titles and abstracts to identify relevant articles. Data were extracted from eligible articles using a predefined data collection form. Discrepancies were resolved by discussion and the involvement of a third reviewer. RESULT Three hundred and forty articles were retained for final analysis. For the design of anchors, Subjective anchors (99.12%) were the most common type of anchor used, mainly the Patient's rating of change or patient satisfaction (66.47%) and related scale health status evaluation items or scores (39.41%). Almost half of the studies (48.53%) did not assess the correlation test between the anchor and the research indicator or scale. The cut-off values and grouping were usually based on the choice of the anchor types. In addition, due to the large number of included studies, this study selected the most calculated SF-36 (28 articles) for an in-depth analysis. The results showed that the overall design of the anchor and the cut-off value were the same as above. The statistical methods used were mostly traditional (mean change, ROC). The MCID thresholds of these studies had a wide range (SF-36 PCS: 2-17.4, SF-36 MCS: 1.46-10.28), and different anchors or statistical methods lead to different results. CONCLUSION It is of great importance to select several types of anchors and to use more reliable statistical methods to calculate the MCID. It is suggested that the order of selection of anchors should be: objective anchors > anchors with established MCID in subjective anchors (specific scale > generic scale) > ranked anchors in subjective anchors. The selection of internal anchors should be avoided, and anchors should be evaluated by a correlation test.
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Affiliation(s)
- Yu Zhang
- China Pharmaceutical University, No. 639, Longmian Avenue, Jiangning District, Nanjing, 211198, Jiangsu Province, China
| | - Xiaoyu Xi
- China Pharmaceutical University, No. 639, Longmian Avenue, Jiangning District, Nanjing, 211198, Jiangsu Province, China
| | - Yuankai Huang
- China Pharmaceutical University, No. 639, Longmian Avenue, Jiangning District, Nanjing, 211198, Jiangsu Province, China.
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Singh A, Blixt S, Edström E, Elmi-Terander A, Gerdhem P. Outcome and Health-Related Quality of Life After Combined Anteroposterior Surgery Versus Anterior Surgery Alone in Subaxial Cervical Spine Fractures : Analysis of a National Multicenter Data Set. Spine (Phila Pa 1976) 2023; 48:853-858. [PMID: 37036279 DOI: 10.1097/brs.0000000000004601] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/20/2022] [Indexed: 04/11/2023]
Abstract
STUDY DESIGN Observational study on prospectively collected data. OBJECTIVES To compare patient-reported outcomes and complications after anteroposterior surgery or anterior surgery in subaxial cervical spine fractures. SUMMARY OF BACKGROUND DATA There is no consensus regarding the optimal surgical approach for subaxial cervical spine fractures. Although anterior surgery is often sufficient to restore stability, anteroposterior surgery is sometimes preferred in severe instability. The effects of a more extensive procedure on patient-reported outcomes have not been investigated. We hypothesized that patient-reported outcomes and complication rates were similar between these surgical approaches. MATERIALS AND METHODS Individuals treated with either a combined anteroposterior or anterior surgery alone between 2006 and 2016 and with at least 1-year follow-up were identified in the Swedish Spine Registry. Cases were matched 1:2 for age (±5 y). Outcomes were Neck Disability Index (NDI), EQ-5D-3L index, satisfaction, reoperations, and surgeon-reported and patient-reported complications within 90 days. Mann-Whitney U -tests and χ 2 tests were used in statistical comparisons. RESULTS The median [interquartile range] number of instrumented vertebrae was 3 [2-5.5] in the anteroposterior group and 2 [2-3] in the anterior group ( P <0.001). The mean±SD follow-up time was 3.5±2.3 years in the anteroposterior and 3.8±2.0 years in the anterior group ( P =0.39), respectively. At follow-up, Neck Disability Index was 20 [6-37] in the anteroposterior group and 18 [3.5-40] in the anterior group ( P =0.69), and the median EQ-5D-3L index was 0.73 [0.12-0.80] in the anteroposterior group and 0.75 [0.62-0.89] in the anterior group ( P =0.27). Satisfaction with the treatment was reported by 90% in the anteroposterior group and by 87% in the anterior group ( P =0.98). None of the individuals in the anteroposterior and 6 of the individuals in the anterior group were reoperated ( P =0.18). CONCLUSION Patients operated on with anteroposterior or anterior surgery for subaxial cervical spine fractures are equally satisfied and report similar health-related quality of life measures.
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Affiliation(s)
- Aman Singh
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Simon Blixt
- Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Department of Reconstructive Orthopedics, Karolinska University Hospital, Stockholm, Sweden
| | - Erik Edström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Spine Center, Löwenströmska sjukhuset, Upplands Väsby, Sweden
| | - Adrian Elmi-Terander
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Spine Center, Löwenströmska sjukhuset, Upplands Väsby, Sweden
| | - Paul Gerdhem
- Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Department of Orthopedics and Hand Surgery, Uppsala University Hospital, Uppsala, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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Bayrak G, Özdemir H, Aslan UB, Yağcı N. Does the Covid‐19 lockdown affect pain and anxiety in high school seniors and high school graduates preparing for the university exam? PSYCHOLOGY IN THE SCHOOLS 2023. [DOI: 10.1002/pits.22913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Affiliation(s)
- Gökhan Bayrak
- Physiotherapy and Rehabilitation Department of Faculty of Health Sciences Muş Alparslan University Muş Türkiye
| | - Hatice Özdemir
- Faculty of Physical Therapy and Rehabilitation Pamukkale University Denizli Türkiye
| | - Ummuhan Baş Aslan
- Faculty of Physical Therapy and Rehabilitation Pamukkale University Denizli Türkiye
| | - Nesrin Yağcı
- Faculty of Physical Therapy and Rehabilitation Pamukkale University Denizli Türkiye
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Onan D, Ulger O, Martelletti P. Effects of spinal stabilization exercises delivered using telerehabilitation on outcomes in patients with chronic neck pain: a randomized controlled trial. Expert Rev Neurother 2023; 23:269-280. [PMID: 36927237 DOI: 10.1080/14737175.2023.2192870] [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: 03/18/2023]
Abstract
BACKGROUND When spinal stabilization exercises (SSE) are performed regularly, may provide benefits on outcome measures in chronic nonspecific neck pain (CNNP) patients. The pandemic has made it difficult for CNNP patients to access regular physiotherapy-exercise services. This study aims to compare telerehabilitation (TR) with face-to-face rehabilitation in CNNP. METHODS Neck Functional Capacity Evaluation Test (NFCET) results were the primary outcomes. Pain intensity (PI), disability, awareness, neck muscles architecture, andexercise satisfaction were the secondary outcomes. Patients were randomized into the TR group (TRG) (n = 15) and the control group (CG) (n = 16). Patients performed SSE 3 days a week, for 8 weeks. The TRG was instructed remotely while the CG was instructed in the clinic. RESULTS After 8 weeks in both groups, NFCET values and neck awareness increased (p < 0.05), PI and disability decreased (p < 0.05). Muscle architecture improved in both groups (p < 0.05), except for the Right Sternocleidomastoideus in both groups and the Right Upper-Trapezius in TRG (p > 0.05). There was no difference between the groups for all variables and exercise satisfaction(p > 0.05). CONCLUSION SSE for CNNP, whether supervised by therapists in the clinic or by telerehabilitation, was equally effective. THE CLINICAL TRIAL NUMBER NCT04691024.
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Affiliation(s)
- Dilara Onan
- Spine Health Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ozlem Ulger
- Spine Health Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
- Regional Referral Headache Centre, Sant'Andrea Hospital, Sapienza University, Rome, Italy
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15
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Gercek H, Unuvar BS, Umit Yemisci O, Aytar A. Acute effects of instrument assisted soft tissue mobilization technique on pain and joint position error in individuals with chronic neck pain: a double-blind, randomized controlled trial. Somatosens Mot Res 2023; 40:25-32. [PMID: 36538383 DOI: 10.1080/08990220.2022.2157388] [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: 12/24/2022]
Abstract
PURPOSE/AIM The aim of this study was to determine the acute effects of IASTM on cervical joint position error and pain in individuals with chronic neck pain. METHODS A total of 39 individuals with chronic neck pain were included in this study. Participants were randomized into three groups: Instrument-assisted soft-tissue mobilization(IASTM (n = 13), sham (n = 13), and control (n = 13). In the IASTM group, intervention was applied to the sternocleidomastoid and trapezius muscles with an application time of 45 s and a frequency of 60 beats/min. In the sham group, IASTM was applied at a 90° angle without pressure. The control group did not receive any intervention. The pain severity and joint position error(JPE) were evaluated before and after the intervention, by using the visual analogue scale and a cervical range of motion device. RESULTS The effects of time and treatment group on visual analogue scale(VAS) score were statistically significant (p = .001). Instrument-assisted soft-tissue mobilization was more effective in VAS score than sham and control group (p < .001). Significant improvement was found in JPE in all range of motions of the cervical region in the instrument-assisted soft-tissue mobilization group (p < .05). In the sham group, significant improvements were observed in cervical extension, left rotation, and left lateral flexion movements in JPE during each cervical spine active movement (p < .05). Instrument-assisted soft-tissue mobilization group was more effective in JPE all directions than sham and control group. CONCLUSIONS Instrument-assisted soft-tissue mobilization may be a useful technique in individuals with chronic neck pain. Instrument-assisted soft-tissue mobilization decreases VAS and improves JPE. CLINICAL TRIAL REGISTRATION NUMBER NCT04882397 (05 August 2021).
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Affiliation(s)
- Hasan Gercek
- Department of Physiotherapy, Vocational School of Health Services, KTO Karatay University, Konya, Turkey
| | - Bayram Sonmez Unuvar
- Department of Physiotherapy, Vocational School of Health Services, KTO Karatay University, Konya, Turkey
| | - Oya Umit Yemisci
- Faculty of Medicine, Physical Medicine and Rehabilitation Department, Baskent University, Ankara, Turkey
| | - Aydan Aytar
- Department of Orthopedic Physiotherapy and Rehabilitation, University of Health Sciences Gulhane Faculty of Physiotherapy and Rehabilitation, Ankara, Turkey
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Cholewicki J, Popovich JM, Reeves NP, DeStefano LA, Rowan JJ, Francisco TJ, Prokop LL, Zatkin MA, Lee AS, Sikorskii A, Pathak PK, Choi J, Radcliffe CJ, Ramadan A. The effects of osteopathic manipulative treatment on pain and disability in patients with chronic neck pain: A single-blinded randomized controlled trial. PM R 2022; 14:1417-1429. [PMID: 34719122 PMCID: PMC9054945 DOI: 10.1002/pmrj.12732] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Neck pain (NP) affects up to 70% of individuals at some point in their lives. Systematic reviews indicate that manual treatments can be moderately effective in the management of chronic, nonspecific NP. However, there is a paucity of studies specifically evaluating the efficacy of osteopathic manipulative treatment (OMT). OBJECTIVE To evaluate the efficacy of OMT in reducing pain and disability in patients with chronic NP. DESIGN Single-blinded, cross-over, randomized-controlled trial. SETTING University-based, osteopathic manipulative medicine outpatient clinic. PARTICIPANTS Ninety-seven participants, 21 to 65 years of age, with chronic, nonspecific NP. INTERVENTIONS Participants were randomized to two trial arms: immediate OMT intervention or waiting period first. The intervention consisted of three to four OMT sessions over 4 to 6 weeks, after which the participants switched groups. MAIN OUTCOME MEASURES Primary outcome measures were pain intensity (average and current) on the numerical rating scale and Neck Disability Index. Secondary outcomes included Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) health domains and Fear Avoidance Beliefs Questionnaire. Outcomes obtained prior to the cross-over allocation were evaluated using general linear models and after adjusting for baseline values. RESULTS A total of 38 and 37 participants were available for the analysis in the OMT and waiting period groups, respectively. The results showed significantly better primary outcomes in the immediate OMT group for reductions in average pain (-1.02, 95% confidence interval [CI] -1.72, -0.32; p = .005), current pain (-1.02, 95% CI -1.75, -0.30; p = .006), disability (-5.30%, 95% CI -9.2%, -1.3%; p = .010) and improved secondary outcomes (PROMIS) related to sleep (-3.25, 95% CI -6.95, -1.54; p = .003), fatigue (-3.26, 95% CI -6.04, -0.48; p = .022), and depression (-2.59, 95% CI -4.73, -0.45; p = .018). The effect sizes were in the clinically meaningful range between 0.5 and 1 standard deviation. No study-related serious adverse events were reported. CONCLUSIONS OMT is relatively safe and effective in reducing pain and disability along with improving sleep, fatigue, and depression in patients with chronic NP immediately following treatment delivered over approximately 4 to 6 weeks.
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Affiliation(s)
- Jacek Cholewicki
- Center for Orthopedic Research (MSUCOR), Michigan State University, East Lansing, Michigan, USA
- Center for Neuromusculoskeletal Clinical Research (CNCR), Michigan State University, East Lansing, Michigan, USA
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA
| | - John M. Popovich
- Center for Orthopedic Research (MSUCOR), Michigan State University, East Lansing, Michigan, USA
- Center for Neuromusculoskeletal Clinical Research (CNCR), Michigan State University, East Lansing, Michigan, USA
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA
| | - N. Peter Reeves
- Center for Orthopedic Research (MSUCOR), Michigan State University, East Lansing, Michigan, USA
- Sumaq Life, LLC, East Lansing, Michigan, USA
| | - Lisa A. DeStefano
- Center for Orthopedic Research (MSUCOR), Michigan State University, East Lansing, Michigan, USA
- Center for Neuromusculoskeletal Clinical Research (CNCR), Michigan State University, East Lansing, Michigan, USA
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Jacob J. Rowan
- Center for Orthopedic Research (MSUCOR), Michigan State University, East Lansing, Michigan, USA
- Center for Neuromusculoskeletal Clinical Research (CNCR), Michigan State University, East Lansing, Michigan, USA
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Timothy J. Francisco
- Center for Orthopedic Research (MSUCOR), Michigan State University, East Lansing, Michigan, USA
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Lawrence L. Prokop
- Center for Orthopedic Research (MSUCOR), Michigan State University, East Lansing, Michigan, USA
- Department of Physical Medicine & Rehabilitation, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Mathew A. Zatkin
- Center for Orthopedic Research (MSUCOR), Michigan State University, East Lansing, Michigan, USA
- Center for Neuromusculoskeletal Clinical Research (CNCR), Michigan State University, East Lansing, Michigan, USA
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Angela S. Lee
- Center for Orthopedic Research (MSUCOR), Michigan State University, East Lansing, Michigan, USA
- Center for Neuromusculoskeletal Clinical Research (CNCR), Michigan State University, East Lansing, Michigan, USA
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Alla Sikorskii
- Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Pramod K. Pathak
- Center for Orthopedic Research (MSUCOR), Michigan State University, East Lansing, Michigan, USA
- Department of Statistics and Probability, College of Natural Science, Michigan State University, East Lansing, Michigan, USA
| | - Jongeun Choi
- Center for Orthopedic Research (MSUCOR), Michigan State University, East Lansing, Michigan, USA
- Department of Mechanical Engineering, College of Engineering, Michigan State University, East Lansing, Michigan, USA
- Department of Electrical and Computer Engineering, College of Engineering, Michigan State University, East Lansing, Michigan, USA
- Present affiliation: School of Mechanical Engineering, Yonsei University, Seoul, Republic of Korea
| | - Clark J. Radcliffe
- Center for Orthopedic Research (MSUCOR), Michigan State University, East Lansing, Michigan, USA
- Department of Mechanical Engineering, College of Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Ahmed Ramadan
- Center for Orthopedic Research (MSUCOR), Michigan State University, East Lansing, Michigan, USA
- Department of Mechanical Engineering, College of Engineering, Michigan State University, East Lansing, Michigan, USA
- Present affiliation: Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
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Effects of clinical pilates exercises in patients with chronic nonspecific neck pain: a randomized clinical trial. Ir J Med Sci 2022:10.1007/s11845-022-03101-y. [PMID: 35857170 DOI: 10.1007/s11845-022-03101-y] [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: 04/18/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Neck pain is a common musculoskeletal problem in adults. Clinical pilates exercises can be beneficial managing the pain and improving the risk factors. AIMS The aim of this study was to investigate the effects of clinical pilates exercises on pain and disability, deep neck flexor endurance (DNFE), posture, cervical range of motion (CROM), and proprioception in patients with chronic nonspecific neck pain. METHODS Fifty patients with chronic nonspecific neck pain were randomized into two groups. The clinical pilates exercise group (CPEG) received clinical pilates exercises for 6 weeks. The control group (CG) received posture education. Pain and disability, DNFE, forward head angle (FHA) and forward shoulder angle (FSA) degrees, CROM, and joint position error (JPE) were measured before and after 6 weeks. RESULTS Clinical pilates exercises improved pain, Neck Disability Index (NDI), DNFE, posture, CROM (except extension), and JPE (p < 0.05). We found significant differences between CPEG and CG in the comparisons for the change of pain, NDI, DNFE, FSA, CROM (except extension), and JPE (except left rotation) (p < 0.05). NDI, FSA, and rotational JPE also improved in CG (p < 0.05). However, these improvements were significantly better in CPEG than CG (p < 0.05) except JPE in left rotation (p = 0.118). CONCLUSION In patients with chronic nonspecific neck pain, clinical pilates exercise is a safe and effective method to improve pain and disability, DNFE, posture, ROM, and proprioception. CLINICAL TRIAL REGISTRATION NCT03782584 retrospectively registered December 20 2018.
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Garzonio S, Arbasetti C, Geri T, Testa M, Carta G. Effectiveness of Specific Exercise for Deep Cervical Muscles in Nonspecific Neck Pain: A Systematic Review and Meta-Analysis. Phys Ther 2022; 102:6506309. [PMID: 35079832 DOI: 10.1093/ptj/pzac001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 10/13/2022] [Accepted: 12/03/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The purpose of this review, focused on people with nonspecific neck pain (NSNP), was to assess the effectiveness of specific exercises that recruit the deep cervical muscles compared with other types of exercises or interventions and minimal or no treatment. METHODS This systematic review with meta-analysis screened 5 databases (MEDLINE, Embase, CINAHL, Physiotherapy Evidence Database, and The Cochrane Library). Randomized controlled trials investigating the effectiveness of this type of exercise on the intensity of pain were included. Data for each included trial were extracted by 2 independent reviewers. The Cochrane Risk of Bias 2.0 tool was adopted to assess the internal validity of the included trials. The overall quality of evidence was layered with the Grading of Recommendations, Assessment, Development and Evaluations system. RESULTS The review identified a total of 2397 records. Sixteen articles were included in the qualitative synthesis, and 9 studies were included in the meta-analysis. The pooled results found moderate- to very low-quality evidence that deep cervical muscle exercise protocols are not superior to other types of active exercises in reducing the intensity of pain in people with NSNP. Studies not included in the meta-analysis suggest that specific exercises induce better effects that are superior to those of nontreatment with clinically relevant results. CONCLUSION Clinicians can share this information with their patients through shared decision-making to determine a more tailored approach to adopt. Future studies with high methodological quality are necessary to reach firm conclusions. IMPACT There has been no consensus on exercise type and dosage for the management of NSNP. This study shows that exercises are a useful tool and that the effect of an exercise program that recruits deep cervical muscles seems to be comparable with the effect of other types of active exercises on pain intensity reduction. LAY SUMMARY If you have neck pain, exercises designed by a physical therapist can be a useful treatment tool. An exercise program that targets specific deep cervical muscles may be just as good as other types of active exercises to reduce the intensity of pain intensity; you and your therapist can work together to develop a program.
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Affiliation(s)
- Stefano Garzonio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Chiara Arbasetti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Tommaso Geri
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Giacomo Carta
- Human Anatomy, Department of Clinical and Biological Sciences, University of Torino, Torino, Italy
- Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Torino, Torino, Italy
- ASST Nord Milano, Sesto San Giovanni Hospital, Milano, Italy
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Ceballos-Laita L, Medrano-de-la-Fuente R, Mingo-Gómez MT, Hernando-Garijo I, Estébanez-de-Miguel E, Jiménez-Del-Barrio S. Effects of dry needling on pain, disability, kinesiophobia, pain catastrophizing and psychological distress in patients with chronic neck pain: A randomized controlled pilot study. J Back Musculoskelet Rehabil 2022; 35:393-401. [PMID: 34334377 DOI: 10.3233/bmr-200322] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Myofascial trigger points (MTrPs) in neck muscles seem to be related to the main symptoms of patients with chronic neck pain. OBJECTIVE The objective was to investigate the effects of dry needling (DN) on pain, disability, kinesiophobia, pain catastrophizing and psychological distress in patients with chronic neck pain. METHODS A double blind randomized controlled pilot trial was designed. Twenty-one patients with chronic neck pain were randomly allocated to the DN group (n= 7), Sham-DN group (n= 7) or Control group (n= 7). All groups received a Transcutaneous Electrical Nerve Stimulation and Therapeutic Ultrasound (TENS/US) protocol with patient education. The DN and Sham-DN groups received two sessions of DN and sham DN, respectively. The primary outcome was pain intensity. Secondary outcomes were disability, kinesiophobia, pain catastrophizing, psychological distress, self-reported improvement and success of blinding. RESULTS The DN group showed a greater decrease in pain intensity, disability and pain catastrophizing compared to the Sham-DN group (p< 0.05) and the Control group (p< 0.05). The DN group showed the highest self-reported improvement. CONCLUSION Adding two sessions of DN in active MTrPs in upper trapezius, levator scapulae and sternocleidomastoid muscles to a TENS/US protocol with patient education decreased pain intensity, disability and pain catastrophizing in patients with chronic neck pain.
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Affiliation(s)
- Luis Ceballos-Laita
- Department of Surgery, Ophtalmology and Physiotherapy, University of Valladolid, Soria, Spain
| | | | | | - Ignacio Hernando-Garijo
- Department of Surgery, Ophtalmology and Physiotherapy, University of Valladolid, Soria, Spain
| | - Elena Estébanez-de-Miguel
- Department of Physiatrist and Nursey, Faculty of Health Sciencies, University of Zaragoza, Zaragoza, Spain
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Trigger point therapy – ischemic compression or perhaps cupping? BIOMEDICAL HUMAN KINETICS 2022. [DOI: 10.2478/bhk-2022-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Study aim: To evaluate and compare the effectiveness of single ischemic compression and cupping therapy on the most common trigger point, on the descending part of the trapezius muscle.
Materials and methods: Twenty-five students (15 women and 10 men) aged 24.20 ± 1.27 years were enrolled in the study. The mobility of the cervical spine area was measured with a measuring tape. The pain pressure threshold of the trigger point of the trapezius muscle was tested using a Wagner FDX 50 Force Gage digital algometer. Each person participated in three tests with an interval of approximately one week between them. The following study protocol was followed; 1) cupping therapy, with a cup statically positioned on the trigger point for two minutes, 2) at a minimum interval of 7 days, ischemic compression performed with the thumb twice for 1 minute on each side 3) control test at an interval of another 7 days.
Results: Ischemic compression resulted in a statistically significant difference in cervical spine mobility scores (except for extension) and pain pressure threshold values. After applying cups, statistically significant differences were also observed in the results of cervical spine mobility and pain pressure threshold values. No statistically significant differences were found in the effectiveness of the therapies tested.
Conclusions: In the present study, single trigger point cupping and ischemic compression therapies improved cervical spine mobility and resulted in an increase in the pain pressure threshold in the trapezius muscle trigger point. These two therapies did not differ in terms of their effectiveness.
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Goedmakers CMW, van Beelen I, Komen F, van Zwet EW, Peul WC, Arts MP, Vleggeert-Lankamp CLA. The impact of mental health on outcome after anterior cervical discectomy: cohort study assessing the influence of mental health using predictive modelling. Acta Neurochir (Wien) 2022; 164:3035-3046. [PMID: 36109365 PMCID: PMC9613752 DOI: 10.1007/s00701-022-05362-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/30/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Depression and anxiety are common mental disorders among patients with chronic pain. It is hypothesised that patients suffering from these disorders benefit less from cervical spine surgery than mentally healthy patients. Therefore, this study aimed to quantify the effect of mental health status on functional outcome after anterior cervical discectomy in a post hoc analysis on RCT data. METHODS One hundred eight patients from the NECK trial, with radiculopathy due to a one-level herniated disc, underwent anterior cervical discectomy and were included into this analysis. Functional outcome was quantified using the Neck Disability Index (NDI), and mental health status was measured using the Hospital Anxiety and Depression Score (HADS) questionnaire. NDI differences were assessed using generalised estimated equations (GEE), crude means, a predictive linear mixed model (LMM) using baseline scores and over time with an explanatory LMM. RESULTS At baseline, 24% and 32% of patients were respectively depressed and anxious and had statistically significant and clinically relevant higher NDI scores during follow-up. However, in those patients in which the HADS returned to normal during follow-up, NDI values decreased comparably to the non-depression or non-anxiety cases. Those patients that demonstrated persisting high HADS values had convincingly worse NDI scores. A predictive LMM showed that combining baseline NDI and HADS scores was highly predictive of NDI during follow-up. The R shiny application enabled the effective, visual communication of results from the predictive LMM. CONCLUSION This study shows that mental health status and disability are strongly associated and provides insight into the size of the effect, as well as a way to use this relation to improve preoperative patient counselling. These findings give rise to the suggestion that incorporating mental health screening in the preoperative assessment of patients could help to adequately manage patients' expectations for functional recovery. TRIAL REGISTRATION Dutch Trial Register Number: NTR1289.
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Affiliation(s)
- Caroline M. W. Goedmakers
- grid.10419.3d0000000089452978Neurosurgical Center Holland, Department of Neurosurgery, Leiden University Medical Center & Haaglanden MC & Haga Teaching Hospital, Albinusdreef 2, Leiden, 2300 RC the Netherlands ,grid.38142.3c000000041936754XComputational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Ilse van Beelen
- grid.10419.3d0000000089452978Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Floor Komen
- grid.10419.3d0000000089452978Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Erik W. van Zwet
- grid.10419.3d0000000089452978Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Wilco C. Peul
- grid.10419.3d0000000089452978Neurosurgical Center Holland, Department of Neurosurgery, Leiden University Medical Center & Haaglanden MC & Haga Teaching Hospital, Albinusdreef 2, Leiden, 2300 RC the Netherlands
| | - Mark P. Arts
- grid.10419.3d0000000089452978Neurosurgical Center Holland, Department of Neurosurgery, Leiden University Medical Center & Haaglanden MC & Haga Teaching Hospital, Albinusdreef 2, Leiden, 2300 RC the Netherlands
| | - Carmen L. A. Vleggeert-Lankamp
- grid.10419.3d0000000089452978Neurosurgical Center Holland, Department of Neurosurgery, Leiden University Medical Center & Haaglanden MC & Haga Teaching Hospital, Albinusdreef 2, Leiden, 2300 RC the Netherlands ,grid.416219.90000 0004 0568 6419Department of Neurosurgery, Spaarne Gasthuis, Haarlem, Hoofddorp the Netherlands
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Pérez-Llanes R, Ruiz-Cárdenas JD, Meroño-Gallut AJ, Fernández-Calero MI, Ríos-Díaz J. Effectiveness of suboccipital muscle inhibition combined with interferential current in patients with chronic tension-type headache: a randomised controlled clinical trial. NEUROLOGÍA (ENGLISH EDITION) 2021; 37:717-725. [PMID: 34583886 DOI: 10.1016/j.nrleng.2019.12.004] [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: 06/26/2019] [Accepted: 12/12/2019] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Manual therapy has been shown to reduce self-reported symptoms in patients with chronic tension-type headache (CTTH). However, simultaneous application of suboccipital muscle inhibition and interferential current has not previously been investigated. This study evaluates the effectiveness of combined treatment with suboccipital muscle inhibition and interferential current compared to standard treatment for pain, disability, and headache impact in patients with CTTH. METHODS Patients were randomly allocated to receive either standard treatment (n = 13) or the experimental treatment (n = 12), consisting of 20 minutes of suboccipital muscle inhibition plus interferential current twice weekly for 4 weeks. The primary outcome was improvement in pain, and secondary outcomes included improvement in headache-related disability and reduction in headache impact, which were assessed at baseline and at 4 weeks by a blinded rater. RESULTS Statistical analysis showed improvements in the experimental treatment group at 4 weeks for headache-related disability (Neck Disability Index: Hedges' g = 1.01, P = .001; and Headache Disability Inventory: Hedges' g = 0.48, P = .022) and headache impact (6-item Headache Impact Test: Hedges' g = 0.15, P = .037) but not for self-reported pain (numerical rating scale: Hedges' g = 1.13, P = .18). CONCLUSIONS Combined treatment with suboccipital muscle inhibition and interferential current in patients with CTTH did not significantly improve self-reported pain but did reduce disability and the impact of headache on daily life at 4 weeks. These improvements exceed the minimum clinically important difference, demonstrating the clinical relevance of our findings.
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Affiliation(s)
- R Pérez-Llanes
- Physical Therapy Department, Faculty of Health Sciences, Catholic University of Murcia, Murcia, Spain
| | - J D Ruiz-Cárdenas
- ECOFISTEM Research Group Physical Therapy Department, Faculty of Health Sciences, Catholic University of Murcia, Murcia, Spain.
| | | | - M I Fernández-Calero
- INGRIS Research Group, Physical Therapy Department, Faculty of Health Sciences, Catholic University of Murcia, Murcia, Spain
| | - J Ríos-Díaz
- Physical Therapy Research Group (INFIS), Fundación San Juan de Dios, Centro de Ciencias de la Salud San Rafael, Universidad Antonio de Nebrija, Madrid, Spain
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Subaxial Spine Fractures: A Comparison of Patient-reported Outcomes and Complications Between Anterior and Posterior Surgery. Spine (Phila Pa 1976) 2021; 46:E926-E931. [PMID: 34384090 DOI: 10.1097/brs.0000000000003979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Observational study on prospectively collected data. OBJECTIVES The aim of this study was to compare long-term patient-reported outcomes and complications after anterior or posterior cervical spine surgery for subaxial fractures. SUMMARY OF BACKGROUND DATA There is no consensus in the literature regarding the optimal surgical approach when treating spine fractures in the subaxial region. METHODS A total of 200 individuals who had been treated with either anterior or posterior surgery due to a subaxial single segment, or single vertebra, injury between 2006 and 2016 and had at least 1 year follow-up were identified in the Swedish Spine register. Cases were matched 1:1 for age (±5 years). Outcomes were Neck Disability Index (NDI) and EQ-5D-3L, and reoperations, mortality, and surgeon- and patient-reported wound complications within 90 days. t Tests and χ2 tests were used statistical comparisons. RESULTS At follow-up, NDI was 23 (21) in the anterior group and 29 (21) in the posterior group (P = 0.07). EQ-5D-3L index was 0.62 (0.37) in the anterior group and 0.54 (0.39) in the posterior group (P = 0.13). Patient satisfaction was higher in the anterior group (89% vs. 73%, P = 0.03). No deaths occurred within the first 90 days after surgery, six individuals in the anterior group and three individuals in the posterior group were reoperated (P = 0.31), and five individuals in the anterior group and 24 in the posterior group suffered a wound infection (P < 0.001). CONCLUSION Anterior surgery and posterior surgery were associated with similar neck disability and general quality of life at follow-up, whereas anterior surgery was associated with higher patient satisfaction and lower infection rates.Level of Evidence: 3.
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Rotter G, Binting S, Tissen-Diabaté T, Ortiz M, Brinkhaus B. Osteopathic Medicine in Four Chronic Musculoskeletal Pain Diseases: An Observational Trial with Follow-Up. Complement Med Res 2021; 29:53-66. [PMID: 34515079 DOI: 10.1159/000518311] [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: 07/13/2020] [Accepted: 06/25/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIM Patients with chronic musculoskeletal pain diseases (CMPDs) often use osteopathic medicine (OM), although the changes in patients with pain diseases are still insufficiently investigated. This study aimed to observe changes along and after OM in addition to routine care on pain, functioning, and quality of life in patients with four CMPDs. METHODS In this observational trial with follow-up, patients suffering from chronic neck pain (CNP, n = 10), chronic low back pain (CLBP, n = 10), chronic shoulder pain (CSP, n = 10), or chronic knee pain (CKP, n = 10) received up to six OM sessions in addition to routine care. RESULTS A total of 40 patients (73% female, mean age 47.7 ± 8.3 years, mean pain intensity 59.4 ± 12.5 mm, measured by a visual analog scale [VAS] 0-100 mm) were included. After 26 weeks, there was an improvement in the VAS pain score in the whole population (mean difference to baseline -33.1 mm [95% CI -40.5 to -25.7]), as well in the patients with the four diseases: CNP (-33.7 mm [-54.7 to -12.6]), CLBP (-28.2 mm [-47.9 to -8.4]), CSP (-32.4 [-46.8 to -18.0]), and CKP (-38.1 mm [-49.1 to -27.0]). Regarding disease-specific outcomes, we found improvements in CNP, as measured by the neck disability index (scale 0-50; mean difference -3.6 [-9.0 to 1.9]), CLBP, as measured by the low back pain rating scale (scale 0-60; -3.4 [-12.5 to 5.7]), CSP, as measured by the disabilities of the arm, shoulder and hand score (scale 0-100; -13.4 [-23.1 to -3.7]), and CKP, as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (scale 0-96; -13.0 [-23.5 to -2.5]). These improvements persisted through week 52. No adverse events were observed. CONCLUSION The study observed beneficial changes along and after the OM treatment in addition to routine care in patients with four different CMPDs. High-quality, multicenter randomized controlled trials are strongly needed to compare the effectiveness of OM and standard care interventions in treating CMPDs in the future. We have provided sufficient data for sample size calculations for these trials.
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Affiliation(s)
- Gabriele Rotter
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Kurt-Singer-Institute for Music Physiology and Musicians Health, Hanns Eisler School of Music Berlin, Berlin, Germany
| | - Sylvia Binting
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tatjana Tissen-Diabaté
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Miriam Ortiz
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Zhou Y, Wang W, Tian K, Huang H, Jia M. Efficacy and safety of electroacupuncture in treatment of cervical spondylosis: A protocol of randomized controlled trial. Medicine (Baltimore) 2021; 100:e25570. [PMID: 33950931 PMCID: PMC8104160 DOI: 10.1097/md.0000000000025570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Cervical Spondylotic radiculopathy (CSR) is the most common spinal degenerative disease. Its clinical manifestations are pain and numbness in the neck and arm and limitation of neck movement, which greatly affects the life and work of patients. Acupuncture and electroacupuncture are commonly used in China, the efficacy of acupuncture has been confirmed. Existing evidence shows that electroacupuncture seems to be better than acupuncture, but there is a lack of clinical research to directly compare the two. METHODS This is a prospective randomized controlled trial to compare the efficacy of electroacupuncture and acupuncture in the treatment of CSR and to explore the safety and potential mechanism of electroacupuncture in the treatment of CSR. Approved by the Clinical Research Ethics Committee of our hospital, the patients are randomly divided into an experimental group (electroacupuncture group) or control group (acupuncture group). The patients are followed up for 30 days after 4 weeks of treatment. Observation indexes included VAS score, Neck Disability Index, Yasuhisa Tanaka 20 Score Scale, adverse reactions and so on. Finally, the data will be analyzed by SPSS 18.0 software. DISCUSSION This study will directly compare the advantages and disadvantages of electroacupuncture and acupuncture in the treatment of CSR. The results of this study will help to guide patients with CSR to choose appropriate treatment. TRIAL REGISTRATION OSF Registration number: DOI 10.17605/OSF.IO/9MKPN.
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Affiliation(s)
| | - WenGang Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan province, China
| | - Ke Tian
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan province, China
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Harada GK, Tao Y, Louie PK, Basques BA, Galbusera F, Niemeyer F, Wilke HJ, Goldberg E, An HS, Samartzis D. Cervical spine MRI phenotypes and prediction of pain, disability and adjacent segment degeneration/disease after ACDF. J Orthop Res 2021; 39:657-670. [PMID: 32159238 DOI: 10.1002/jor.24658] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 03/06/2020] [Indexed: 02/04/2023]
Abstract
Degenerative spine imaging findings have been extensively studied in the lumbar region and are associated with pain and adverse clinical outcomes after surgery. However, few studies have investigated the significance of these imaging "phenotypes" in the cervical spine. Patients with degenerative cervical spine pathology undergoing anterior cervical discectomy and fusion (ACDF) from 2008 to 2015 were retrospectively and prospectively assessed using preoperative MRI for disc degeneration, narrowing, and displacement, high-intensity zones, endplate abnormalities, Modic changes, and osteophyte formation from C2-T1. Points were assigned for these phenotypes to generate a novel Cervical Phenotype Index (CPI). Demographics were evaluated for association with phenotypes and the CPI using forward stepwise regression. Bootstrap sampling and multiple imputations assessed phenotypes and the CPI in association with patient-reported outcomes (Neck Disability Index [NDI], Visual Analog Scale [VAS]-neck, VAS-arm) and adjacent segment degeneration (ASDeg) and disease (ASDz). Of 861 patients, disc displacement was the most common (99.7%), followed by osteophytes (92.0%) and endplate abnormalities (57.3%). Most findings were associated with age and were identified at similar cervical vertebral levels; at C5-C7. Imaging phenotypes demonstrated both increased and decreased associations with adverse patient-reported outcomes and ASDeg/Dz. However, the CPI consistently predicted worse NDI (P = .012), VAS-neck (P = .007), and VAS-arm (P = .013) scores, in addition to higher odds of ASDeg (P = .002) and ASDz (P = .004). The CPI was significantly predictive of postoperative symptoms of pain/disability and ASDeg/Dz after ACDF, suggesting that the totality of degenerative findings may be more clinically relevant than individual phenotypes and that this tool may help prognosticate outcomes after surgery.
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Affiliation(s)
- Garrett K Harada
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
- International Spine Research and Innovation Initiative (ISRII), Rush University Medical Center, Chicago, Illinois
| | - Youping Tao
- Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm, Ulm University Medical Centre, Ulm, Germany
| | - Philip K Louie
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
- International Spine Research and Innovation Initiative (ISRII), Rush University Medical Center, Chicago, Illinois
| | - Bryce A Basques
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
- International Spine Research and Innovation Initiative (ISRII), Rush University Medical Center, Chicago, Illinois
| | | | - Frank Niemeyer
- Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm, Ulm University Medical Centre, Ulm, Germany
| | - Hans-Joachim Wilke
- Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm, Ulm University Medical Centre, Ulm, Germany
| | - Edward Goldberg
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
- International Spine Research and Innovation Initiative (ISRII), Rush University Medical Center, Chicago, Illinois
| | - Howard S An
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
- International Spine Research and Innovation Initiative (ISRII), Rush University Medical Center, Chicago, Illinois
| | - Dino Samartzis
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
- International Spine Research and Innovation Initiative (ISRII), Rush University Medical Center, Chicago, Illinois
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Jun JH, Park GY, Chae CS, Suh DC. The Effect of Extracorporeal Shock Wave Therapy on Pain Intensity and Neck Disability for Patients With Myofascial Pain Syndrome in the Neck and Shoulder: A Meta-Analysis of Randomized Controlled Trials. Am J Phys Med Rehabil 2021; 100:120-129. [PMID: 32520797 DOI: 10.1097/phm.0000000000001493] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the efficacy of extracorporeal shock wave therapy on myofascial pain syndrome in the neck and shoulder compared with that of other treatments. DATA SOURCES PubMed, Embase, and Web of Science were systematically searched until May 30, 2019, to select randomized controlled trials. REVIEW METHODS The randomized controlled trials comparing extracorporeal shock wave therapy with sham extracorporeal shock wave therapy or other treatments for patients with myofascial pain syndrome in the neck and shoulder patients were included. Two reviewers independently identified eligible studies. The Cochrane Handbook was used to evaluate the methodological quality of the included randomized controlled trials. Main outcomes associated with pain intensity, pressure pain threshold, and neck disability were selected. The study was registered with PROSPERO (Registration Number CRD 42019137459). RESULTS A total of 11 randomized controlled trials were finally included. The results indicated that extracorporeal shock wave therapy had a large effect size on improving pain intensity (standardized mean difference [SMD] = 0.67, 95% confidence interval = 0.11 to 1.23, P = 0.02) and pressure pain threshold (SMD = 1.19, 95% confidence interval = 0.27 to l2.12, P = 0.01) at postintervention. However, there was no significant effect on neck disability at postintervention (SMD = 0.03, 95% confidence interval = -0.76 to 0.83, P = 0.93). After the subgroup analyses on the type of extracorporeal shock wave therapy, focused extracorporeal shock wave therapy had a significant effect on improving pain intensity (SMD = 0.75, 95% confidence interval = 0.13 to 1.36, P = 0.02) and pressure pain threshold (SMD = 1.70, 95% confidence interval = 0.21 to 3.18, P = 0.03) at postintervention in comparison with that of other treatments. CONCLUSIONS Extracorporeal shock wave therapy is superior to other treatments in terms of alleviating the pain intensity and pressure pain threshold of patients with myofascial pain syndrome in the neck and shoulder at postintervention. In particular, focused extracorporeal shock wave therapy shows significant improvement in pain relief. However, radical extracorporeal shock wave therapy for myofascial pain syndrome treatment still remains unclear.
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Affiliation(s)
- Ji Hyun Jun
- From the Health Insurance Review and Assessment Service, Wonju, Gangwondo, Republic of Korea (JHJ); Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea (G-YP); Department of Rehabilitation Medicine, Cheonan Medical Center, Cheonan, Chungcheongnamdo, Republic of Korea (CSC); and College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea (JHJ, D-CS)
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Rotter G, Fernholz I, Binting S, Keller T, Roll S, Kass B, Reinhold T, Willich SN, Schmidt A, Brinkhaus B. The effect of osteopathic medicine on pain in musicians with nonspecific chronic neck pain: a randomized controlled trial. Ther Adv Musculoskelet Dis 2020; 12:1759720X20979853. [PMID: 33354233 PMCID: PMC7734566 DOI: 10.1177/1759720x20979853] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 11/18/2020] [Indexed: 12/31/2022] Open
Abstract
Background: Nonspecific chronic neck pain (cNP) is common in adult violinists and violists and is often treated with osteopathic medicine (OM), although the effectiveness of this treatment has not been determined to date. This study aimed to evaluate the effectiveness and safety of OM in adult violinists and violists with cNP. Methods: In a two-armed randomized controlled single-center open trial, adult violinists and violists, including music students, with cNP (⩾12 weeks) were randomized to either five individualized OM sessions (OM group) or to no intervention (control group, CG) in the outpatient clinic for integrative medicine, Charité - Universitätsmedizin Berlin, Germany. All patients received a musicians’ medicine consultation and paracetamol on demand. The primary outcome parameter was the neck pain intensity on a visual analog scale (VAS, 0–100 mm, 0 = no pain, 100 = worst imaginable pain) after 12 weeks. Secondary outcomes included neck pain disability (Neck Disability Index, NDI, 0–100%) after 12 weeks. The last follow-up visit was after 52 weeks. Statistical analysis included analysis of covariance adjusted for respective baseline value. Results: Altogether, 62 outpatients were included [OM group (n = 28), CG (n = 34); 81% female; mean age, 41.6 ± 11.1 years; mean baseline neck pain, 55.9 ± 11.6 mm]. After 12 weeks, OM was associated with an improvement in the OM group versus the CG in neck pain on the VAS [14.6 mm (95% confidence interval 8.0; 21.2) versus 40.8 mm (34.7; 46.9), p < 0.001, Cohen’s d = 1.4], and neck pain disability as determined by the NDI [8.8% (6.7; 10.8) versus 17.2% (15.3; 19.1), p < 0.001]. Some improvements were maintained until 52 weeks of follow-up. No serious adverse events were observed. Conclusions: The results of this study suggest that OM might be effective in reducing pain intensity in adult violinists and violists with nonspecific cNP. Further studies should investigate the efficacy of OM in comparison with a sham procedure and with other effective therapy methods in high-quality multicenter trials. Trial registration: WHO Trial Registration https://apps.who.int/trialsearch/NoAccess.aspx?aspxerrorpath=/trialsearch/Trial2.aspx by German Clinical Trials Register DRKS00009258, Universal Trial Number (UTN): U1111-1173-5943.
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Affiliation(s)
- Gabriele Rotter
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Luisenstrasse 57, Berlin, 10117, Germany
| | - Isabel Fernholz
- Kurt-Singer-Institute for Music Physiology and Musicians Health, Hanns Eisler School of Music Berlin, Germany
| | - Sylvia Binting
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Theresa Keller
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Stephanie Roll
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Benjamin Kass
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Thomas Reinhold
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Stefan N Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Alexander Schmidt
- Kurt-Singer-Institute for Music Physiology and Musicians Health, Hanns Eisler School of Music Berlin, Germany
| | - Benno Brinkhaus
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
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Kim M, Kim J. Effects of Acupressure on Pain, Flexibility, and Substance P in Middle-Age Women with Chronic Neck Pain. J Altern Complement Med 2020; 27:160-167. [PMID: 33296258 DOI: 10.1089/acm.2020.0413] [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: 12/14/2022] Open
Abstract
Introduction: Acupressure is known to be effective for some types of chronic pain. However, the effect of acupressure on chronic neck pain has not been investigated. Accordingly, the authors aimed to evaluate effects of the 4-week acupressure treatment on pain, neck function, and substance P in women with chronic neck pain. Methods: The acupressure treatment was performed two times a week for 4 weeks in an acupressure group (n = 24), meanwhile a control group (n = 26) was untreated. Before and after intervention, pain intensity and physical disability were measured by visual analogue scale (VAS) and neck disability index (NDI), respectively. In addition, cervical range of motion (CROM) and serum substance P were evaluated. Results: Results of two-way analysis of variance with repeated measures revealed that time × group interactions were significant in all outcomes (all p < 0.001) except substance P. These results indicate that after 4 weeks, VAS and NDI significantly decreased in the acupressure group compared with those changes in the control group. The CROM values for six cervical movements significantly increased in the acupressure group compared with those changes in the control group. Serum substance P did not change significantly in both groups. However, when the pre- and postintervention data from all subjects were pooled, substance P was significantly correlated with VAS (r = 20; p < 0.05; n = 100). Conclusions: The 4-week acupressure intervention showed significant reduction in pain and improvement in neck disability and flexibility, suggesting that acupressure intervention is an effective treatment for chronic neck pain. This study was registered with the Korean Clinical Trial Registry and WHO Clinical Trial Registry (KCT0005363).
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Affiliation(s)
- Manjung Kim
- Department of Alternative Medicine, Graduate School, Kyonggi University (Seoul Campus), Seoul, Republic of Korea
| | - Jaehee Kim
- Department of Alternative Medicine, Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), Seoul, Republic of Korea
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Dalpiaz A, Kuriki HU, Barbosa RAP, Diefenthaeler F, Marcolino AM, Barbosa RI. Dry Needling and Photobiomodulation Decreases Myofascial Pain in Trapezius of Women: Randomized Blind Clinical Trial. J Manipulative Physiol Ther 2020; 44:61-71. [PMID: 33248747 DOI: 10.1016/j.jmpt.2020.07.002] [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: 12/11/2019] [Revised: 05/22/2020] [Accepted: 07/01/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The purpose of this study was to assess whether dry needling (DN) added to photobiomodulation (PBM) has effects on the treatment of active myofascial trigger points in the upper trapezius. METHODS This study was a randomized clinical trial, with 43 participants divided into 3 groups: DN and PBM (DNP), DN, and DN outside of the trigger point (DNout). Each group received 1 session of DN followed by PBM therapy with the machine turned on or off. Pain, disability, pain pressure threshold, and muscle activity were assessed before the intervention and afterward at intervals of 10 minutes, 30 minutes, 1 week, and 1 month. RESULTS Pain decreased after intervention in the DNP and DNout groups, with mean differences, respectively, of 1.33 cm (95% confidence interval [CI], 0.019-2.647) and 2.78 cm (95% CI, 1.170-2.973). Scores for the disability questionnaire decreased in all groups after intervention (F = 36.53, P < .0001) after the intervention, with mean differences of 3.8 points in the DNP group (95% CI, 1.082-5.518), 3.57 in the DN group (95% CI, 0.994-6.149), and 5.43 in the DNout group (95% CI, 3.101-7.756). There were no significant differences between or within groups in pain pressure threshold (F = 2.14, P = .139), with mean differences after 30 minutes of 0.139 kgf for the DNP group (95% CI, -0.343 to 0.622), 0.273 for the DN group (95% CI, -0.661 to 1.209), and -0.07 for the DNout group (95% CI, -0.465 to 0.324). Muscle activation for the DN group increased 8.49% after the intervention, where for the DNP group it decreased 11.5%, with a significant difference between groups. CONCLUSION DN added to PBM presented similar results compared to DNout and DN. In this sample, the effects of the application of DN outside of the trigger point had better effects on pain and disability scores than DN applied directly on the trigger point.
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Affiliation(s)
- Ameg Dalpiaz
- Center of Sciences, Technologies and Health, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Heloyse Uliam Kuriki
- Center of Sciences, Technologies and Health, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Renan Andrade Pereira Barbosa
- Center of Sciences, Technologies and Health, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Fernando Diefenthaeler
- Center of Sciences, Technologies and Health, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Alexandre Marcio Marcolino
- Center of Sciences, Technologies and Health, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Rafael Inacio Barbosa
- Center of Sciences, Technologies and Health, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil.
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Diep D, Chen KJQ, Kumbhare D. Ultrasound-guided interventional procedures for myofascial trigger points: a systematic review. Reg Anesth Pain Med 2020; 46:73-80. [PMID: 33159004 DOI: 10.1136/rapm-2020-101898] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 11/03/2022]
Abstract
Myofascial pain syndrome (MPS) is characterized by the presence of clinically detected myofascial trigger points (MTrPs). Diagnostic ultrasound (US) has been proposed as a method to strengthen the reliability of MTrP localization, thus potentially improving the efficacy and safety profile of interventional procedures. The objective is to evaluate the benefit and safety profile of any US-guided interventional procedure for MPS. Medline, Embase, PubMed, the Allied and Complementary Medicine Database (AMED), and Web of Science were systematically searched from their inception to May 2020 for any randomized controlled trial that evaluated treatment benefit and safety of any US-guided interventional procedure for MPS. The primary outcome of interest was pain severity. Additional outcomes of interest were function and adverse effects. The risk of bias was assessed using the Risk of Bias V.2.0 tool. eleven studies met all inclusion and exclusion criteria. Two studies (n=174) with a high risk of bias revealed some evidence supporting US guidance over blinded interventions for improvement in pain and function. Eight studies (n=483) with varying risks of bias were of head-to-head comparisons of different US modalities. These studies revealed that US-guided local anesthetic injections were inferior to US-guided pulse radiofrequency and US-guided dry needling (DN). US-guided DN was also found to be superior to US-guided platelet-rich-plasma injections but inferior to US-guided miniscalpel. Meanwhile, one study (n=21) with some concerns of bias found that US-guided local anesthetic injections were superior to non-steroidal anti-inflammatory drugs for pain outcomes and fewer adverse events. All US-guided procedures resulted in zero or minimal self-limited adverse events. Issues with clinical relevance, limited sample sizes, and small point estimates warrant more high-quality research to better characterize the possible value of US-guided injections.
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Affiliation(s)
- Dion Diep
- Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kevin Jia Qi Chen
- Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Dinesh Kumbhare
- Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Eftekharsadat B, Fasaie N, Golalizadeh D, Babaei-Ghazani A, Jahanjou F, Eslampoor Y, Dolatkhah N. Comparison of efficacy of corticosteroid injection versus extracorporeal shock wave therapy on inferior trigger points in the quadratus lumborum muscle: a randomized clinical trial. BMC Musculoskelet Disord 2020; 21:695. [PMID: 33076888 PMCID: PMC7574569 DOI: 10.1186/s12891-020-03714-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 10/13/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND In this study, we aimed to compare the efficacy of corticosteroid trigger point injection (TPI) versus extracorporeal shock wave therapy (ESWT) on inferior trigger points in the quadratus lumborum (QL) muscle. METHODS In this single-blind randomized clinical trial, 54 low back pain patients with myofascial trigger points on QL muscle were investigated. Participants were randomly allocated into two groups with A and B pockets. Patients in group A underwent radial ESWT and received 5 treatment sessions (1 per week) and actually were not followed-up. However, patients in group B received corticosteroid TPI and received one session of corticosteroid treatment and followed-up for 4 weeks after injection. Oswestry Disability Index (ODI), visual analogue scale (VAS), pain pressure threshold (PPT) and short form (36) health survey (SF-36) were measured in both groups before, two weeks after and four weeks after intervention. RESULTS The between group comparison indicated that corticosteroid TPI leaded to significant higher improvements of ODI (P-value< 0.01), VAS (P value< 0.001), and PPT (P-value = 0.001) scores compared to the ESWT group at two-week follow-up time-point. ESWT group recorded significant higher improvement of ODI (P-value< 0.01) and SF-36 (P-value< 0.001) compared to the corticosteroid TPI at 4th week post treatment evaluation. At four-week follow-up time-point, the patients in the ESWT group were 1.46 times more likely to achieve 30% reduction in VAS, 2.67 times more likely to achieve 30% reduction in ODI, and 2.30 times more likely to achieve 20% improvement in SF-36 compared to the participants in corticosteroid TPI group. These results refer to large effect size for all study outcomes in ESWT group (d = 4.72, d = 1.58, d = 5.48, and d = 7.47 for ODI, PPT, SF-36, and VAS, respectively). CONCLUSION Corticosteroid TPI was more effective compared to ESWT in short-term controlling of pain and disability caused by myofascial pain syndrome of QL muscle. However, after 4 weeks treatment, ESWT further improved the quality of life and disability and was related with more probability of achievement the minimal clinically important difference concerning pain, disability and quality of life and large effect size for all study outcomes in treated patients compared to corticosteroid TPI. TRIAL REGISTRATION www.irct.ir , IRCT20100827004641N14 , retrospectively registered 2019-01-19.
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Affiliation(s)
- Bina Eftekharsadat
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Negar Fasaie
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dina Golalizadeh
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arash Babaei-Ghazani
- Neuromusculoskeletal Research Center, Department of physical medicine and rehabilitation, Iran University of Medical Sciences, Tehran, Iran
| | | | - Yashar Eslampoor
- Palliative Care Medicine Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Dolatkhah
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
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What Is the Effectiveness of Different Duration Interdisciplinary Treatment Programs in Patients with Chronic Pain? A Large-Scale Longitudinal Register Study. J Clin Med 2020; 9:jcm9092788. [PMID: 32872448 PMCID: PMC7564573 DOI: 10.3390/jcm9092788] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/17/2020] [Accepted: 08/20/2020] [Indexed: 02/07/2023] Open
Abstract
Chronic pain is a leading cause of disability globally. Interdisciplinary multimodal pain rehabilitation (IMPR) targets pain with a bio-psycho-social approach, often delivered as composite programs. However, evidence of optimal program duration for the rehabilitation to succeed remains scarce. This study evaluated the effectiveness of different duration IMPR-programs-using within- and between-effects analyses in a pragmatic multicenter register-based controlled design. Using the Swedish Quality Registry for Pain Rehabilitation, data from fifteen clinics specialized in chronic pain rehabilitation across Sweden were retrieved. Participants were patients with chronic musculoskeletal pain who had taken part in short (4-9 weeks; n = 924), moderate (10 weeks; n = 1379), or long (11-18 weeks; n = 395) IMPR programs. Longitudinal patient-reported outcome data were assessed at baseline, post-intervention, and at a 12-month follow-up. Primary outcomes were health-related quality of life, presented as perceived physical and mental health (SF-36). Secondary outcomes included the Hospital Anxiety and Depression Scale (HADS), pain intensity (NRS 0-10), the Multidimensional Pain Inventory (MPI), and perceived health (EQ-5D). Overall, all groups showed improvements. No clinically important effect emerged for different duration IMPR. In conclusion, while our results showed that patients following IMPR report improvement across a bio-psycho-social specter, a longer program duration was no more effective than a shorter one.
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Rahbar M, Samandarian M, Salekzamani Y, Khamnian Z, Dolatkhah N. Effectiveness of extracorporeal shock wave therapy versus standard care in the treatment of neck and upper back myofascial pain: a single blinded randomised clinical trial. Clin Rehabil 2020; 35:102-113. [PMID: 32731757 DOI: 10.1177/0269215520947074] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To compare the efficacy of extracorporeal shock wave therapy versus standard care (ultrasound + hot pack + self-stretch-exercises) in treatment of neck and upper back myofascial pain syndrome. DESIGN Single-blind randomised clinical trial. SETTING Outpatients setting. SUBJECTS Patients with neck and upper back myofascial pain. INTERVENTION Participants were randomly allocated into shock wave group (n = 24), standard care (ultrasound + hot pack + self-stretch-exercises) group (n = 24) and control (self-stretch-exercises) group (n = 24) for four weeks. MAIN MEASURES The primary outcomes were pain intensity (visual analogue scale), pain pressure threshold (algometer) and disability (neck disability index). Measures were performed at baseline (week 0), week 1 and post-intervention (week 4). RESULTS Shock wave and ultrasound improved visual analogue scale (7.50 ± 1.71 to 5.72 ± 2.20 and 6.22 ± 2.54 to 4.95 ± 2.86, respectively, P = 0.083) and disability index (54.24 ± 15.53 to 39.04 ± 19.58 50.23 ± 19.57 to 32.10 ± 18.34, respectively, P = 0.495) similarly at first week examinations that were significantly higher than control (P < 0.05). In week 4 measurements, additional improvements were achieved concerning visual analogue scale and disability index in the shock wave (-4.00 ± 2.22 and -20.24 ± 16.56, respectively) and ultrasound (-2.18 ± 2.71 and -21.79 ± 10.56, respectively) groups. However, visual analogue scale improved more significantly in shock wave group than ultrasound group in fourth week measurements (P = 0.012). CONCLUSION Extracorporeal shock wave therapy was more effective in controlling of the pain intensity compared to ultrasound one month after treatment. However it had no superiority over ultrasound in improving neck disability index at this time point.Trial registrationwww.irct.ir, IRCT201608154104N5, registered 2016-09-25.
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Affiliation(s)
- Mohammad Rahbar
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Samandarian
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yaghoub Salekzamani
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zhila Khamnian
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Dolatkhah
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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Rodríguez-Huguet M, Rodríguez-Huguet P, Lomas-Vega R, Ibáñez-Vera AJ, Rodríguez-Almagro D. Vacuum myofascial therapy device for non-specific neck pain. A single blind randomized clinical trial. Complement Ther Med 2020; 52:102449. [PMID: 32951712 DOI: 10.1016/j.ctim.2020.102449] [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: 01/24/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the efficacy of a vacuum myofascial therapy device (VT) for improving pressure pain thresholds (PPTs), range of motion (ROM), neck pain-related disability, pain, and quality of life in patients with non-specific neck pain. METHODS A randomized controlled trial in which thirty-eight participants with non-specific neck pain (NP) were randomly assigned to either an experimental (VT) or a comparison physical therapy program (PTP) group. The VT group (n = 19) received five sessions of treatment with a vacuum myofascial therapy device while the PTP group (n = 19) received five sessions of massage, ultrasound therapy (US), and transcutaneous electric nerve stimulation (TENS) over two weeks. The outcome measures were the numerical pain rating scale (NPRS), range of motion, quality of life (SF-12), neck disability Index (NDI), and PPTs at the end of treatment and at one-month follow-up. RESULTS Although both groups experienced improvements in pain, neck disability, range of motion, and pressure pain, these only were statistically significant in the VT group. At one-month follow-up, the VT group still showed improvements in pain, neck disability, and range of motion. DISCUSSION Vacuum myofascial therapy applied with a device offers similar results to other vacuum-based techniques such as cupping therapy. Moreover, in this device the parameters are digitally controlled, which allows for the precise reproduction of treatment.
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Affiliation(s)
- Manuel Rodríguez-Huguet
- Department of Nursing and Physical Therapy. University of Cádiz. Avenida Ana de Viya, 52. 11009, Cádiz, Spain
| | - Pablo Rodríguez-Huguet
- Department of Traumatology and Orthopedic Surgery. Jerez de la Frontera Hospital. Ronda de Circunvalación. 11407, Jerez de la Frontera, Cádiz, Spain
| | - Rafael Lomas-Vega
- Department of Health Sciences, University of Jaén, Paraje Las Lagunillas s/n. 23071, Jaén, Spain
| | | | - Daniel Rodríguez-Almagro
- Department of Health Sciences, University of Jaén, Paraje Las Lagunillas s/n. 23071, Jaén, Spain
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Pérez-Llanes R, Ruiz-Cárdenas JD, Meroño-Gallut AJ, Fernández-Calero MI, Ríos-Díaz J. Effectiveness of suboccipital muscle inhibition combined with interferential current in patients with chronic tension-type headache: a randomised controlled clinical trial. Neurologia 2020; 37:S0213-4853(20)30042-6. [PMID: 32345452 DOI: 10.1016/j.nrl.2019.12.004] [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: 06/26/2019] [Revised: 10/24/2019] [Accepted: 12/12/2019] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION Manual therapy has been shown to reduce self-reported symptoms in patients with chronic tension-type headache (CTTH). However, simultaneous application of suboccipital muscle inhibition and interferential current has not previously been investigated. This study evaluates the effectiveness of combined treatment with suboccipital muscle inhibition and interferential current compared to standard treatment for pain, disability, and headache impact in patients with CTTH. METHODS Patients were randomly allocated to receive either standard treatment (n = 13) or the experimental treatment (n = 12), consisting of 20 minutes of suboccipital muscle inhibition plus interferential current twice weekly for 4 weeks. The primary outcome was improvement in pain, and secondary outcomes included improvement in headache-related disability and reduction in headache impact, which were assessed at baseline and at 4 weeks by a blinded rater. RESULTS Statistical analysis showed improvements in the experimental treatment group at 4 weeks for headache-related disability (Neck Disability Index: Hedges' g = 1.01, P = .001; and Headache Disability Inventory: Hedges' g = 0.48, P = .022) and headache impact (6-item Headache Impact Test: Hedges' g = 0.15, P = .037) but not for self-reported pain (numerical rating scale: Hedges' g = 1.13, P = .18). CONCLUSIONS Combined treatment with suboccipital muscle inhibition and interferential current in patients with CTTH did not significantly improve self-reported pain but did reduce disability and the impact of headache on daily life at 4 weeks. These improvements exceed the minimum clinically important difference, demonstrating the clinical relevance of our findings.
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Affiliation(s)
- R Pérez-Llanes
- Physical Therapy Department, Faculty of Health Sciences, Catholic University of Murcia, Murcia, Spain
| | - J D Ruiz-Cárdenas
- ECOFISTEM Research group Physical Therapy Department, Faculty of Health Sciences, Catholic University of Murcia, Murcia, Spain.
| | | | - M I Fernández-Calero
- INGRIS Research group, Physical Therapy Department, Faculty of Health Sciences, Catholic University of Murcia, Murcia, Spain
| | - J Ríos-Díaz
- Physical Therapy Research Group (INFIS), Fundación San Juan de Dios, Centro de Ciencias de la Salud San Rafael, Universidad Antonio de Nebrija, Madrid, España
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Eslamian F, Jahanjoo F, Dolatkhah N, Pishgahi A, Pirani A. Relative Effectiveness of Electroacupuncture and Biofeedback in the Treatment of Neck and Upper Back Myofascial Pain: A Randomized Clinical Trial. Arch Phys Med Rehabil 2020; 101:770-780. [PMID: 31954696 DOI: 10.1016/j.apmr.2019.12.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 12/12/2019] [Accepted: 12/17/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To determine the differences between clinical effects of electroacupuncture and biofeedback therapy in addition to conventional treatment in patients with cervical myofascial pain syndrome (MPS). DESIGN Randomized clinical trial. SETTING Physical medicine and rehabilitation clinic of a university hospital. PARTICIPANTS Fifty patients (N=50) aged 25-55 years of both sexes with chronic neck pain diagnosed with MPS (characterized by trigger points within taut bands) were randomly assigned to 2 equal groups of 25 individuals. INTERVENTIONS The patients in electroacupuncture group were treated with standard acupuncture and concomitant electrical stimulation; those in biofeedback group received visual electromyography biofeedback therapy for muscle activity and relaxation. Both groups received the intervention 2 times a week for a total of 6 sessions. Basic exercise training and medicines were administered for all the patients. MAIN OUTCOME MEASURES Pain severity based on the visual analog scale (VAS), functional status using Neck Disability Index (NDI), cervical range of motion (ROM) using and inclinometer, and pressure pain threshold (PPT) using an algometer were evaluated before and at 3 and 12 weeks after the treatment. Primary outcome was defined as 20% reduction in the 3-month neck pain and dysfunction compared to baseline, assessed through the NDI. RESULTS Fifty patients (39 women, 11 men) with a mean age (years) ± SD of 39.0±5.5 and neck pain duration (weeks) of 6.0±2.2 were analyzed. All parameters, except for PPT of the lower trapezius and paravertebral muscles were improved significantly in both groups, while baseline values were controlled. The primary outcome was achieved more significantly in the acupuncture group than in the biofeedback group: 20 (80.0%) vs 10 (40.0%); rate ratio=2 with 95% confidence interval (CI), 1.19-3.36; number needed to treat (NNT)=2.5 with 95% CI, 1.54-6.58. Advantages of acupuncture over biofeedback were observed according to values obtained from the NDI, VAS, extension and left lateral-bending ROM, and PPT on the left upper trapezius after the last session of intervention until 3 months (P<.05). CONCLUSIONS Both electroacupuncture and biofeedback therapies were found to be effective in management of MPS when integrated with conventional treatment. However, intergroup differences showed priority of acupuncture in some parameters vs biofeedback. Thus, electroacupuncture seems to be a better complementary modality for treatment of MPS in the neck and upper back area.
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Affiliation(s)
- Fariba Eslamian
- Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Fatemeh Jahanjoo
- Road Traffic Injury Research Center, Department of Biostatistic and Epidemiology,Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Dolatkhah
- Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Pishgahi
- Physical Medicine and Rehabilitation Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Pirani
- Physical Medicine and Rehabilitation Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Rahman HS, Ahmad GA, Mustapha B, Al-Rawi HA, Hussein RH, Amin K, Othman HH, Abdullah R. Wet cupping therapy ameliorates pain in patients with hyperlipidemia, hypertension, and diabetes: A controlled clinical study. INTERNATIONAL JOURNAL OF SURGERY OPEN 2020. [DOI: 10.1016/j.ijso.2020.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ghodrati M, Mosallanezhad Z, Shati M, Noroozi M, Moghadam AN, Rostami M, Nourbakhsh MR. Adding Temporomandibular joint treatments to routine physiotherapy for patients with non-specific chronic neck pain: A randomized clinical study. J Bodyw Mov Ther 2019; 24:202-212. [PMID: 32507146 DOI: 10.1016/j.jbmt.2019.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 11/12/2019] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Neck Pain can be related to the disorders of other adjacent areas such as the Temporomandibular Joint (TMJ). This study aimed to investigate whether there is value in adding TMJ treatments to routine physiotherapy in patients with non-specific chronic neck pain compared with a control group. METHODS A randomized, single-blind, clinical study desined including two groups of patients. Group A (20 people) received routine physiotherapy for neck pain and group B (20 people) received TMJ manual therapy plus exercise therapy in addition to routine physiotherapy for neck pain. The Treatment program included six sessions for two days a week over a period of 21 days. Assessments were performed during the first session, in the last session and one month after treatment as a follow-up. Outcome measures included neck range of motion (ROM), neck disability index (NDI) and visual analogue scale (VAS). Before starting the study, the reliability of methods for measuring neck ROM was evaluated. RESULTS Participants were 21 women and 19 men. Initially, a pilot study was carried out on the 40 volunteers to assess the reliability of the measurement methods, and the results were acceptable. With both the control group and the intervention group, the indexes showed significant improvement (p < 0.001), although the intervention group showed more improvement (p < 0.001). CONCLUSION This result means adding treatments of TMJ to routine neck physiotherapy can magnify the effect of the intervention, a significant change still in evidence at follow up. Moreover, given the clinically important differences, our results for VAS and NDI were acceptable.
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Affiliation(s)
- Maryam Ghodrati
- Health and Rehabilitation Sciences Program, University of Western Ontario, London, Canada
| | - Zahra Mosallanezhad
- Department of Physical Therapy and Research Center of Aging, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran.
| | - Mohsen Shati
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mehdi Noroozi
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
| | - Afsun Nodehi Moghadam
- Department of Physical Therapy and Research Center of Aging, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
| | - Mohamad Rostami
- Department of Physical Therapy and Research Center of Aging, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
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Wong JJ, Tricco AC, Côté P, Rosella LC. The association between depressive symptoms or depression and health outcomes in adults with low back pain with or without radiculopathy: protocol of a systematic review. Syst Rev 2019; 8:267. [PMID: 31703727 PMCID: PMC6839250 DOI: 10.1186/s13643-019-1192-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 10/09/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND A considerable proportion of adults with low back pain (LBP) suffer from depressive symptoms or depression. Those with depressive symptoms or depression may be at risk of poorer LBP recovery and require more health care. Understanding the role of prognostic factors for LBP is critically important to guide management and health services delivery. Our objective is to conduct a systematic review to assess the association between depressive symptoms or depression and health outcomes in adults with LBP with or without radiculopathy. METHODS Electronic databases including MEDLINE, Embase, CINAHL, and PsycINFO will be searched from inception to April 2019 to identify relevant studies. Additional citations will be identified by searching reference lists of included studies and related systematic reviews. Cohort and case-control studies assessing the association between depressive symptoms/depression and health outcomes in adults aged 16 years and older with LBP with or without radiculopathy will be included. The following will be included: depressive symptoms as measured on standardized questionnaires (e.g., Center for Epidemiologic Studies Depression Scale, Beck Depression Index), and depression as standardized diagnoses (e.g., International Classification of Diseases codes) or self-reported depression diagnosis on standardized questionnaires. Outcomes of interest are standardized measures for pain, disability, overall health status, satisfaction with care, and health care utilization. These are informed by core outcome domains that international expert panels consider important for LBP research. Pairs of reviewers will screen articles retrieved from the search, extract data, and assess risk of bias using the Risk Of Bias In Non-randomized Studies-of Exposures (ROBINS-E) tool. Reviewers will use these criteria to inform their judgment on the internal validity of studies (e.g., low, moderate, or high risk of bias). If studies are deemed homogeneous, a random effects meta-analysis on the association between depressive symptoms and health outcomes will be performed. The results of the included studies will be descriptively outlined if studies are deemed heterogeneous. DISCUSSION The impact of depressive symptoms and depression on health- and health care-related outcomes for LBP with or without radiculopathy will be assessed and quantified. Findings of this systematic review will advance our understanding of LBP prognosis, and guide decision-making and improve quality of care for adults with LBP. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019130047.
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Affiliation(s)
- Jessica J. Wong
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, ON M5T 3M7 Canada
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College, 2000 Simcoe Street North, Oshawa, ON L1H 7K4 Canada
| | - Andrea C. Tricco
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, ON M5T 3M7 Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Knowledge Translation Program, 209 Victoria Street, East Building, Room 716, Toronto, ON M5B 1W8 Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th floor, Toronto, ON M5T 3M7 Canada
| | - Pierre Côté
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, ON M5T 3M7 Canada
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College, 2000 Simcoe Street North, Oshawa, ON L1H 7K4 Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th floor, Toronto, ON M5T 3M7 Canada
- Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON L1H 7K4 Canada
| | - Laura C. Rosella
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, ON M5T 3M7 Canada
- ICES, 155 College Street, Toronto, ON M5T 3M7 Canada
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Cervical radiculopathy: is a prosthesis preferred over fusion surgery? A systematic review. 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 2019; 29:2640-2654. [PMID: 31641906 DOI: 10.1007/s00586-019-06175-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 07/17/2019] [Accepted: 10/05/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Meta-analyses on the comparison between fusion and prosthesis in the treatment of cervical radiculopathy mainly analyse studies including mixed patient populations: patients with radiculopathy with and without myelopathy. The outcome for patients with myelopathy is different compared to those without. Furthermore, apart from decompression of the spinal cord, restriction of motion is one of the cornerstones of the surgical treatment of spondylotic myelopathy. From this point of view, the results for arthroplasty might be suboptimal for this category of patients. Comparing clinical outcome in patients exclusively suffering from radiculopathy is therefore a more valid method to compare the true clinical effect of the prosthesis to that of fusion surgery. AIM The objective of this study was to compare clinical outcome of cervical arthroplasty (ACDA) to the clinical outcome of fusion (ACDF) after anterior cervical discectomy in patients exclusively suffering from radiculopathy, and to evaluate differences with mixed patient populations. METHODS A literature search was completed in PubMed, EMBASE, Web of Science, COCHRANE, CENTRAL and CINAHL using a sensitive search strategy. Studies were selected by predefined selection criteria (i.a.) patients exclusively suffering from cervical radiculopathy), and risk of bias was assessed using a validated Cochrane Checklist adjusted for this purpose. An additional overview of results was added from articles considering a mix of patients suffering from myelopathy with or without radiculopathy. RESULTS Eight studies were included that exclusively compared intervertebral devices in radiculopathy patients. Additionally, 29 articles concerning patients with myelopathy with or without radiculopathy were studied in a separate results table. All articles showed intermediate to high risk of bias. There was neither a difference in decrease in mean NDI score between the prosthesis (20.6 points) and the fusion (20.3 points) group, nor was there a clinically important difference in neck pain (VAS). Comparing these data to the mixed population data demonstrated comparable mean values, except for the 2-year follow-up NDI values in the prosthesis group: mixed group patients that received a prosthesis reported a mean NDI score of 15.6, indicating better clinical outcome than the radiculopathy patients that received a prosthesis though not reaching clinical importance. CONCLUSIONS ACDF and ACDA are comparably effective in treating cervical radiculopathy due to a herniated disc in radiculopathy patients. Comparing the 8 radiculopathy with the 29 mixed population studies demonstrated that no clinically relevant differences were present in clinical outcome between the two types of patients. These slides can be retrieved under Electronic Supplementary Material.
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Pecos-Martin D, Ponce-Castro MJ, Jiménez-Rejano JJ, Nunez-Nagy S, Calvo-Lobo C, Gallego-Izquierdo T. Immediate effects of variable durations of pressure release technique on latent myofascial trigger points of the levator scapulae: a double-blinded randomised clinical trial. Acupunct Med 2019; 37:141-150. [PMID: 31060367 DOI: 10.1136/acupmed-2018-011738] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Latent myofascial trigger points (MTrPs) of the levator scapulae have a high prevalence and may influenceconditions of the neck and shoulder. The pressure release technique is one of the most recommended manual therapy techniques. The aim of this study was to determine the effect of varying durations of the pressure release technique application on latent MTrPs of the levator scapulae. METHODS In a three-arm (1:1:1 ratio), double-blinded, parallel, randomised clinical trial, 60 healthy university students (23 men, 37 women) with a mean±SD age of 20.0±2.67 years were recruited. Subjects were assigned to receive pressure release in one latent MTrP of the levator scapulae lasting 30s (T30s; n=17), 60s (T60s; n=22) or 90s (T90s; n=21). Active cervical range of movement (CROM), strength, pressure pain threshold (PPT) and neck pain intensity at full stretch were measured immediately before and after treatment. RESULTS Mixed-model analyses of variance showed statistically significant differences for PPT (P=0.045; partial Eta2=0.103), comparing T60s versus T30s (P=0.009; Cohen's d=1.044) and T90s versus T30s groups (P=0.001; Cohen's d=1.253), and for left side bending strength (P=0.043; partial Eta2=0.105), comparing T90s versus T30s (P=0.023; Cohen's d=0.907). The rest of the comparisons did not present any significant differences (P⩾0.05). CONCLUSIONS The 60 s and 90 s applications of the pressure release technique may be recommended to increase PPT and strength, respectively, in latent MTrPs of the levator scapulae in the short term. TRIAL REGISTRATION NUMBER NCT03006822.
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Affiliation(s)
- Daniel Pecos-Martin
- 1 Physiotherapy and Pain Group, Department of Physiotherapy and Nursing, Alcalá University, Alcalá de Henares, Spain
| | - Manuel José Ponce-Castro
- 2 Faculty of Physical Therapy, Nursing and Podiatry, University of Sevilla, Sevilla, Sevilla, Spain
| | | | - Susana Nunez-Nagy
- 4 Physiotherapy and Nursing Departament, Alcalá University, Alcalá de Henares, Spain
| | - César Calvo-Lobo
- 5 Nursing and Physical Therapy Department, Institute of Biomedicine (IBIOMED), Universidad de León, Ponferrada, Spain
| | - Tomás Gallego-Izquierdo
- 1 Physiotherapy and Pain Group, Department of Physiotherapy and Nursing, Alcalá University, Alcalá de Henares, Spain
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Martín-Rodríguez A, Sáez-Olmo E, Pecos-Martín D, Calvo-Lobo C. Effects of dry needling in the sternocleidomastoid muscle on cervical motor control in patients with neck pain: a randomised clinical trial. Acupunct Med 2019; 37:151-163. [DOI: 10.1177/0964528419843913] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: To determine the changes produced by trigger point dry needling (TrP-DN) of sternocleidomastoid in patients with neck pain, and to observe how it might modify cervical motor control (CMC). Design: Single-centre, randomised, double-blinded clinical trial. Setting: Participants were recruited through advertising. The duration of the study was 6 months. Subjects: Thirty-four subjects with non-specific neck pain, aged over 18 years with an active myofascial trigger point in sternocleidomastoid, participated in the study. They were randomly assigned to treatment or control groups. Methods: TrP-DN inside or (1.5 cm) outside of the active myofascial trigger point of sternocleidomastoid. Main outcome measures: CMC, visual analogue scale and cervical range of motion were assessed before treatment, immediately post treatment, and 24 h, 1 week and 1 month after the intervention; the neck disability index was evaluated before treatment and 1 month later. Results: With a confidence interval of 99%, TrP-DN of sternocleidomastoid was associated with a decrease in pain after 1 week and CMC improved 1 month after the intervention (p < 0.001), when compared with baseline measurements, within the experimental group; there were no statistically significant differences between experimental and control groups. Conclusion: The effects of TrP-DN inside and outside of active myofascial trigger points did not differ in this study. Both interventions were associated with a similar temporal effect, specifically a reduction in neck pain at 1 week and an increase CMC at 1 month. However, these findings should be interpreted with caution due to the lack of a contemporaneous untreated control group.
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Affiliation(s)
| | - Esther Sáez-Olmo
- Physical Therapy Department, Alcalá de Henares University, Alcalá de Henares, Spain
| | - Daniel Pecos-Martín
- Physical Therapy Department, Alcalá de Henares University, Alcalá de Henares, Spain
- Physiotherapy and Pain Group, Madrid, Spain
| | - César Calvo-Lobo
- Nursing and Physical Therapy Department, Institute of Biomedicine (IBIOMED), Universidad de León, León, Spain
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Strömqvist F, Sigmundsson FG, Strömqvist B, Jönsson B, Karlsson MK. Incidental durotomy in degenerative lumbar spine surgery - a register study of 64,431 operations. Spine J 2019; 19:624-630. [PMID: 30172899 DOI: 10.1016/j.spinee.2018.08.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 08/24/2018] [Accepted: 08/27/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Incidental durotomy (ID) is one of the most common intraoperative complications seen in spine surgery. Conflicting evidence has been presented regarding whether or not outcomes are affected by the presence of an ID. PURPOSE To evaluate whether outcomes following degenerative spine surgery are affected by ID and the incidence of ID with different diagnoses and different surgical procedures. MATERIALS By using SweSpine, the national Swedish Spine Surgery Register, preoperative, surgical and postoperative 1-year follow-up data were obtained for 64,431 surgeries. All patients were surgically treated due to lumbar spinal stenosis (LSS) without or with concomitant degenerative spondylolisthesis (DS) or lumbar disc herniation (LDH) between 2000 and 2015. Gender, age, smoking habits, walking distance, consumption of analgesics, back and leg pain (Visual Analogue Scale [VAS]), quality of life (EuroQol [EQ5D] and Short Form 36 [SF-36]), and disability (Oswestry Disability Index [ODI]) were recorded. RESULTS Overall, incidence of ID during the study period was 5.0%. For the LDH, LSS, and DS subgroups, it was 2.8%, 6.5%, and 6.5%, respectively. Laminectomy was associated with a higher incidence of ID than discectomy (p<.001). ID was more common in all three subgroups if the patient had previously been subjected to spine surgery and with increasing age of the patients (p<.001). LDH patients with an ID reported a higher degree of residual leg pain, inferior mental quality of life (SF-36 MCS), and higher disability (ODI) than LDH patients without ID (all p<.001) 1-year after surgery. LSS patients with an ID reported inferior SF-36 MCS (p<.001) and DS patients with an ID had inferior SF-36 MCS and higher ODI compared to patients with the same diagnosis but without an ID (p<.001). However, these numerical differences are well below references for MCID, for all three subgroups. ID was associated with a higher frequency of patients being dissatisfied with the surgical outcome at 1-year follow-up. In patients who did not improve in back and leg pain following surgery (delta-value), ID was less common than in patients reporting improved back and leg pain from before as compared to following surgery. CONCLUSIONS The overall occurrence of ID in the present study was 5%, with higher figures in LSS and DS and lower figures in LDH. Higher age of the patient and previous surgery were associated with higher frequencies of ID. The outcome at 1 year following surgery was not affected to a clinically relevant extent when an ID was obtained. However, ID was associated with a higher degree of patient dissatisfaction and a longer hospital length of stay.
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Affiliation(s)
- Fredrik Strömqvist
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopaedics, Lund University, Akutgatan 4, Lund, Sweden; Department of Clinical Sciences, Skåne University Hospital, Inga Marie Nilssons gata 22, SE-205 02 Malmö, Sweden.
| | - Freyr Gauti Sigmundsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopaedics, Lund University, Akutgatan 4, Lund, Sweden; Department of Clinical Sciences, Skåne University Hospital, Inga Marie Nilssons gata 22, SE-205 02 Malmö, Sweden
| | - Björn Strömqvist
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopaedics, Lund University, Akutgatan 4, Lund, Sweden; Department of Clinical Sciences, Skåne University Hospital, Inga Marie Nilssons gata 22, SE-205 02 Malmö, Sweden
| | - Bo Jönsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopaedics, Lund University, Akutgatan 4, Lund, Sweden; Department of Clinical Sciences, Skåne University Hospital, Inga Marie Nilssons gata 22, SE-205 02 Malmö, Sweden
| | - Magnus K Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopaedics, Lund University, Akutgatan 4, Lund, Sweden; Department of Clinical Sciences, Skåne University Hospital, Inga Marie Nilssons gata 22, SE-205 02 Malmö, Sweden
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Côté P, Yu H, Shearer HM, Randhawa K, Wong JJ, Mior S, Ameis A, Carroll LJ, Nordin M, Varatharajan S, Sutton D, Southerst D, Jacobs C, Stupar M, Taylor-Vaisey A, Gross DP, Brison RJ, Paulden M, Ammendolia C, Cassidy JD, Loisel P, Marshall S, Bohay RN, Stapleton J, Lacerte M. Non-pharmacological management of persistent headaches associated with neck pain: A clinical practice guideline from the Ontario protocol for traffic injury management (OPTIMa) collaboration. Eur J Pain 2019; 23:1051-1070. [PMID: 30707486 DOI: 10.1002/ejp.1374] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 01/25/2019] [Accepted: 01/27/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To develop an evidence-based guideline for the non-pharmacological management of persistent headaches associated with neck pain (i.e., tension-type or cervicogenic). METHODS This guideline is based on systematic reviews of high-quality studies. A multidisciplinary expert panel considered the evidence of clinical benefits, cost-effectiveness, societal and ethical values, and patient experiences when formulating recommendations. Target audience includes clinicians; target population is adults with persistent headaches associated with neck pain. RESULTS When managing patients with headaches associated with neck pain, clinicians should (a) rule out major structural or other pathologies, or migraine as the cause of headaches; (b) classify headaches associated with neck pain as tension-type headache or cervicogenic headache once other sources of headache pathology has been ruled out; (c) provide care in partnership with the patient and involve the patient in care planning and decision making; (d) provide care in addition to structured patient education; (e) consider low-load endurance craniocervical and cervicoscapular exercises for tension-type headaches (episodic or chronic) or cervicogenic headaches >3 months duration; (f) consider general exercise, multimodal care (spinal mobilization, craniocervical exercise and postural correction) or clinical massage for chronic tension-type headaches; (g) do not offer manipulation of the cervical spine as the sole form of treatment for episodic or chronic tension-type headaches; (h) consider manual therapy (manipulation with or without mobilization) to the cervical and thoracic spine for cervicogenic headaches >3 months duration. However, there is no added benefit in combining spinal manipulation, spinal mobilization and exercises; and (i) reassess the patient at every visit to assess outcomes and determine whether a referral is indicated. CONCLUSIONS Our evidence-based guideline provides recommendations for the conservative management of persistent headaches associated with neck pain. The impact of the guideline in clinical practice requires validation. SIGNIFICANCE Neck pain and headaches are very common comorbidities in the population. Tension-type and cervicogenic headaches can be treated effectively with specific exercises. Manual therapy can be considered as an adjunct therapy to exercise to treat patients with cervicogenic headaches. The management of tension-type and cervicogenic headaches should be patient-centred.
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Affiliation(s)
- Pierre Côté
- Canada Research Chair in Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada.,UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College (CMCC), University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada.,Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada
| | - Hainan Yu
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College (CMCC), University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada.,Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Heather M Shearer
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College (CMCC), University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada.,Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Kristi Randhawa
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College (CMCC), University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada.,Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Jessica J Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College (CMCC), University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada.,Canadian Memorial Chiropractic College, Toronto, Ontario, Canada.,Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Silvano Mior
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College (CMCC), University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada.,Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada.,Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Arthur Ameis
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada
| | - Linda J Carroll
- School of Public Health and Injury Prevention Centre, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alberta, Canada
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, NYU School of Medicine, Occupational and Industrial Orthopedic Center, New York University, New York, New York
| | - Sharanya Varatharajan
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College (CMCC), University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada.,Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Deborah Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College (CMCC), University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada.,Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Danielle Southerst
- Rebecca MacDonald Centre for Arthritis and Autoimmune Disease, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Craig Jacobs
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College (CMCC), University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada.,Division of Clinical Education, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Maja Stupar
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College (CMCC), University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada
| | - Anne Taylor-Vaisey
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College (CMCC), University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada.,Rehabilitation Research Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Robert J Brison
- Clinical Research, Kingston General Hospital, Kingston, Ontario, Canada.,Department of Emergency Medicine, School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Mike Paulden
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Carlo Ammendolia
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Institute for Work and Health, Toronto, Ontario, Canada
| | - J David Cassidy
- University of Southern Denmark, Odense, Denmark.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Patrick Loisel
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada.,Division of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | - Michel Lacerte
- Université de Montréal, Montreal, Quebec, Canada.,Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Côté P, Boyle E, Shearer HM, Stupar M, Jacobs C, Cassidy JD, Carette S, van der Velde G, Wong JJ, Hogg-Johnson S, Ammendolia C, Hayden JA, van Tulder M, Frank JW. Is a government-regulated rehabilitation guideline more effective than general practitioner education or preferred-provider rehabilitation in promoting recovery from acute whiplash-associated disorders? A pragmatic randomised controlled trial. BMJ Open 2019; 9:e021283. [PMID: 30679283 PMCID: PMC6347946 DOI: 10.1136/bmjopen-2017-021283] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of a government-regulated rehabilitation guideline compared with education and activation by general practitioners, and to a preferred-provider insurance-based rehabilitation programme on self-reported global recovery from acute whiplash-associated disorders (WAD) grade I-II. DESIGN Pragmatic randomised clinical trial with blinded outcome assessment. SETTING Multidisciplinary rehabilitation clinics and general practitioners in Ontario, Canada. PARTICIPANTS 340 participants with acute WAD grade I and II. Potential participants were sampled from a large automobile insurer when reporting a traffic injury. INTERVENTIONS Participants were randomised to receive one of three protocols: government-regulated rehabilitation guideline, education and activation by general practitioners or a preferred-provider insurance-based rehabilitation. PRIMARY AND SECONDARY OUTCOME MEASURES Our primary outcome was time to self-reported global recovery. Secondary outcomes included time on insurance benefits, neck pain intensity, whiplash-related disability, health-related quality of life and depressive symptomatology at 6 weeks and 3, 6, 9 and 12 months postinjury. RESULTS The median time to self-reported global recovery was 59 days (95% CI 55 to 68) for the government-regulated guideline group, 105 days (95% CI 61 to 126) for the preferred-provider group and 108 days (95% CI 93 to 206) for the general practitioner group; the difference was not statistically significant (Χ2=3.96; 2 df: p=0.138). We found no clinically important differences between groups in secondary outcomes. Post hoc analysis suggests that the general practitioner (hazard rate ratio (HRR)=0.51, 95% CI 0.34 to 0.77) and preferred-provider groups (HRR=0.67, 95% CI 0.46 to 0.96) had slower recovery than the government-regulated guideline group during the first 80 days postinjury. No major adverse events were reported. CONCLUSIONS Time-to-recovery did not significantly differ across intervention groups. We found no differences between groups with regard to neck-specific outcomes, depression and health-related quality of life. TRIAL REGISTRATION NUMBER NCT00546806.
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Affiliation(s)
- Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Eleanor Boyle
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark
| | - Heather M Shearer
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Ontario, Canada
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Maja Stupar
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Craig Jacobs
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Ontario, Canada
| | - John David Cassidy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark
| | - Simon Carette
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Rheumatology, University Health Network, Toronto, Ontario, Canada
| | - Gabrielle van der Velde
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto General Hospital, Toronto, Ontario, Canada
| | - Jessica J Wong
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Ontario, Canada
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Sheilah Hogg-Johnson
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Institute for Work & Health, Toronto, Ontario, Canada
| | - Carlo Ammendolia
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Jill Alison Hayden
- Department of Community Health & Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Maurits van Tulder
- Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - John W Frank
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Usher Institute of Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
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Cerezo-Téllez E, Torres-Lacomba M, Mayoral-Del-Moral O, Pacheco-da-Costa S, Prieto-Merino D, Sánchez-Sánchez B. Health related quality of life improvement in chronic non-specific neck pain: secondary analysis from a single blinded, randomized clinical trial. Health Qual Life Outcomes 2018; 16:207. [PMID: 30400984 PMCID: PMC6219051 DOI: 10.1186/s12955-018-1032-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 10/16/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Chronic non-specific neck pain is related to limited cervical mobility, impaired function, neck muscles myofascial pain syndrome, and stress at work. The aforementioned factors are strongly related and may lead to a negative impact on health-related quality of life. There are some effective conservative Physical therapy interventions for treating chronic non-specific neck pain. Currently, Deep Dry Needling is emerging as an alternative for improving symptoms and consequently, the quality of life in patients with chronic non-specific neck pain. The purpose of the study was to examine the effectiveness of Deep Dry Needling of myofascial trigger points on health-related quality of life improvement, as a secondary analysis, in people with chronic non-specific neck pain. METHODS A randomized parallel-group blinded controlled clinical trial was conducted at a public Primary Health Care Centre in Madrid, Spain, from January 2011 to September 2014. One hundred thirty subjects with chronic non-specific neck pain and active myofascial trigger points in neck muscles were randomly allocated into two groups. Subjects in the intervention group (n = 65) were treated with Deep Dry Needling in active myofascial trigger points plus stretching in neck muscles; Control group (n = 65) received only stretching. Both interventions lasted 2 weeks, 2 sessions per week. Health-related quality of life was measured with Short Form-36 (SF-36), in 5 assessments: at baseline, after intervention period; and at 1, 3 and 6 months after intervention. RESULTS For both groups, SF-36 mean values increased in all dimensions in every assessment. Significant differences (p < 0.05) were found in favor of the intervention group for all dimensions at the last assessment. For some dimensions (physical function, physical role, social function and vitality), the evidence was more consistent from the beginning. CONCLUSIONS Deep Dry Needling plus stretching is more effective than stretching alone for Health-related quality of life improvement, especially for physical function, physical role, social function and vitality dimensions, in people with non-specific neck pain. TRIAL REGISTRATION Current Controlled Trials ISRCTN22726482 . Registered 9 October 2011.
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Affiliation(s)
- Ester Cerezo-Téllez
- Alcalá de Henares University, Physiotherapy in Women's Health Research Group Department of Physiotherapy, Physiotherapy Faculty, University of Alcalá, Carretera Madrid - Barcelona, km 33,600, E-28871 Alcalá de Henares, Madrid, Spain.,Primary Health Care, Alcalá de Henares, Madrid, Spain
| | - María Torres-Lacomba
- Alcalá de Henares University, Physiotherapy in Women's Health Research Group Department of Physiotherapy, Physiotherapy Faculty, University of Alcalá, Carretera Madrid - Barcelona, km 33,600, E-28871 Alcalá de Henares, Madrid, Spain.
| | - Orlando Mayoral-Del-Moral
- Alcalá de Henares University, Physiotherapy in Women's Health Research Group Department of Physiotherapy, Physiotherapy Faculty, University of Alcalá, Carretera Madrid - Barcelona, km 33,600, E-28871 Alcalá de Henares, Madrid, Spain.,Physical Therapy Unit, Provincial Hospital, Toledo, Spain
| | - Soraya Pacheco-da-Costa
- Physical Therapy, Disability and Dependence Research Group, Physical Therapy Department, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - David Prieto-Merino
- Applied Statistical Methods in Medical Research Group, Catholic University of Murcia, UCAM, Murcia, Spain
| | - Beatriz Sánchez-Sánchez
- Alcalá de Henares University, Physiotherapy in Women's Health Research Group Department of Physiotherapy, Physiotherapy Faculty, University of Alcalá, Carretera Madrid - Barcelona, km 33,600, E-28871 Alcalá de Henares, Madrid, Spain
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Kim S, Lee SH, Kim MR, Kim EJ, Hwang DS, Lee J, Shin JS, Ha IH, Lee YJ. Is cupping therapy effective in patients with neck pain? A systematic review and meta-analysis. BMJ Open 2018; 8:e021070. [PMID: 30397006 PMCID: PMC6231582 DOI: 10.1136/bmjopen-2017-021070] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Neck pain is a significant condition that is second only to depression as a cause of years lived with disability worldwide. Thus, identifying and understanding effective treatment modalities for neck pain is of heightened importance. This systematic review aimed to investigate the effects of cupping on neck pain from the current literature. DESIGN Systematic review and meta-analysis of randomised controlled trials (RCTs). SETTING Nine databases, including Chinese, Korean and Japanese databases, were searched for data up to January 2018 with no restrictions on publication language. PARTICIPANTS Patients with neck pain. INTERVENTIONS Cupping therapy as the sole or add-on intervention compared with no treatment or active controls. PRIMARY AND SECONDARY OUTCOME MEASURES Pain severity, functional disability and quality of life. RESULTS Eighteen RCTs were selected. Compared with the no intervention group, the cupping group exhibited significant reduction in pain (mean difference (MD) -2.42(95% CI -3.98 to -0.86)) and improvement in function (MD -4.34(95% CI -6.77 to -1.19)). Compared with the active control, the cupping group reported significant reduction in pain (p=0.0009) and significantly improved quality of life (p=0.001). The group that received control treatment with cupping therapy (add-on group) displayed significant pain reduction compared with the active control group (p=0.001). Of the 18 studies, only 8 reported occurrence of adverse events, which were mostly mild and temporary. CONCLUSIONS Cupping was found to reduce neck pain in patients compared with no intervention or active control groups, or as an add-on treatment. Depending on the type of control group, cupping was also associated with significant improvement in terms of function and quality of life; however, due to the low quality of evidence of the included studies, definitive conclusions could not be drawn from this review. Future well-designed studies are needed to substantiate the effectiveness of cupping on neck pain. PROSPERO REGISTRATION NUMBER CRD42016047218.
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Affiliation(s)
- Seoyoun Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
- Graduate School of Public Health, Korea University, Seoul, Republic of Korea
| | - Sook-Hyun Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Me-Riong Kim
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Eun-Jung Kim
- Department of Acupuncture and Moxibustion, College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Deok-Sang Hwang
- Department of Obstetrics & Gynecology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jinho Lee
- Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea
| | - Joon-Shik Shin
- Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
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The effect of three exercise approaches on health-related quality of life, and factors associated with its improvement in chronic whiplash-associated disorders: analysis of a randomized controlled trial. Qual Life Res 2018; 28:357-368. [PMID: 30225786 PMCID: PMC6373318 DOI: 10.1007/s11136-018-2004-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2018] [Indexed: 01/17/2023]
Abstract
Purpose The aim was to evaluate whether neck-specific exercise, with (NSEB) or without (NSE) a behavioural approach, improves health-related quality of life (HRQoL) compared to physical activity prescription (PPA) in chronic whiplash-associated disorders (WAD) grades 2 and 3. A secondary aim was to identify factors associated with HRQoL and HRQoL improvement following exercise interventions. Methods This is a secondary analysis of a multicentre randomized clinical trial. Participants (n = 216) with chronic WAD grades 2 and 3 were randomized to 12 weeks of PPA or physiotherapist-led NSE or NSEB. The EQ-5D 3L/EQ-VAS and SF-36v2 physical (PCS) and mental (MCS) component summaries were collected together with several neck-related and psychosocial outcomes at baseline, after 3, 6 and 12 months, and were analysed with linear mixed models (all time points) and multivariate linear regressions (baseline, 6 months). Results NSE/NSEB resulted in better outcomes than PPA (EQ-VAS and SF-36 PCS, both groups, p < 0.01) but not in a higher EQ-5D score. Improvement over time was seen in EQ-5D/EQ-VAS for the NSEB group (p < 0.01), and for NSE/NSEB as measured with the PCS (p < 0.01). Factors associated with baseline HRQoL and change to 6 months in HRQoL (R2 = 0.38–0.59) were both neck-related and psychosocial (e.g. depression, work ability). Conclusion Neck-specific exercise, particularly with a behavioural approach, may have a more positive impact on HRQoL than physical activity prescription in chronic WAD grades 2 and 3. HRQoL is however complex, and other factors also need to be considered. Factors associated with HRQL and improvements in HRQoL following exercise are multidimensional. Trial registration number: ClinicalTrials.gov, No. NCT01528579. Electronic supplementary material The online version of this article (10.1007/s11136-018-2004-3) contains supplementary material, which is available to authorized users.
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Sleight AG, Lyons KD, Vigen C, Macdonald H, Clark F. The association of health-related quality of life with unmet supportive care needs and sociodemographic factors in low-income Latina breast cancer survivors: a single-centre pilot study. Disabil Rehabil 2018; 41:3151-3156. [PMID: 30052478 DOI: 10.1080/09638288.2018.1485179] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Purpose: Determine correlations between health-related quality of life (HRQOL), supportive care need, and sociodemographic factors in low-income Latina breast cancer survivors.Methods: A descriptive, survey-based, cross-sectional study was completed with 102 low-income Latina breast cancer survivors at a major public safety net hospital. Correlation coefficients were calculated between number of unmet supportive care needs (per Supportive Care Needs Survey), HRQOL (per SF-36), and sociodemographic variables.Results: Unmet supportive care needs were correlated with lower HRQOL in all domains (r > -0.40; p < 0.0001). Lower income was significantly associated with lower HRQOL (r > 0.21; p < 0.05) and more supportive care needs (r = -0.22; p < 0.05). Multimorbidity was significantly associated with decreased HRQOL (r > -0.23; p < 0.05) and greater supportive care need (r = 0.19; p < 0.05).Conclusions: Identifying and addressing unmet supportive care needs may improve HRQOL in low-income Latina breast cancer survivors. Rehabilitation interventions that address barriers to accessing supportive care related to low SES and multimorbidity may also improve health outcomes in this population. The dual effect of multimorbidity on both quality of life and level of supportive care need in this population warrants further investigation.Implications for rehabilitationScreening for unmet supportive care needs may be an important step in improving health-related quality of life during cancer rehabilitation.Challenges accompanying multimorbidity and lower socioeconomic status may prevent low-income cancer patients from accessing adequate supportive care.Rehabilitation interventions for socioeconomically disadvantaged cancer survivors should compensate for both socioeconomic status and the presence of comorbidities in order to reduce disparities in quality of life during survivorship.
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Affiliation(s)
- Alix G Sleight
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Kathleen Doyle Lyons
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.,Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Cheryl Vigen
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Heather Macdonald
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA.,Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Florence Clark
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
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