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Yang S, Boudier-Revéret M, Yi YG, Hong KY, Chang MC. Treatment of Chronic Neck Pain in Patients with Forward Head Posture: A Systematic Narrative Review. Healthcare (Basel) 2023; 11:2604. [PMID: 37830641 PMCID: PMC10572307 DOI: 10.3390/healthcare11192604] [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: 07/20/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/14/2023] Open
Abstract
(1) Background: Forward head posture (FHP) is one of the most common cervical postural deviations and is characterized by head protrusion or forward head placement in relation to the shoulder in the sagittal plane. Patients with FHP often experience neck pain and disability. The aim of this study was to investigate whether treatment programs are effective in the management of neck pain in patients with FHP. (2) Methods: A MEDLINE (PubMed), Embase, Cochrane Library, and Scopus database search was conducted for English language articles on patients with chronic neck pain and FHP published until 12 April 2023. To identify potentially relevant articles, the following key search phrases were combined: 'forward head posture' and 'pain'. After searching, 2516 potentially relevant articles were identified. After reading the titles and abstracts and assessing their eligibility based on full-text articles, 16 articles were included in this review. (3) Results: Among the 16 studies that investigated the efficacy of treatment programs for managing chronic pain in patients with FHP, 11 investigated the effect of exercise programs, and 5 investigated the effect of manual therapy. Patients reported significant improvement in pain and disability after receiving treatment programs such as corrective postural exercises and special manual therapy techniques. (4) Conclusions: Various treatment programs, including postural corrective exercises and manual therapy, are beneficial for improving pain and disability in patients with FHP.
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Affiliation(s)
- Seoyon Yang
- Department of Rehabilitation Medicine, School of Medicine, Ewha Woman’s University Seoul Hospital, Seoul 07804, Republic of Korea; (S.Y.); (Y.G.Y.)
| | - Mathieu Boudier-Revéret
- Department of Physical Medicine and Rehabilitation, Centre Hospitalier de l’Université de Montréal, Montreal, QC H2X 0A9, Canada;
| | - You Gyoung Yi
- Department of Rehabilitation Medicine, School of Medicine, Ewha Woman’s University Seoul Hospital, Seoul 07804, Republic of Korea; (S.Y.); (Y.G.Y.)
| | - Kee Yong Hong
- Cheonho S Orthopedic Clinic, 1015, Cheonho-daero, Gangdong-du, Seoul 06014, Republic of Korea;
| | - Min Cheol Chang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea
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Plener J, da Silva-Oolup S, To D, Csiernik B, Hofkirchner C, Cox J, Chow N, Hogg-Johnson S, Ammendolia C. Eligibility Criteria of Participants in Randomized Controlled Trials Assessing Conservative Management of Cervical Radiculopathy: A Systematic Review. Spine (Phila Pa 1976) 2023; 48:E132-E157. [PMID: 36730764 DOI: 10.1097/brs.0000000000004537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/13/2022] [Indexed: 02/04/2023]
Abstract
STUDY DESIGN Systematic review. OBJECTIVE The aim of this study was to evaluate the inclusion and exclusion criteria for participants in randomized control trials (RCTs) assessing conservative management for cervical radiculopathy (CR), to determine if any consensus exists within the literature. SUMMARY OF BACKGROUND DATA A 2012 systematic review identified a lack of uniformity for the eligibility criteria of participants in RCTs evaluating conservative interventions for CR. Since then, a large number of RCTs have been published, signaling the need for an updated evaluation of this topic. MATERIALS AND METHODS We electronically searched MEDLINE, CENTRAL, CINAHL, Embase, and PsycINFO from inception to June 15, 2022, to identify RCTs assessing conservative management of CR. Information extracted was analyzed to determine the level of homogeneity and/or heterogeneity of the inclusion and exclusion criteria across studies. RESULTS Seventy-six RCTs met our inclusion criteria with 68 distinct trials identified. The inclusion of arm pain with or without another symptom ( i.e. numbness, paresthesia, or weakness) was required in 69.12% of trials, 50% of trials required participants to exhibit neck symptoms, and 73.53% of studies required some form of clinical examination findings, but inconsistencies existed for the number and type of tests used. Furthermore, 41.18% of trials included imaging, with 33.82% of trials requiring magnetic resonance imaging findings. The most common exclusion criteria included were the presence of red flags and cervical myelopathy in 66.18% and 58.82% of trials, respectively. CONCLUSIONS Overall, there is still a lack of uniformity for the inclusion/exclusion criteria of trials assessing the conservative management of CR, with some improvements noted compared with the 2012 review. Based on the current literature assessing the diagnostic utility of clinical symptoms and confirmatory tests, we proposed inclusion criteria for trials assessing conservative interventions. Future research should aim to develop standardized classification criteria to improve consistency among studies.
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Affiliation(s)
- Joshua Plener
- Division of Graduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sophia da Silva-Oolup
- Division of Graduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Daphne To
- Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Ben Csiernik
- Department of Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | | | - Jocelyn Cox
- Department of Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Ngai Chow
- Private Practice, Toronto, ON, Canada
| | - Sheilah Hogg-Johnson
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Institute for Disability and Rehabilitation Research, Oshawa, ON, Canada
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Carlo Ammendolia
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Mount Sinai Hospital, Toronto, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
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Plener J, Csiernik B, To D, da Silva-Oolup S, Hofkirchner C, Cox J, Cancelliere C, Chow N, Hogg-Johnson S, Ammendolia C. Conservative Management of Cervical Radiculopathy: A Systematic Review. Clin J Pain 2023; 39:138-146. [PMID: 36599029 DOI: 10.1097/ajp.0000000000001092] [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: 08/31/2022] [Accepted: 12/13/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The purpose of this systematic review was to assess the effectiveness and safety of conservative interventions compared with other interventions, placebo/sham interventions, or no intervention on disability, pain, function, quality of life, and psychological impact in adults with cervical radiculopathy (CR). METHODS We searched MEDLINE, CENTRAL, CINAHL, Embase, and PsycINFO from inception to June 15, 2022 to identify studies that were randomized controlled trials, had at least one conservative treatment arm, and diagnosed participants with CR through confirmatory clinical examination and/or diagnostic tests. Studies were appraised using the Cochrane Risk of Bias 2 tool and the quality of the evidence was rated using the Grades of Recommendations, Assessment, Development, and Evaluation approach. RESULTS Of the 2561 records identified, 59 trials met our inclusion criteria (n = 4108 participants). Due to clinical and statistical heterogeneity, the findings were synthesized narratively. There is very-low certainty evidence supporting the use of acupuncture, prednisolone, cervical manipulation, and low-level laser therapy for pain and disability in the immediate to short-term, and thoracic manipulation and low-level laser therapy for improvements in cervical range of motion in the immediate term. There is low to very-low certainty evidence for multimodal interventions, providing inconclusive evidence for pain, disability, and range of motion. There is inconclusive evidence for pain reduction after conservative management compared with surgery, rated as very-low certainty. DISCUSSION There is a lack of high-quality evidence, limiting our ability to make any meaningful conclusions. As the number of people with CR is expected to increase, there is an urgent need for future research to help address these gaps.
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Affiliation(s)
- Joshua Plener
- Division of Graduate Education
- Institute of Health Policy, Management and Evaluation
| | | | | | | | | | | | - Carol Cancelliere
- Institute for Disability and Rehabilitation Research
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | | | - Sheilah Hogg-Johnson
- Department of Research and Innovation, Canadian Memorial Chiropractic College
- Institute of Health Policy, Management and Evaluation
- Dalla Lana School of Public Health
- Institute for Disability and Rehabilitation Research
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Carlo Ammendolia
- Institute of Health Policy, Management and Evaluation
- Department of Surgery, University of Toronto
- Department of Medicine, Mount Sinai Hospital, Toronto
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Mohamed AA. Influence of enhancing dynamic scapular recognition on shoulder disability, and pain in diabetics with frozen shoulder: A case report. World J Clin Cases 2022; 10:12410-12415. [PMID: 36483817 PMCID: PMC9724531 DOI: 10.12998/wjcc.v10.i33.12410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/14/2022] [Accepted: 10/27/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Frozen shoulder (FS) is a familiar disorder. Diabetics with FS have more severe symptoms and a worse prognosis. Thus, this study investigated the influence of enhancing dynamic scapular recognition on shoulder disability and pain in diabetics with FS.
CASE SUMMARY A Forty-five years-old male person with diabetes mellitus and a unilateral FS (stage II) for at least 3 mo with shoulder pain and limitation in both passive and active ranges of motion (ROMs) of the glenohumeral joint of ≥ 25% in 2 directions participated in this study. This person received dynamic scapular recognition exercise was applied to a diabetic person with a unilateral FS (stage II). The main outcome measures were upward rotation of the scapula, shoulder pain and disability index, and shoulder range of motion of flexion, abduction, and external rotation. The dynamic scapular exercise was performed for 15 min/session and 3 sessions/wk lasted for 4 wk. After 4 wk of intervention, there were improvements between pre-treatment and post-treatment in shoulder pain, shoulder pain and disability index, shoulder ROM, and upward rotation of the scapula.
CONCLUSION This case report suggested that enhancing dynamic scapular recognition may improve shoulder pain and disability; upward rotation of the scapula; and shoulder ROM of shoulder abduction, flexion, and external rotation after 4 wk.
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Affiliation(s)
- Ayman A Mohamed
- Basic Sciences Department, Faculty of Physical Therapy, Beni-Suef University, Beni Suef 34522, Egypt
- Basic Sciences Department, Faculty of Physical Therapy, Nahda University, Beni Suef 23146, Egypt
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