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Akkarakittichoke N, Jensen MP, Sitthipornvorakul E, Janwantanakul P. Mediators and moderators of a walking intervention to prevent neck pain among high-risk office workers: a secondary analysis of a randomized controlled trial. Musculoskelet Sci Pract 2024; 71:102939. [PMID: 38547548 DOI: 10.1016/j.msksp.2024.102939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/04/2024] [Accepted: 03/11/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVES To test hypothesized mediators and moderators of the benefits of an app-provided walking intervention for preventing neck pain in high-risk office workers. METHODS Ninety-one office workers at risk for developing neck pain participated in the primary clinical trial. Two hypothesized mediators (the total number of steps taken and the number of days that participants exceed the number of recommended steps) were tested using a smartphone application every month during a 6-month period. Four hypothesized moderators (number of working hours, level of work psychological demands, chair height adjustability, and body mass index) were assessed at baseline. Parallel mediation and moderation analyses were conducted using the Hayes PROCESS macro, model 4 and 1, respectively, with post-hoc Johnson-Neyman techniques. RESULTS The number of days that participants exceeded the recommended steps ‒ the specific number was tailored to each participant, but averaged 7735 steps/day ‒ mediated the benefits of the walking intervention for reducing the risk for neck pain at each of six assessment points (B's range -0.63 to -0.89, all p's < 0.05) over 6-month period. None of the hypothesized moderators evidenced statistically significant moderator effects of the walking intervention. CONCLUSION Workers should walk at rates greater than recommended levels on as many days as possible, rather than attempt to maximize walking within a limited number of days. Given that the walking program studied appeared to be similarly effective across multiple groups of workers, the findings suggest that regular walking can reduce the risk for developing neck pain among high-risk office workers.
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Affiliation(s)
- Nipaporn Akkarakittichoke
- Inter-Department Program of Biomedical Sciences, Faculty of Graduate School, Chulalongkorn University, Bangkok, Thailand.
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
| | - Ekalak Sitthipornvorakul
- Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand.
| | - Prawit Janwantanakul
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
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Wang A, Zhou Y, Li X, Wang W, Zhao X, Chen P, Liao W. Investigating and analyzing the current situation and factors influencing chronic neck, shoulder, and lumbar back pain among medical personnel after the epidemic. BMC Musculoskelet Disord 2024; 25:316. [PMID: 38654285 PMCID: PMC11036770 DOI: 10.1186/s12891-024-07425-x] [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: 07/21/2023] [Accepted: 04/08/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Chronic shoulder and neck pain is one of the most common chronic occupational disorders, with an average incidence rate of 48.5%, severely affecting patients' quality of life and ability to work. According to epidemiological research, the prevalence of chronic neck, shoulder, and low back pain in adults over the age of 45 ranges from 40 to 80%. According to reports, medical staff have a higher incidence rate than other populations, and there is a positive correlation between the grade of the medical institution and the incidence rate, making medical staff a priority group for the prevention of chronic neck, shoulder, and low back pain. By the end of 2022, China has been fully opened to epidemic prevention and control, the total number of patients in domestic hospitals has increased significantly, and resulting in medical personnel shoulting great pressure, which seriously affects the physical and mental health of medical personnel. The aim of this study was to explore the risk factors of chronic neck, shoulder and lumbar back pain in medical staff. To provide guidelines for medical staff to improve cervical and lumbar subacute pain and reduce the emergence of spinal lesions. METHODS From January to February 2023, 602 staff members of a third-grade hospital in Zunyi City were studied by Questionnaire star. Univariate and multivariate Logistic regression were used to analyze the independent risk factors of chronic neck, shoulder and lumbar back pain in medical staff, with stepwise regression utilized to choose the optimum model. The model was selected using Akaike's information criterion (AIC) and the Hosmer-Lemeshow goodness-of-fit test. RESULTS A total of 602 medical staff were polled, and the findings revealed that 588 cases of chronic neck, shoulder, and low back pain of varied severity had occurred in the previous 1 to 2 years, with a 97.7% incidence rate; logistic regression analysis revealed that anxiety level, frequency of bending over in the previous 1 to 2 years, whether related preventive measures were taken at work, gender, positive senior title, daily ambulation time, and whether the department they worked in organized independent influencing factors. CONCLUSION The incidence of chronic neck, shoulder, and lumbar back pain among medical staff is high; its influencing factors are different and have not been systematically identified. Hospitals should take effective measures tailored to local conditions to improve the physical and mental health of medical staff.
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Affiliation(s)
- Ansu Wang
- Department of Orthopedics, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China.
| | - Yufeng Zhou
- Department of Orthopedics, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
| | - Xuyan Li
- Department of Orthopedics, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
| | - Weiqun Wang
- Department of Orthopedics, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
| | - Xu Zhao
- Department of Orthopedics, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
| | - Ping Chen
- Department of Orthopedics, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
| | - Wenbo Liao
- Department of Orthopedics, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China.
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Nejadghaderi SA, Mousavi SE, Sullman MJM, Kolahi A, Namazi Shabestari A, Safiri S. The burden of neck pain among adults aged 70 years and older in Iran, 1990-2019. Health Sci Rep 2023; 6:e1477. [PMID: 38028676 PMCID: PMC10630745 DOI: 10.1002/hsr2.1477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/10/2023] [Accepted: 07/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Neck pain is a complex musculoskeletal disorder that can result in substantial morbidity. The present article presents the neck pain burden in Iranians who were at least 70 years old, from 1990 to 2019, by sex, age group, and province. Methods Publicly available information on the prevalence, incidence, and years lived with disability (YLD) caused by neck pain was extracted from the Global Burden of Disease study 2019. The estimates were all provided as counts and age-standardized rates (per 100,000), and included 95% uncertainty intervals. Results The point prevalence of neck pain in 2019 was 8710.6, while the incidence rate was 1334.7 per 100,000 population. That same year, there were number of 27.8 thousand YLDs and an YLD rate of 801.7 per 100,000. The prevalence, incidence, and YLD rates did not change substantially over the measurement period (1990-2019). The highest YLD rate was found in Tehran (960.9 per 100,000), while Kohgiluyeh and Boyer-Ahmad had the lowest (730.5 per 100,000). Females had slightly higher prevalent cases, incident cases, and YLDs, as well as their corresponding rates in 2019. In 2019, the number of prevalent cases, incident cases, and YLDs peaked in the 70-74 age group, for both sexes, and in all cases they reduced with age. In both 1990 and 2019, Iran had a higher YLD rate than that found among elderly adults in the Middle East and North Africa region. Conclusions The burden of neck pain in Iran has decreased slightly over the last three decades, but it still imposes a substantial burden and is higher than that found in the rest of the region. Therefore, preventive programs should be initiated at a young age to reduce the attributable burden later in life.
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Affiliation(s)
- Seyed Aria Nejadghaderi
- Student's Scientific Research Center (SSRC)Tehran University of Medical SciencesTehranIran
- Neurosciences Research Center, Aging Research InstituteTabriz University of Medical SciencesTabrizIran
- Systematic Review and Meta‑Analysis Expert Group (SRMEG)Universal Scientific Education and Research Network (USERN)TehranIran
| | - Seyed Ehsan Mousavi
- Neurosciences Research Center, Aging Research InstituteTabriz University of Medical SciencesTabrizIran
| | - Mark J. M. Sullman
- Department of Life and Health SciencesUniversity of NicosiaNicosiaCyprus
- Department of Social SciencesUniversity of NicosiaNicosiaCyprus
| | - Ali‐Asghar Kolahi
- Social Determinants of Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | | | - Saeid Safiri
- Neurosciences Research Center, Aging Research InstituteTabriz University of Medical SciencesTabrizIran
- Clinical Research Development Unit of Tabriz Valiasr HospitalTabriz University of Medical SciencesTabrizIran
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Teichert F, Karner V, Döding R, Saueressig T, Owen PJ, Belavy DL. Effectiveness of Exercise Interventions for Preventing Neck Pain: A Systematic Review With Meta-analysis of Randomized Controlled Trials. J Orthop Sports Phys Ther 2023; 53:594–609. [PMID: 37683100 DOI: 10.2519/jospt.2023.12063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
OBJECTIVE: To update the evidence on the effectiveness of exercise interventions to prevent episodes of neck pain. DESIGN: Systematic review with meta-analysis. LITERATURE SEARCH: MEDLINE, Embase, CENTRAL, CINAHL, SPORTDiscus, PEDro, and trial registries from inception to December 2, 2022. Forward and backward citation searches. STUDY SELECTION CRITERIA: Randomized controlled trials (RCTs) that enrolled adults without neck pain at baseline and compared exercise interventions to no intervention, placebo/sham, attention control, or minimal intervention. Military populations and astronauts were excluded. DATA SYNTHESIS: Random-effects meta-analysis. Risk of bias was assessed using the Cochrane RoB 2 tool. The certainty of evidence was judged according to the GRADE approach. RESULTS: Of 4703 records screened, 5 trials (1722 participants at baseline) were included and eligible for meta-analysis. Most (80%) participants were office workers. Risk of bias was rated as some concerns for 2 trials and high for 3 trials. There was moderate-certainty evidence that exercise interventions probably reduce the risk of a new episode of neck pain (OR, 0.49; 95% confidence interval: 0.31, 0.76) compared to no or minimal intervention in the short-term (≤12 months). The results were not robust to sensitivity analyses for missing outcome data. CONCLUSION: There was moderate-certainty evidence supporting exercise interventions for reducing the risk for an episode of neck pain in the next 12 months. The clinical significance of the effect is unclear. J Orthop Sports Phys Ther 2023;53(10):1-16. Epub: 8 September 2023. doi:10.2519/jospt.2023.12063.
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Affiliation(s)
- Florian Teichert
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
| | - Vera Karner
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
| | - Rebekka Döding
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
| | | | - Patrick J Owen
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Daniel L Belavy
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
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Barbosa JC, Comachio J, Marques AP, Saragiotto BT, Magalhaes MO. Effect of a telerehabilitation exercise program versus a digital booklet with self-care for patients with chronic non-specific neck pain: a protocol of a randomized controlled trial assessor-blinded, 3 months follow-up. Trials 2023; 24:616. [PMID: 37770963 PMCID: PMC10537532 DOI: 10.1186/s13063-023-07651-z] [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: 10/06/2022] [Accepted: 09/13/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Neck pain is the fourth worldwide leading cause of disability and represents 22% of musculoskeletal disorders. Conservative intervention has been strongly recommended to treat chronic neck pain and Telerehabilitation is the alternative for the treatment of musculoskeletal conditions. There is a lack of high-quality research on the effects of telerehabilitation in patients with neck pain and functional disability. Therefore, this study aims to evaluate the effect of a telerehabilitation exercise program versus a digital booklet only with self-care information in individuals with non-specific chronic neck pain. METHODS This is a prospectively registered, assessor-blinded, two-arm randomized controlled trial comparing a telerehabilitation exercise program versus a digital booklet with self-care information. Seventy patients will be recruited with non-specific chronic neck pain. Follow-ups will be conducted post-treatment, 6 weeks, and 3 months after randomization. The primary outcome will be disability at post-treatment (6 weeks) measured using neck pain disability. Secondary outcomes will be pain intensity levels, global perceived effect, self-efficacy, quality of life, kinesiophobia, and adherence to treatment. In our hypothesis, patients allocated to the intervention group experience outcomes that are similar to those of those assigned to the self-care digital booklet. Our hypothesis can then be approved or disapproved based on the results of the study. DISCUSSION This randomized clinical trial will provide reliable information on the use of telerehabilitation to treat patients with chronic non-specific neck pain. TRIAL REGISTRATION The study was prospectively registered at the Brazilian Registry of Clinical Trials (number: RBR-10h7khvk). Registered on 16 September 2022.
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Affiliation(s)
- Juliene Corrêa Barbosa
- Master's Program in Human Movement Sciences, Federal University of Pará, Belém-Pará, 66050-160, Brazil
| | - Josielli Comachio
- School of Health Sciences, Faculty of Medicine and Health, Sydney Musculoskeletal HealthCharles Perkins CentreUniversity of Sydney, Sydney, NSW, 2009, Australia
| | - Amelia Pasqual Marques
- Department of Physiotherapy, Speech-Language Pathology and Audiology and Occupational Therapy, Faculty of Medicine, University of São Paulo, Rehabilitation Sciences Program, São Paulo, 05360-160, Brazil
| | - Bruno Tirotti Saragiotto
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São, Paulo, São Paulo, 03071-000, Brazil
- Discipline of Physiotherapy, Graduate School of Health, University of Technology, Sydney, Sydney, Australia
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Barati Jozan MM, Ghorbani BD, Khalid MS, Lotfata A, Tabesh H. Impact assessment of e-trainings in occupational safety and health: a literature review. BMC Public Health 2023; 23:1187. [PMID: 37340453 DOI: 10.1186/s12889-023-16114-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 06/13/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Implementing workplace preventive interventions reduces occupational accidents and injuries, as well as the negative consequences of those accidents and injuries. Online occupational safety and health training is one of the most effective preventive interventions. This study aims to present current knowledge on e-training interventions, make recommendations on the flexibility, accessibility, and cost-effectiveness of online training, and identify research gaps and obstacles. METHOD All studies that addressed occupational safety and health e-training interventions designed to address worker injuries, accidents, and diseases were chosen from PubMed and Scopus until 2021. Two independent reviewers conducted the screening process for titles, abstracts, and full texts, and disagreements on the inclusion or exclusion of an article were resolved by consensus and, if necessary, by a third reviewer. The included articles were analyzed and synthesized using the constant comparative analysis method. RESULT The search identified 7,497 articles and 7,325 unique records. Following the title, abstract, and full-text screening, 25 studies met the review criteria. Of the 25 studies, 23 were conducted in developed and two in developing countries. The interventions were carried out on either the mobile platform, the website platform, or both. The study designs and the number of outcomes of the interventions varied significantly (multi-outcomes vs. single-outcome). Obesity, hypertension, neck/shoulder pain, office ergonomics issues, sedentary behaviors, heart disease, physical inactivity, dairy farm injuries, nutrition, respiratory problems, and diabetes were all addressed in the articles. CONCLUSION According to the findings of this literature study, e-trainings can significantly improve occupational safety and health. E-training is adaptable, affordable, and can increase workers' knowledge and abilities, resulting in fewer workplace injuries and accidents. Furthermore, e-training platforms can assist businesses in tracking employee development and ensuring that training needs are completed. Overall, this analysis reveals that e-training has enormous promise in the field of occupational safety and health for both businesses and employees.
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Affiliation(s)
- Mohammad Mahdi Barati Jozan
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Md Saifuddin Khalid
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Aynaz Lotfata
- School Of Veterinary Medicine, Department Of Veterinary Pathology, University of California, Davis, USA
| | - Hamed Tabesh
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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7
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Gorgon E, Maka K, Sullivan J, Nisbet G, Hancock M, Regan G, Leaver A. Redesigning care for back pain in an Australian hospital setting: A service evaluation to identify need for change. Musculoskeletal Care 2023; 21:232-243. [PMID: 36069172 DOI: 10.1002/msc.1695] [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: 08/26/2022] [Accepted: 08/31/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This needs assessment study examined current processes of physiotherapy care for adults with back pain in a large teaching hospital serving a multicultural community in Sydney, Australia. Evaluation of current practices is a necessary first step in the design of a patient-centred, multidisciplinary service that promotes best practice in back pain management. METHODS We conducted a retrospective service evaluation in the physiotherapy outpatient department by reviewing clinical data on episode of care and processes of care for adults managed for back pain over a 6-month period using a defined protocol (n = 252). RESULTS Patients (median age = 56 years; 72.2% born outside of Australia) were referred from various internal and external sources, with 79.8% having chronic back pain. The median length of episode of care was 8 weeks. Active interventions were almost universally used (98.4% of records). Key aspects of assessment were frequently recorded (84.5%-98% of records), but psychosocial risk assessment was not routinely recorded. Aspects of longitudinal management planning, including goal setting, outcome measurement, and routine follow-up, were also not routinely recorded. CONCLUSIONS This study demonstrated that physiotherapy processes of care in this setting followed key messages of best practice particularly with regard to interventions, in contrast to other settings and jurisdictions. However, the brief episodes of care and less evident focus on psychosocial aspects might not align with the needs of the majority with chronic back pain. These findings suggest the need to reframe processes of care with a biopsychosocial approach and structure episodes of care towards long-term management solutions.
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Affiliation(s)
- Edward Gorgon
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Physical Therapy, University of the Philippines Manila, Manila, Philippines
| | - Katherine Maka
- Western Sydney Local Health District, New South Wales Health, Sydney, New South Wales, Australia
| | - Justin Sullivan
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Gillian Nisbet
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Michelle Hancock
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Gerard Regan
- Western Sydney Local Health District, New South Wales Health, Sydney, New South Wales, Australia
| | - Andrew Leaver
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Araújo LMC, Guimarães-do-Carmo VJ, Andrade TGVS, Claudino SC, Soares DM, Melo RS. Musculoskeletal pain and quality of life in mothers of children with microcephaly, due to congenital Zika virus syndrome. Child Care Health Dev 2023; 49:268-280. [PMID: 35959527 DOI: 10.1111/cch.13039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/07/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study is to observe the prevalence and intensity of musculoskeletal pain and the quality of life in mothers of children with microcephaly and also to compare the scores of the quality of life domains between mothers who had or did not have musculoskeletal pain. METHODS This is a cross-sectional study that evaluated mothers of children with a clinical diagnosis of microcephaly, due to congenital Zika virus syndrome, in the state of Pernambuco, northeast region, Brazil. To assess musculoskeletal pain, the Nordic Questionnaire of Musculoskeletal Symptoms was used, pain intensity was assessed by the Visual Analogue Scale and quality of life by the SF-36 Questionnaire. RESULTS Of the 63 mothers evaluated, 59 (93.7%) reported currently experiencing musculoskeletal pain. The lumbar spine was the body region with the highest prevalence of pain (77.8%), followed by the thoracic spine (57.1%) and cervical spine (50.8%). Pain intensity was higher in the lumbar spine (6.00 ± 0.47), thoracic spine (4.44 ± 0.52) and shoulders (3.81 ± 0.51). The domains that presented the lowest scores in the quality of life assessment were general health status (49.0 ± 3.19), emotional aspects (49.7 ± 5.88) and pain (49.7 ± 2.50). Mothers who had musculoskeletal pain had lower scores in all domains of quality of life assessment compared to mothers who did not have pain, demonstrating significant differences for functional capacity (P = 0.035), physical aspects (P = 0.047) and pain (P = 0.002). CONCLUSION A high prevalence of musculoskeletal pain was observed in mothers of children with microcephaly, with a higher prevalence and intensity in the lumbar spine. The domains related to physical and emotional health presented the worst scores in the quality of life of the evaluated mothers and the presence of musculoskeletal pain reduced the quality of life of the mothers of children with microcephaly in this study.
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Affiliation(s)
| | | | | | | | - Diego Moura Soares
- Department of Dentistry, Faculdade Pernambucana de Saúde (FPS), Recife, Brazil
| | - Renato S Melo
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.,Laboratory of Pediatric Studies, (LEPed), Universidade Federal de Pernambuco (UFPE), Recife, Brazil
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Comparison of neural mobilization and conservative treatment on pain, range of motion, and disability in cervical radiculopathy: A randomized controlled trial. PLoS One 2022; 17:e0278177. [PMID: 36472990 PMCID: PMC9725158 DOI: 10.1371/journal.pone.0278177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/12/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The objective of the study was to compare the effectiveness of neural mobilization technique with conservative treatment on pain intensity, cervical range of motion, and disability. METHODS It was a randomized clinical trial; data was collected from Mayo Hospital, Lahore. Eighty-eight patients fulfilling the sample selection criteria were randomly assigned into group 1 (neural mobilization) and group 2 (conventional treatment). Pain intensity was measured on a numeric pain rating scale, range of motion with an inclinometer, and functional status with neck disability index (NDI). Data were analyzed using SPSS, repeated measure ANOVA for cervical ranges and the Friedman test for NPRS and NDI were used for within-group analysis. Independent samples t-test for cervical ranges and Mann-Whitney U test for NPRS and NDI were used for between-group comparisons. RESULTS There was a significant improvement in pain, disability, and cervical range of motion after the treatment in both groups compared to the pre-treatment status (p < 0.001), and when both groups were compared neural mobilization was more effective than conventional treatment in reducing pain and neck disability (p < 0.001), but there was no significant difference present in the mean score of cervical range of motion between both groups. (p>0.05). CONCLUSIONS The present study concluded that both neural mobilization and conservative treatment were effective as an exercise program for patients with cervical radiculopathy, however, neural mobilization was more effective in reducing pain and neck disability in cervical radiculopathy. TRIAL REGISTRATION RCT20190325043109N1.
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10
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Bezerra LMR, Melo TMDS, Gomes VMDSA, Pas RCD, Alves LIDN, Salemi MDM, Silva IR, Tenório ADS, Siqueira GRD. Home exercises for neck pain: A Delphi survey. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2022; 28:e1982. [PMID: 36373555 DOI: 10.1002/pri.1982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 03/10/2022] [Accepted: 10/09/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE The current context of the COVID-19 pandemic has demonstrated the need for home exercise strategies for the relief of neck pain, which, in recent times, has increased. However, there is a gap regarding home exercises that are aimed at reducing neck pain. Therefore, the aim of this study was to develop, validate and culturally adapt a home exercise protocol for neck pain. METHODS This was an observational study conducted in three stages: (1) Developing an online search of databases for articles on neck pain exercises. (2) Validating a panel of 12 physical therapists, using the Delphi technique, and (3) Cultural adaptation, through face-to-face assessment with individuals aged 18-30 years with neck pain (n = 15). This resulted in the production of a final version of the protocol. Consensus on the protocol items (using the five-point Likert scale) was considered when the percent agreement was equal to or greater than 75%. Individuals were also asked about pain intensity during the last week before and after performing the protocol. RESULTS A protocol was developed with the principles of neck and scapular stabilization and upper limb movements, for a period of 4 weeks. Nine physical therapists completed two rounds online, and all items in the second version of the protocol presented an agreement of over 75%. The protocol was culturally adapted by the target population, in which 73% of individuals presented pain reduction with a minimally clinically important difference. CONCLUSION A 4-week home exercise protocol was created based on the best evidence in the literature, was validated by physical therapists and adapted for the population with neck pain. It proved to be an understandable, useful, practical and convenient tool in the treatment of this disorder and demonstrated an improvement in neck pain. CLINICALTRIALS GOV: (NCT04187001).
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Affiliation(s)
| | - Thania Maion de Souza Melo
- Physical Therapy Department Health Sciences Center Federal University of Pernambuco Recife Pernambuco Brazil
| | | | - Ray Cosme da Pas
- Physical Therapy Department Health Sciences Center Federal University of Pernambuco Recife Pernambuco Brazil
| | | | - Marianna de Melo Salemi
- Physical Therapy Department Health Sciences Center Federal University of Pernambuco Recife Pernambuco Brazil
| | - Iditácylla Reis Silva
- Physical Therapy Department Health Sciences Center Federal University of Pernambuco Recife Pernambuco Brazil
| | - Angélica da Silva Tenório
- Physical Therapy Department Health Sciences Center Federal University of Pernambuco Recife Pernambuco Brazil
| | - Gisela Rocha de Siqueira
- Physical Therapy Department Health Sciences Center Federal University of Pernambuco Recife Pernambuco Brazil
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Wei J, Chen L, Huang S, Li Y, Zheng J, Cheng Z, Xie Z. Time Trends in the Incidence of Spinal Pain in China, 1990 to 2019 and Its Prediction to 2030: The Global Burden of Disease Study 2019. Pain Ther 2022; 11:1245-1266. [PMID: 35969366 PMCID: PMC9633916 DOI: 10.1007/s40122-022-00422-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND With increasing life expectancy in China, the associated burden of low back and neck pain (spinal pain) on the healthcare system increases, posing a substantial public health challenge. This study aimed to investigate trends in spinal pain incidence across China from 1990 to 2019 and to predict incidence trends between 2020 and 2030. METHODS Data were derived from the Global Burden of Disease Study (GBD) 2019. The annual percentage change (APC) and average annual percentage change (AAPC) between 1990 and 2019 were calculated using Joinpoint regression analysis. The effects of age, period, and cohort on spinal pain were estimated by an age-period-cohort model. An autoregressive integrated moving average (ARIMA) model was used to forecast incidence trends from 2020 to 2030. RESULTS From 1990 to 2019, the age-standardized incidence rate (ASIR) of low back pain (LBP) significantly decreased in both male and female subjects, while the ASIR of neck pain (NP) slightly increased regardless of sex. Joinpoint regression analysis showed that the incidence rates of LBP decreased in all age groups, and incidence rates of NP increased after 45 years old among men and women. The age effects showed that the relative risks (RR) of LBP incidence increased with age, and the group aged 40-49 years had the highest RR for NP incidence, regardless of sex. Period effects showed that the risk of NP continuously increased with increasing time periods, but not in LBP. The cohort effect showed a continuously decreasing trend in later birth cohorts. The prediction results of the ARIMA model show that the ASIR of NP in both male and female subjects in China shows an increasing trend in the next 10 years, and the ASIR of LBP increased in male but decreased in female subjects. CONCLUSION Spinal pain has remained a major public health burden over the past 30 years in China and will likely increase further with population aging. Therefore, spinal pain should be a priority for future research on prevention and therapy, and is especially critical as the aging population increases in China.
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Affiliation(s)
- Jiehua Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Shengbin Huang
- Department of Orthopedics, Guigang People's Hospital, Guigang, 537100, Guangxi, China
| | - Ying Li
- Department of Orthopedics, Guigang People's Hospital, Guigang, 537100, Guangxi, China
| | - Jingmao Zheng
- Department of Orthopedics, Guigang People's Hospital, Guigang, 537100, Guangxi, China
| | - Zhilin Cheng
- Department of Orthopedics, Guigang People's Hospital, Guigang, 537100, Guangxi, China
| | - Zhaolin Xie
- Department of Orthopedics, Guigang People's Hospital, Guigang, 537100, Guangxi, China.
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12
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Khan ZK, Ahmed SI, Baig AAM, Farooqui WA. Effect of post-isometric relaxation versus myofascial release therapy on pain, functional disability, rom and qol in the management of non-specific neck pain: a randomized controlled trial. BMC Musculoskelet Disord 2022; 23:567. [PMID: 35698187 PMCID: PMC9190112 DOI: 10.1186/s12891-022-05516-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 06/03/2022] [Indexed: 12/24/2022] Open
Abstract
Background Non-specific neck pain is the most prevailing musculoskeletal disorder which has a large socioeconomic burden worldwide. It is associated with poor posture and neck strain which may lead to pain and restricted mobility. Physical therapists treat such patients through several means. Post isometric relaxation and Myofascial release therapy are used in clinical practice with little evidence to be firmed appropriately. So, this study was conducted to explore the effect of Post-isometric relaxation in comparison to Myofascial release therapy for patients having non-specific neck pain. Methodology Sixty patients were randomly allocated to Post isometric group and the Myofascial group. The treatment period was of 2 weeks. All the patients were evaluated using the Visual analogue scale (VAS), Neck disability index (NDI), Universal Goniometer, and WHO BREF Quality of life-100 in the 1st and 6th sessions. Recorded data was entered on SPSS 21. Data were examined using two-way repeated ANOVA to measure the variance of analysis (group x time). Results Analysis of the baseline characteristics revealed that both groups were homogenous in terms of age and gender i.e. a total of 60 participants were included in this research study 30 in each group. Out of 60 patients, there were 20(33.3%) males and 40(66.7%) females with a mean age of 32.4(5.0) years. Participants in the Post Isometric group demonstrated significant improvements (p < 0.025) in VAS, NDI, Cervical Extension, left side rotation ranges, and QoL (Social Domain) at the 2-week follow-up compared with those in the Myofascial group. In addition, the Myofascial group indicated significantly better improvement in the mean score of CROM (flexion and right and left side bending). Conclusion The study demonstrated patients with nonspecific neck pain can benefit from the post isometric relaxation with significant improvement in pain, disability, cervical ROM, and Quality of life compared with myofascial release therapy. Trial registration Clinical Trial registered on clinicaltrial.gov (NCT number) NCT04638062, 20/11/2020 (prospectively registered).
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Affiliation(s)
- Zainab Khalid Khan
- Institute of Physical Medicine and Rehabilitation, Dow University of Health Sciences, Karachi, Pakistan.
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13
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Özel M, Kaya Ciddi P. The effectiveness of telerehabilitation-based structured exercise therapy for chronic nonspecific neck pain: A randomized controlled trial. J Telemed Telecare 2022:1357633X221095782. [PMID: 35570728 DOI: 10.1177/1357633x221095782] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The aim of this research was to investigate the effects of telerehabilitation-based remote supervised or unsupervised structured exercise therapy on pain, disability, and quality of life related to chronic nonspecific neck pain. METHOD The study was designed as a single-blinded randomized controlled trial. Sixty-six eligible chronic nonspecific neck pain patients were randomized across three groups: remote supervised group (RSG, n = 22), unsupervised group (UG, n = 22), and waitlist control group (CG, n = 22). Progressive structured exercise therapy program was delivered weekly to patients in remote supervised group and unsupervised group to perform four days a week for four weeks. Remote supervised group was supervised by videoconference and text message. Pain, disability, and quality of life of participants were assessed at baseline, week 2, and post-therapy. RESULTS Post-therapy pain and disability total change scores were -3.64 (95% CI -4.85 to -2.42) and -7.27 (95% CI -11.05 to -3.50) for remote supervised group compared with a change of -2.44 (95% CI -3.46 to -1.43) and -5.77 (95% CI -8.54 to -3.01) for unsupervised group, respectively. Post-therapy, quality of life improvements were greater for remote supervised group than unsupervised group overall (general health; remote supervised group: 19.01 (95% CI 6.86 to 31.16), unsupervised group: 12.50 (95% CI 4.79 to 20.21), and physical health; remote supervised group: 18.35 (95% CI 10.35 to 26.35), unsupervised group: 7.31 (95% CI 0.01 to 14.60)). Significant improvements in psychological health and environment-telerehabilitation for remote supervised group were not seen for unsupervised group and outcomes differences did not reach significance for control group (p > 0.05) post-therapy, except environment-telerehabilitation. DISCUSSION Structured exercise therapy can improve chronic nonspecific neck pain outcomes when remotely supervised or unsupervised. Structured exercise therapy content and frequent communication are important for remote chronic nonspecific neck pain management.
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Affiliation(s)
- Merve Özel
- Physiotherapy and Rehabilitation Department, Medipol University, Health Sciences Institute, Istanbul, Turkey
| | - Pınar Kaya Ciddi
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, 218502Istanbul Medipol University, Istanbul, Turkey
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14
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Characteristics of office workers who benefit most from interventions for preventing neck and low back pain: a moderation analysis. Pain Rep 2022; 7:e1014. [PMID: 35620247 PMCID: PMC9128793 DOI: 10.1097/pr9.0000000000001014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/15/2022] [Accepted: 04/20/2022] [Indexed: 11/27/2022] Open
Abstract
Number of working hours, work-related psychological demands, and use of lumbar support moderate the beneficial effects of preventive interventions for neck and low back pain. Introduction: Neck and low back pain are significant health problem in sedentary office workers. Active break and postural shift interventions has been proved to reduce the incidence of new onset of both neck and low back pain. Objectives: To identify variables that moderate the effects of active breaks and postural shift interventions on the development of neck and low back pain in office workers. Methods: Using data from a 3-arm (active break, postural shift, and control group) cluster randomized controlled trial (N = 193), we evaluated the moderating effects of age, job position, education level, sex, perceived psychological work demands, number of working hours, and using a chair with lumbar support on the benefits of 2 interventions designed to prevent the development of neck and low back pain in office workers. Moderation analyses were conducted using the Hayes PROCESS macro, with post hoc Johnson–Neyman techniques and logistic regressions. Results: Significant interactions between intervention groups and 3 moderators assessed at baseline emerged. For the prevention of neck pain, the effect of the active break intervention was moderated by the number of working hours and the effect of the postural shift intervention was moderated by the level of perceived psychological work demands and the number of working hours. For the prevention of low back pain, the effect of postural shift intervention was moderated by having or not having a chair with lumbar support. Conclusions: The study findings can be used to help determine who might benefit the most from 2 treatments that can reduce the risk of developing neck and low back pain in sedentary workers and may also help us to understand the mechanisms underlying the benefits of these interventions.
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15
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Schäfer AGM. [Innovative interventions in pain physiotherapy : Advancing care for people with chronic pain]. Schmerz 2022; 36:248-255. [PMID: 35301593 DOI: 10.1007/s00482-022-00631-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/22/2022] [Accepted: 01/31/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Chronic pain, with a prevalence of at least 17%, is a costly health problem associated with a high burden of disease. Musculoskeletal chronic pain is particulary common, which in many cases is treated with physiotherapy. AIM The aim of this paper is to provide an overview of innovative, promising physiotherapy interventions in pain management, to present their effectiveness and to discuss their implementation in healthcare. METHODS A narrative review was conducted. The Cochrane, Medline (via PubMed) and PEDro databases were searched using the search terms chronic pain, physiotherapy, prevention, pain education, behavioural intervention, eHealth, and systematic review as well as chronic pain, guideline and relevant synonyms. RESULTS One guideline review, two guidelines and ten systematic reviews were included. Chronic pain prevention, digital health apps, lifestyle interventions and behavioural approaches were identified as promising and effective interventions for people with chronic pain, showing the potential to meaningfully complement pain physiotherapy and improve quality of care. CONCLUSIONS Despite the predominantly positive results from systematic reviews, implementation in everyday care is difficult due to conditions of care and the contemporary education system for physiotherapists in Germany. Health services research can play an important role in accelerating the transfer of innovations into practice.
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Affiliation(s)
- Axel Georg Meender Schäfer
- Fakultät Soziale Arbeit und Gesundheit, Hochschule für angewandte Wissenschaft und Kunst, Goschentor 1, 31134, Hildesheim, Deutschland.
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16
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Ireland J, Window P, O'Leary SP. The impact of exercise intended for fitness or sport on the prevalence of non-specific neck pain in adults: A systematic review. Musculoskeletal Care 2021; 20:229-244. [PMID: 34586706 DOI: 10.1002/msc.1592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This study systematically reviewed the literature investigating the relationship between participation in exercise intended to improve fitness or sport and the prevalence of non-specific neck pain in adults. A secondary objective evaluated if exercise characteristics (frequency, and total duration of weekly exercise) impacted any observed relationship between this form of exercise and neck pain prevalence. DESIGN Narrative systematic review. LITERATURE SEARCH Six databases including Pubmed/Medline, Scopus, EMBASE, SPORTDiscus, CINAHL, and the Cochrane Library were searched from their inception up to April 2021. STUDY SELECTION CRITERIA Studies were deemed eligible if they investigated the relationship between exercise participation and prevalence of non-specific neck pain. Only full-text, cross-sectional and longitudinal studies in an adult population were included. DATA SYNTHESIS Due to heterogeneity of characteristics in the included studies, a meta-analysis was not deemed feasible. Data were synthesised using narrative synthesis with subgroup analysis of exercise themes including frequency, and total weekly duration. RESULTS Fair to good quality evidence from eight studies indicated that regular participation in exercise intended for fitness or sport was associated with a reduced prevalence of neck pain in adults. Three cross-sectional studies reported a positive relationship between greater weekly exercise duration and reduced neck pain prevalence. CONCLUSION The results of this review provide preliminary evidence of a potential protective effect of participation in exercise intended for fitness or sport on the prevalence of non-specific neck pain in the community. This protective relationship appeared to be stronger when exercise was undertaken for a greater total weekly duration.
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Affiliation(s)
- Josh Ireland
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Peter Window
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Shaun P O'Leary
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia.,Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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17
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Morze J, Rücker G, Danielewicz A, Przybyłowicz K, Neuenschwander M, Schlesinger S, Schwingshackl L. Impact of different training modalities on anthropometric outcomes in patients with obesity: A systematic review and network meta-analysis. Obes Rev 2021; 22:e13218. [PMID: 33624411 PMCID: PMC8244024 DOI: 10.1111/obr.13218] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/08/2021] [Accepted: 01/15/2021] [Indexed: 12/15/2022]
Abstract
Obesity management guidelines consistently advise aerobic training for weight loss, whereas recommendations for other training modalities are sparse. This systematic review and network meta-analysis (NMA) aimed to compare the long-term effects of different training modalities on anthropometric outcomes in patients with obesity. MEDLINE, Cochrane CENTRAL, and Web of Science were searched to identify the following: (1) randomized controlled trials (RCTs); (2) conducted in adults with a mean body mass index (BMI) ≥30 kg/m2 ; (3) comparing aerobic, resistance, combined, or high-intensity interval training head-to-head or to control for ≥6 months; and (4) reporting changes in body weight (BW), BMI, waist circumference (WC), fat mass (FM), or fat-free mass (FFM). Random-effects NMA models were fitted in a frequentist approach. GRADE framework was used to assess certainty of evidence. Thirty-two RCTs with 4774 participants with obesity were included in this review. Aerobic training was ranked as best for improving BW, BMI, and WC and combined training for improving FM, as well as equally with resistance training most effective for improving FFM. Low to moderate certainty of evidence supports use of aerobic training to improve anthropometric outcomes in obesity, and its combination with resistance training provides additional benefit for reducing FM and increasing FFM.
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Affiliation(s)
- Jakub Morze
- Department of Cardiology and Internal Diseases, University of Warmia and Mazury, Olsztyn, Poland.,Department of Human Nutrition, University of Warmia and Mazury, Olsztyn, Poland
| | - Gerta Rücker
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anna Danielewicz
- Department of Human Nutrition, University of Warmia and Mazury, Olsztyn, Poland
| | | | - Manuela Neuenschwander
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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18
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Abadiyan F, Hadadnezhad M, Khosrokiani Z, Letafatkar A, Akhshik H. Adding a smartphone app to global postural re-education to improve neck pain, posture, quality of life, and endurance in people with nonspecific neck pain: a randomized controlled trial. Trials 2021; 22:274. [PMID: 33845880 PMCID: PMC8042925 DOI: 10.1186/s13063-021-05214-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 03/20/2021] [Indexed: 11/10/2022] Open
Abstract
Background In this study, the effect of adding a smartphone app to an 8-week global postural reeducation (GPR) on neck pain, endurance, quality of life, and forward head posture (FHP) in patients with chronic neck pain and FHP was evaluated. Methods Sixty male and female office workers (38.5 ± 9.1 years) with chronic neck pain were randomly assigned into three groups: group 1 (GPR+ a smartphone app, n = 20), group 2 (GPR alone, n = 20), and group 3 (the control group, n = 20). The primary outcome was pain and the secondary outcomes were disability, quality of life, endurance, and posture. Pain, disability, endurance, quality of life, and posture were evaluated using the visual analog scale (VAS), neck disability index (NDI), progressive iso-inertial lifting evaluation (PILE) test, quality of life questionnaire (SF-36), and photogrammetry, respectively, at pre-and post-8-week interventions. A one-way analysis of covariance (ANCOVA) has been conducted to statistically analyze the data. Results The GPR+ a smartphone app had statistically significant improvements versus GPR alone in pain (mean difference, − 2.05 ± 0.65, ES (95% CI) − 0.50 (− 1.04 to − 0.01), P = 0.04), disability (difference = 11.5 ± 1.2, ES (95% CI) = 0.31 (0.22 to 0.97), p = 0.033), FHP (difference = 1.6 ± 0.2, ES (95% CI) = 0.31 (0.09 to 0.92), p = 0.047), and endurance (difference = 2 ± 3.3, ES (95% CI) = 0.51 (0.02 to 1.03), p = 0.039). Both of the GPR+ a smartphone app and GPR alone groups had statistically significant differences versus the control group in all outcomes. Conclusion When a workplace assessment and management could not be as part of any intervention, adding a smartphone app to GPR for NP may be an appropriate tool to administer a home and work exercise program resulting in elevating pain and disability, as well as improving FHP and endurance. Trial registration Current Controlled Trials using the UMIN-RCT website UMIN000039720. Retrospectively registered on January 9, 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05214-8.
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Affiliation(s)
- Fatemeh Abadiyan
- Faculty of Physical Education and Sport Sciences, Department of Biomechanics and Sport injuries, Kharazmi University, Tehran, Iran
| | - Malihe Hadadnezhad
- Faculty of Physical Education and Sport Sciences, Department of Biomechanics and Sport injuries, Kharazmi University, Tehran, Iran. .,Biomechanics and Corrective Exercise Laboratory, Faculty of Physical Education and Sport Sciences, Kharazmi University, Mirdamad Blvd., Hesari St, Tehran, 00982122258084, Iran.
| | - Zohre Khosrokiani
- Faculty of Physical Education and Sport Sciences, Department of Biomechanics and Sport injuries, Kharazmi University, Tehran, Iran
| | - Amir Letafatkar
- Faculty of Physical Education and Sport Sciences, Department of Biomechanics and Sport injuries, Kharazmi University, Tehran, Iran
| | - Haniyeh Akhshik
- Faculty of Physical Education and Sport Sciences, Department of Biomechanics and Sport injuries, Kharazmi University, Tehran, Iran
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19
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Shahabi S, Skempes D, Mojgani P, Bagheri Lankarani K, Heydari ST. Stewardship of physiotherapy services in Iran: common pitfalls and policy solutions. Physiother Theory Pract 2021; 38:2086-2099. [PMID: 33760676 DOI: 10.1080/09593985.2021.1898705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Physiotherapy (PT) is a key component of the rehabilitative health strategy and an effective approach to the management and treatment of a wide range of health conditions. However, it remains underdeveloped and poorly implemented in many national health systems. Previous studies show that weak stewardship of rehabilitation services is, among others, a significant barrier to equitable access to services and supports in many parts of the world, including in Iran. This study investigated the common pitfalls and potential policy solutions to improve the stewardship of PT services in Iran from the perspective of key stakeholders. Semi-structured interviews were conducted by telephone, via the internet, and in face-to-face sessions in Iran with a purposive sample of health planners and policy decision-makers, university professors, rehabilitation managers, and physiotherapists. In total, 30 individuals agreed to participate. Participants identified several pitfalls across the six dimensions of stewardship: 1) strategy formulation; 2) inter-sectoral collaboration; 3) governance and accountability; 4) health system design; 5) policy and regulation; and 6) intelligence generation. In addition, several policy options and solutions to address critical deficiencies in the system were suggested to improve the stewardship of PT services. The study identified challenges and pitfalls affecting the stewardship of the PT sector in Iran as perceived by key stakeholders. Participants' insights can inform deliberative dialogue processes, agenda-setting, and strategy formulation to support the development, expansion, and implementation of PT services.
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Affiliation(s)
- Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, School of Medicine, Shiraz, Iran
| | - Dimitrios Skempes
- Disability Policy and Implementation Research Group, Swiss Paraplegic Research (SPF), Nottwil, Switzerland
| | - Parviz Mojgani
- Iran-Helal Institute of Applied Science and Technology, Tehran.,Research Center for Emergency and Disaster Resilience, Red Crescent Society of The Islamic Republic of Iran, Tehran, Tehran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, School of Medicine, Shiraz, Iran
| | - Seyed Taghi Heydari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, School of Medicine, Shiraz, Iran
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20
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РROKOPCHUK Y, VOLYANSKAYA V, SERAFIMOVA E, GUSHCHA S, PLAKIDA A. Modern views on the role and place of gerontological rehabilitation in the nation's health improvement system. BALNEO AND PRM RESEARCH JOURNAL 2021. [DOI: 10.12680/balneo.2021.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The article discusses the aging process (theory of aging, mechanism, concept of the aging process, physiological and functional changes that negatively affect the condition of a patient with a gerontological profile). Geriatric rehabilitation is discussed, including physical (professional geriatric rehabilitation based on rehabilitation centers) and mental rehabilitation. It is shown that medical and psychological rehabilitation, which includes psychocorrection and psychotherapy, is essential. The paper assesses the rehabilitation possibilities (rehabilitation algorithms involving both natural and preformed physical factors) in gerontological patients suffering from various somatic diseases
Keywords: aging, geriatric rehabilitation, medical and physical rehabilitation, medical and psychological rehabilitation,
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Affiliation(s)
- Yulia РROKOPCHUK
- 1 Special specialized clinical sanatorium named after V.P. Chkalov, Ministry of Health of Ukraine», Odessa, Ukraine
| | - Veronika VOLYANSKAYA
- 1 Special specialized clinical sanatorium named after V.P. Chkalov, Ministry of Health of Ukraine», Odessa, Ukraine
| | - Elvira SERAFIMOVA
- 1 Special specialized clinical sanatorium named after V.P. Chkalov, Ministry of Health of Ukraine», Odessa, Ukraine
| | - Sergey GUSHCHA
- State Institution «Ukrainian Research Institute of Medical Rehabilitation and Balneology of the Ministry of Health of Ukraine», Odessa, Ukraine
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21
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Abstract
INTRODUCTION Neck pain causes serious social and economic burden. Research on the use of acupuncture for managing cervical spondylosis has increased over time, with the quality of studies showing an improved trend. The present study seeks to use a systematic review approach to understand efficacy and safety of acupuncture for treatment of neck pain caused by cervical spondylosis. METHODS AND ANALYSIS We will search PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, Chinese BioMedical Literature, Wanfang database and VIP databases, from their inception to July 2020, to identify and retrieve all randomised controlled trials, describing the use of acupuncture for treatment of cervical spondylosis. Thereafter, two reviewers will independently select the studies, extract data and assess the risk of bias. Any disagreements, between them, will be resolved through a discussion with a third reviewer. Data synthesis and statistical analyses will be performed using the Revman V.5.3 software. Specifically, data will be synthesised by either fixed-effects (heterogeneity less than 50%) or random-effects models, following a heterogeneity test, with outcome measures focusing on pain intensity, functional disability, psychological improvements and adverse events. In cases where no considerable heterogeneity is detected, a meta-analysis will be conducted. ETHICS AND DISSEMINATION No ethical approval will be required for this study, since it does not infringe on anyone's interests. The findings will be published in a peer-reviewed journal or disseminated through conferences. PROSPERO REGISTRATION NUMBER CRD42020152379.
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Affiliation(s)
- Zhen Gao
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Gao-Feng Liu
- Graduate Faculty, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jing Zhang
- Department of acupuncture, Affiliated Hospital of Shanxi University of Traditional Chinese Medicine, Taiyuan, China
| | - Lai-Xi Ji
- The 3rd Teaching Hospital, Shanxi University of Traditional Chinese Medicine, Jinzhong, China
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22
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Fandim JV, Nitzsche R, Michaleff ZA, Pena Costa LO, Saragiotto B. The contemporary management of neck pain in adults. Pain Manag 2020; 11:75-87. [PMID: 33234017 DOI: 10.2217/pmt-2020-0046] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Neck pain is a common condition with a high prevalence worldwide. Neck pain is associated with significant levels of disability and is widely considered an important public health problem. Neck pain is defined as pain perceived between the superior nuchal line and the spinous process of the first thoracic vertebra. In some types of neck conditions, the pain can be referred to the head, trunk and upper limbs. This article aims to provide an overview of the available evidence on prevalence, costs, diagnosis, prognosis, risk factors, prevention and management of patients with neck pain.
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Affiliation(s)
- Junior V Fandim
- Masters & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Renato Nitzsche
- Masters & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Zoe A Michaleff
- Faculty of Health Sciences & Medicine, Institute for Evidence-Based Healthcare, Bond University, Gold Coast, QLD, Australia
| | | | - Bruno Saragiotto
- Masters & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
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23
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Schäfer A, Laekeman M, Egan Moog M, Dieterich AV. [On the move-Prevention of chronic pain with physical activity and movement]. Schmerz 2020; 35:14-20. [PMID: 33048190 DOI: 10.1007/s00482-020-00509-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/28/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Sufficient physical activity and exercise shows a variety of health-promoting positive effects. In the context of pain therapy, promotion of physical activity could be an important contribution to primary, secondary and tertiary prevention of chronic pain. OBJECTIVES The aim is to investigate the relationship between physical activity and chronic pain, the preventive effect of physical activity on pain and the factors to successfully promote physical activity in people with chronic pain. METHODS For this narrative review databases of the Cochrane Library, MEDLINE (via PubMed) and the Physiotherapy Evidence Database (PEDro) were searched for reviews and studies with the keywords chronic pain, physical activity, movement, exercise and prevention. RESULTS A total of 10 reviews, 10 clinical studies and 4 surveys were included and summarized. CONCLUSION Although the evidence base on this topic is still insufficient, positive effects of physical activity on the prevention of chronic pain could be demonstrated. Interventions for people with chronic pain that sustainably increase physical activity should take into account individual resources, address barriers such as maladaptive beliefs, and create positive movement experiences.
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Affiliation(s)
- Axel Schäfer
- Studiengänge Ergotherapie, Logopädie und Physiotherapie, Fakultät Soziale Arbeit und Gesundheit, Hochschule für Angewandte Wissenschaft und Kunst (HAWK) Hildesheim, Goschentor 1, 31134, Hildesheim, Deutschland.
| | - Marjan Laekeman
- Fakultät für Gesundheit, Department für Pflegewissenschaft, Ph.D.-Kolleg, Universität Witten/Herdecke, Witten, Deutschland.,Physiologische Psychologie, Otto-Friedrich-Universität Bamberg, Bamberg, Deutschland
| | - Martina Egan Moog
- Pain Management, Precision Ascend, Melbourne, Australien.,Neuro Orthopaedic Institute, Adelaide, Australien
| | - Angela V Dieterich
- Physiotherapie, Fakultät Gesundheit, Sicherheit, Gesellschaft, Hochschule Furtwangen, Furtwangen, Deutschland
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24
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de Campos TF, Maher CG, Fuller JT, Steffens D, Attwell S, Hancock MJ. Prevention strategies to reduce future impact of low back pain: a systematic review and meta-analysis. Br J Sports Med 2020; 55:468-476. [PMID: 32646887 DOI: 10.1136/bjsports-2019-101436] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the evidence from randomised controlled trials (RCTs) on the effectiveness of prevention strategies to reduce future impact of low back pain (LBP), where impact is measured by LBP intensity and associated disability. DESIGN Systematic review with meta-analysis. DATA SOURCES MEDLINE, Embase, CINAHL, PEDro and The Cochrane (CENTRAL) databases from inception to 22 October 2018. ELIGIBILITY CRITERIA RCTs evaluating any intervention aiming to prevent future impact of LBP, reporting an outcome measure of LBP intensity and/or disability measured at least 3 months post-randomisation, and the intervention group must be compared with a group that received no intervention/placebo or minimal intervention. Trials restricting recruitment to participants with current LBP were excluded. RESULTS 27 published reports of 25 different trials including a total of 8341 participants fulfilled the inclusion criteria. The pooled results, from three RCTs (612 participants), found moderate-quality evidence that an exercise programme can prevent future LBP intensity (mean difference (MD) -4.50; 95% CI -7.26 to -1.74), and from 4 RCTs (471 participants) that an exercise and education programme can prevent future disability due to LBP (MD -6.28; 95% CI -9.51 to -3.06). It is uncertain whether prevention programmes improve future quality of life (QoL) and workability due to the overall low-quality and very low-quality available evidence. CONCLUSIONS This review provides moderate-quality evidence that an exercise programme, and a programme combining exercise and education, are effective to reduce future LBP intensity and associated disability. It is uncertain whether prevention programmes can improve future QoL and workability. Further high-quality RCTs evaluating prevention programmes aiming to reduce future impact of LBP are needed.
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Affiliation(s)
- Tarcisio F de Campos
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Chris G Maher
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Joel T Fuller
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Daniel Steffens
- Royal Prince Alfred Hospital, Surgical Outcomes Research Centre (SOuRCe), Sydney, New South Wales, Australia.,Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Stephanie Attwell
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Mark J Hancock
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
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25
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Sitthipornvorakul E, Sihawong R, Waongenngarm P, Janwantanakul P. The effects of walking intervention on preventing neck pain in office workers: A randomized controlled trial. J Occup Health 2020; 62:e12106. [PMID: 31849170 PMCID: PMC6970409 DOI: 10.1002/1348-9585.12106] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 11/24/2019] [Accepted: 12/02/2019] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the efficacy of increased daily walking steps on the 6-month incidence of neck pain among office workers. METHODS Healthy office workers with high risk of neck pain were recruited into a 6-month prospective cluster-randomized controlled trial. Participants were randomly assigned at the cluster level, into either intervention (n = 50) or control (n = 41) groups. Participants in the intervention group were instructed to increase their daily walking steps to a designated level for a duration of 6 months. Participants in the control group received no intervention. The outcome measures included the 6-month incidence of neck pain as well as its pain intensity and disability level. Analyses were performed using multivariable logistic regression model. RESULTS Of the participants in the intervention and control groups, 22% and 34% reported a 6-month incidence of neck pain, respectively. After adjusting for confounders, a significant preventive effect of walking intervention was found (adjusted odd ratio 0.22, 95% confidence interval 0.06-0.75). No significant difference in pain intensity and disability level was found between those in the intervention and control groups. CONCLUSION An intervention to increase daily walking steps reduced onset neck pain in high-risk office workers. However, the walking interventions did not decrease pain intensity and disability in those increasing the number of daily walking steps compared to the control group.
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Affiliation(s)
- Ekalak Sitthipornvorakul
- Department of Physical TherapyFaculty of Allied Health SciencesChulalongkorn UniversityBangkokThailand
| | - Rattaporn Sihawong
- Department of Physical TherapyFaculty of Allied Health SciencesChulalongkorn UniversityBangkokThailand
| | - Pooriput Waongenngarm
- Department of Physical TherapyFaculty of Allied Health SciencesChulalongkorn UniversityBangkokThailand
| | - Prawit Janwantanakul
- Department of Physical TherapyFaculty of Allied Health SciencesChulalongkorn UniversityBangkokThailand
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26
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Liang L, Feng M, Cui X, Zhou S, Yin X, Wang X, Yang M, Liu C, Xie R, Zhu L, Yu J, Wei X. The effect of exercise on cervical radiculopathy: A systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e17733. [PMID: 31702624 PMCID: PMC6855577 DOI: 10.1097/md.0000000000017733] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Cervical radiculopathy (CR), which is most often stems from degenerative disease in the cervical spine, has increasingly become a common and frequently occurring disease in clinic due to the popularity of electronic products, such as computes and cell phones. Some studies have shown that exercise or exercise combined with other treatments can effectively decrease pain and improve functional status. The objective was to analyze the effects of exercise for treating patients with CR. METHODS Seven databases were searched from inception to December 2018. Randomized controlled trials involving exercise alone or exercise combined with conventional treatment were enrolled. Data were pooled after trials quality assessment for meta-analysis. Outcomes were pain (visual analog scale [VAS]), quality of life (12-short form health survey, 36-short form health survey), and physical function accessed by neck disability index (NDI). RESULTS Ten studies involving 871 participants with CR were included. Meta-analysis revealed that compared with control group, there was a reduction in VAS (standardized mean difference = -0.89; 95% confidence interval [CI]: -1.34 to -0.44; Z = 3.89; P < .001). There was also an improvement of NDI (mean difference = -3.60; 95% CI: -6.27 to -0.94; Z = 2.65; P = .008)]. Additionally, although the results of subgroup analyses were changed due to the paucity of the quantity and quality of the included studies. The pooled results were verified to be stable by sensitivity analyses. Besides, the grading of recommendations assessment, development, and evaluation level of evidence is low for each outcome. CONCLUSION Exercise alone or exercise plus other treatment may be helpful to patients with CR. However, exercise option should be carefully considered for each patient with CR in accordance with their different situations. Large-scale studies using proper methodology are recommended.
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Affiliation(s)
- Long Liang
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
- Beijing Key Laboratory of Orthopedics of Traditional Chinese Medicine, Beijing
| | - Minshan Feng
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
- Beijing Key Laboratory of Orthopedics of Traditional Chinese Medicine, Beijing
| | - Xin Cui
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
| | - Shuaiqi Zhou
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
- Beijing Key Laboratory of Orthopedics of Traditional Chinese Medicine, Beijing
| | - Xunlu Yin
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
- Beijing Key Laboratory of Orthopedics of Traditional Chinese Medicine, Beijing
| | - Xingyu Wang
- First Affiliated Hospital of Anhui University of Chinese Medicine
| | - Mao Yang
- First Affiliated Hospital of Anhui University of Chinese Medicine
| | - Cunhuan Liu
- Jinzhai County Chinese Medicine Hospital, Anhui, China
| | - Rong Xie
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
| | - Liguo Zhu
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
- Beijing Key Laboratory of Orthopedics of Traditional Chinese Medicine, Beijing
| | - Jie Yu
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
- Beijing Key Laboratory of Orthopedics of Traditional Chinese Medicine, Beijing
| | - Xu Wei
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
- Beijing Key Laboratory of Orthopedics of Traditional Chinese Medicine, Beijing
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27
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Best Evidence Rehabilitation for Chronic Pain Part 4: Neck Pain. J Clin Med 2019; 8:jcm8081219. [PMID: 31443149 PMCID: PMC6723111 DOI: 10.3390/jcm8081219] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/05/2019] [Accepted: 08/08/2019] [Indexed: 12/28/2022] Open
Abstract
Neck pain, whether from a traumatic event such as a motor vehicle crash or of a non-traumatic nature, is a leading cause of worldwide disability. This narrative review evaluated the evidence from systematic reviews, recent randomised controlled trials, clinical practice guidelines, and other relevant studies for the effects of rehabilitation approaches for chronic neck pain. Rehabilitation was defined as the aim to restore a person to health or normal life through training and therapy and as such, passive interventions applied in isolation were not considered. The results of this review found that the strongest treatment effects to date are those associated with exercise. Strengthening exercises of the neck and upper quadrant have a moderate effect on neck pain in the short-term. The evidence was of moderate quality at best, indicating that future research will likely change these conclusions. Lower quality evidence and smaller effects were found for other exercise approaches. Other treatments, including education/advice and psychological treatment, showed only very small to small effects, based on low to moderate quality evidence. The review also provided suggestions for promising future directions for clinical practice and research.
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28
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Workplace Interventions can Reduce Sickness Absence for Persons With Work-Related Neck and Upper Extremity Disorders: A One-Year Prospective Cohort Study. J Occup Environ Med 2019; 61:559-564. [PMID: 30985614 DOI: 10.1097/jom.0000000000001608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to investigate whether workplace interventions are effective in reducing sickness absence in persons with work-related neck and upper extremity disorders and whether disorder improvement after intervention reduces sickness absence. METHODS This study was a prospective cohort study of workers with work-related neck pain or upper extremity disorders. Data were obtained from the Swedish "Work-related disorders" and "Work environment" surveys. Register data on sickness-absence 1 year after the surveys were made and obtained from the Swedish health insurance database. RESULTS A significant lower number of sickness-absence days were found for workers reporting improvement after intervention. CONCLUSION The findings in this study suggest that workplace intervention can reduce sickness absence for workers with neck or upper extremity disorders only if the intervention improves the disorder. The interventions were most effective in reducing medium long sickness absence periods.
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Heinrich M, Steiner S, Bauer CM. The effect of visual feedback on people suffering from chronic back and neck pain – a systematic review. Physiother Theory Pract 2019; 36:1220-1231. [DOI: 10.1080/09593985.2019.1571140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Martin Heinrich
- Institute of Physiotherapy, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Simon Steiner
- Institute of Physiotherapy, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Christoph Michael Bauer
- Institute of Physiotherapy, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
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