Therapeutic exercise for chronic non-specific neck pain (original) (raw)
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Effects of Exercises Therapy on Chronic Non-Specific Neck Pain: A Systematic Review
Background: Neck pain is a highly prevalent condition among the general population, where more than 3/4 of individuals around the world have experienced neck pain at some time in their life. Nonspecific neck pain is defined as pain in the posterior neck between the superior nuchal line and the spinous process of the first thoracic vertebra. Objectives: To determine recent research evidences for the effectiveness of exercise therapy interventions for treatment of chronic non-specific neck pain patients. Method: This systematic review mainly includes randomized controlled trails. Searching done by Medline, Embase, CINHAL Centre for Reviews and Dissemination, OAIster, PEDro and the Cochrane Database of Systematic Reviews from 2007 to 2014. We used terms likeneck, pain, muscle spasm, physiotherapy, physical therapy, non-specific, resistance exercise, endurance exercise and strengthening exercises. Result: Present outcomes shows that exercise treatment is effective technique in reducing pain and increasing ROM in patients with chronic nonspecific neck pain without adverse effects. The search resulted in 353 articles but only 09 articles were selected for the study based on criteria. Conclusion: Exercise therapy program designed for treating chronic non-specific neck pain patients proved to reducing pain and improving ROM increasing function during exercise.
Long-term effects of therapeutic exercise on nonspecific chronic neck pain: a literature review
Journal of Physical Therapy Science, 2015
Purpose] Nonspecific neck pain is a common musculoskeletal disease. Therapeutic exercise has been shown to improve pain and disability in short-term and midterm follow-ups. This study performed a literature review of the long-term effects of therapeutic exercise on subjects with nonspecific chronic neck pain. [Subjects and Methods] The databases of the CINAHL, MEDLINE, PEDro and PubMed were used. Randomized controlled trials (RCT) published from January 2000 to January 2014 and explicitly including a one-year follow-up were identified.
Chronic Neck Pain and Exercise Interventions: Frequency, Intensity, Time, and Type Principle
Archives of Physical Medicine and Rehabilitation, 2014
Objective: To identify the most effective components in an active exercise physiotherapy treatment intervention for chronic neck pain based on the frequency, intensity, time, and type (FITT) exercise method of tailoring physical activity recommendations to the individual needs and goals of patients. Data Sources: Databases, including the Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health, MEDLINE, SPORTDiscus, Biomedical Reference Collection, and Academic Search Premier, were searched for relevant articles. Study Selection: Quantitative design studies that included active exercise as part of a multimodal or stand-alone approach were selected. Only studies scoring !6 on the Physiotherapy Evidence Database Scale were included in the review because this reflected a good level of evidence. Data Extraction: Study methodologies and relevant outcome measures, including isometric strength, Neck Disability Index scores, and pain scores, were extracted from relevant articles and grouped together for appraisal and synthesis. Data Synthesis: Evidence from selected articles was synthesized according to the FITT exercise principal to determine the most effective exercise type, frequency, and intensity in the treatment of chronic neck pain. Conclusions: Physiotherapy interventions using a multimodal approach appear to produce more beneficial outcomes in terms of increased strength, improved function, and health-related quality of life and reduced pain scores. Active strengthening exercises appear to be beneficial for all of these outcomes; the inclusion of additional stretching and aerobic exercise components appear to enhance the benefits of an exercise intervention.
Manual Therapy, 2016
OBJECTIVE: To review and update the evidence for different forms of manual therapy (MT) and exercise for patients with different stages of non-specific neck pain (NP). Data sources: MEDLINE, Cochrane-Register-of-Controlled-Trials, PEDro, EM-BASE. METHOD: A qualitative systematic review covering a period from January 2000 to December 2015 was conducted according to updated-guidelines. Specific inclusion criteria only on RCTs were used; including differentiation according to stages of NP (acute-subacute [ASNP] or chronic [CNP]), as well as sub-classification based on type of MT interventions: MT1 (HVLA manipulation); MT2 (mobilization and/or soft-tissue-techniques); MT3 (MT1 + MT2); and MT4 (Mobilization-with-Movement). In each sub-category, MT could be combined or not with exercise and/or usual medical care. RESULTS: Initially 121 studies were identified for potential inclusion. Based on qualitative and quantitative evaluation criteria, 23 RCTs were identified for review. Evidence for ASNP: MODERATE-evidence: In favour of (i) MT1 to the cervical spine (Cx) combined with exercises when compared to MT1 to the thoracic spine (Tx) combined with exercises; (ii) MT3 to the Cx and Tx combined with exercise compared to MT2 to the Cx with exercise or compared to usual medical care for pain and satisfaction with care from short to long-term. Evidence for CNP: STRONG-evidence: Of no difference of efficacy between MT2 at the symptomatic Cx level(s) in comparison to MT2 on asymptomatic Cx level(s) for pain and function. MODERATE to STRONGevidence: In favour of MT1 and MT3 on Cx and Tx with exercise in comparison to exercise or MT alone for pain, function, satisfaction with care and general-health from short to moderate-terms. MODERATE-evidence: In favour (i) of MT1 as compared to MT2 and MT4, all applied to the Cx, for neck mobility, and pain in the very short term; (ii) of MT2 using sof-tissue-techniques to the Cx and Tx or MT3 to the Cx and Tx in comparison to no-treatment in the short-term for pain and disability. CONCLUSION: This systematic review updates the evidence for MT combined or not with exercise and/or usual medical care for different stages of NP and provides recommendations for future studies. Two majors points could be highlighted, the first one is that combining different forms of MT with exercise is better than MT or exercise alone, and the second one is that mobilization need not be applied at the symptomatic level(s) for improvements of NP patients. These both points may have clinical implications for reducing the risk involved with some MT techniques applied to the cervical spine.
Research Paper: The Effect of Combination Therapy; Manual Therapy and Exercise, in Patients With Non-Specific Chronic Neck Pain: A Randomized Clinical Trial Purpose: Neck pain is one of the most common health problems that its prevalence ranges from 34% to 50%. Chronic Neck Pain (CNP) is also a frequent complaint in the general population. The pathogenesis of nonspecific CNP is not clear. This study aimed to assess the effects of soft tissue release, muscle energy techniques and exercise on neck Range of Motion (ROM), Neck Disability Index (NDI), and pain in patients with nonspecific CNP. Methods: This is a randomized, single-blind, clinical study conducted on two groups of patients in Iran, during 2016-2017. Group A received intervention treatment and group B, as control, received no treatment for 21 days. Each group consisted of 12 participants who were selected considering inclusion and exclusion criteria. Each patient in group A received manual treatment protocols (soft tissue release and muscle energy techniques) plus exercise therapy, in six sessions, one session per day, two days a week over a period of 21 days. Clinical assessments were performed at the first and last session (before and after the treatment). Before starting the study, the reliabilities of measurement methods were evaluated and the results were acceptable. Clinical assessments included neck ROM, NDI and pain based on Visual Analogue Scale (VAS). Repeated measures ANOVA test was performed for data analysis using SPSS (version 20). Results: Totally, 16 women and 8 men were participated in this study. To test the hypothesis and analysis of the study variables at regular intervals from the beginning to the end of treatment, repeated measures ANOVA was used. In the intervention group, the indexes showed significant improvements (P<0.001). This means that our intervention treatment was effective. Conclusion: The study results support the effectiveness of the combination therapy (soft tissue release, muscle energy techniques plus exercise therapy) with some improvements in the neck ROM, NDI and pain (Based on VAS scores) for the management of patients with non-specific CNP. CrossMark Citation: Ghodrati M, Mosallanezhad Z, Shati M, Rastgar Koutenaei ?, Nourbakhsh MR, Noroozi M. The Effect of Combina
Specific versus Non-Specific Exercises for Chronic Neck or Shoulder Pain: A Systematic Review
Journal of Clinical Medicine, 2021
The current systematic review aimed to compare the effect of injury-focused (specific) exercises versus more general (non-specific) exercises on pain in patients with chronic neck or shoulder pain. We searched PubMed, EMBASE, and Web of Science. Two reviewers screened and selected studies, extracted outcomes, assessed risk of bias, and rated the quality of evidence. A total of nine eligible studies, represented in 13 articles, were identified, with a considerable risk of bias. One article investigated the acute effect of single bouts of exercise on pain and reported an immediate pain reduction after non-specific exercise. Regarding short-term effects, seven out of the nine studies found no differences in pain between interventions, with inconsistent results among two other studies. Concerning the long-term effects, while pain reduction seems to be favored by specific exercises (two out of four articles), the best format is still unclear. Based on the acute effects, a single bout of ...
Exercises for mechanical neck disorders: A Cochrane review update
Background: Neck pain (NP) is disabling and costly. Objectives: To assess the effectiveness of exercise on pain, disability, function, patient satisfaction, quality of life (QoL) and global perceived effect (GPE) in adults with NP. Methods: We searched computerised databases up to May 2014 for randomized controlled trials (RCTs) comparing exercise to a control in adults with NP with/without cervicogenic headache (CGH) or radi-culopathy. Two reviewers independently conducted selection, data abstraction and assessed risk of bias. Meta-analyses were performed to establish pooled standardised mean differences (SMDp). The Grade of Recommendation, Assessment, Development and Evaluation (GRADE) was used to summarise the body of evidence. Main Results: The following exercises (27 trials) were supported by 'Moderate GRADE' evidence: For chronic NP, 1) cervico-scapulothoracic and upper extremity (UE) strengthening for moderate to large pain reduction immediately post treatment (IP) and at short-term (ST) follow-up; 2) scapulothoracic and UE endurance training for a small pain reduction (IP/ST); 3) cervical, shoulder and scapulothoracic strengthening and stretching exercise for a small to large pain reduction in the long-term (LT) (SMDp À0.45 [95%CI: À0.72 to À0.18]) and function improvement; 4) cervico-scapulothoracic strength-ening/stabilisation exercises for pain and function at intermediate-term (IT) (SMDp À14.90 [95%CI: À22.40 to À7.39]). 5) mindfulness exercises (Qigong) for minor improved function but not GPE (ST). For chronic CGH, cervico-scapulothoracic strengthening and endurance exercises including pressure biofeedback for small/moderate improvement of pain, function and GPE (IP/LT). Authors' conclusions: Specific strengthening exercises of the neck, scapulothoracic and shoulder for chronic NP and chronic CGH are beneficial. Future research should explore optimal dosage.
Clinical Rehabilitation, 2019
Objective: The aim of this study was to compare the effectiveness of a combined intervention of manual therapy and exercise (MET) versus usual care (UC), on disability, pain intensity and global perceived recovery, in patients with non-specific chronic neck pain (CNP). Design: Randomized controlled trial. Setting: Outpatient care units. Subjects: Sixty-four non-specific CNP patients were randomly allocated to MET ( n = 32) or UC ( n = 32) groups. Interventions: Participants in the MET group received 12 sessions of mobilization and exercise, whereas the UC group received 15 sessions of usual care in physiotherapy. Main measures: The primary outcome was disability (Neck Disability Index). The secondary outcomes were pain intensity (Numeric Pain Rating Scale) and global perceived recovery (Patient Global Impression Change). Patients were assessed at baseline, three weeks, six weeks (end of treatment) and at a three-month follow-up. Results: Fifty-eight participants completed the study....
BMJ, 2003
To determine the effectiveness of dynamic muscle training and relaxation training for chronic neck pain. Design Randomised controlled trial. Setting Five occupational healthcare centres, Tampere, Finland. Participants 393 female office workers (mean age 45 years) with chronic non-specific neck pain randomly assigned to 12 weeks of dynamic muscle training (n = 135) or relaxation training (n = 128), plus one week of reinforcement training six months after baseline; or ordinary activity (control group; n = 130). Main outcome measure Change in intensity of neck pain at three, six, and 12 months. Results No significant difference was found in neck pain between the groups at follow up. However, the range of motion for cervical rotation and lateral flexion increased more in the training groups than in the control group. Conclusions Dynamic muscle training and relaxation training do not lead to better improvements in neck pain compared with ordinary activity.