Effectiveness of a "Spring Pillow" Versus Education in Chronic Nonspecific Neck Pain: A Randomized Controlled Trial

Changes in neck pain and somatic symptoms before and after the adjustment of the pillow height

[Purpose] The purpose of this study was to determine whether strict adjustment of the pillow height using the Set-up for Spinal Sleep method improves clinical outcomes like neck pain and somatic symptoms. [Participants and Methods] A total of 84 participants with chief complaints of stiff shoulders and neck pain were evaluated using the numerical rating scale and the Somatic Symptom Scale-8. Questionnaires were used to collect data at the baseline, after two weeks, and after three months of adjusting the pillow height. [Results] Forty-two participants (50%) achieved the minimal clinically important difference for neck pain with a decrease of three points or higher in the numerical rating scale. The baseline neck pain scores were significantly higher in the group that achieved the minimal clinically important difference. The three-month change in neck pain and the Somatic Symptom Scale-8 was significantly greater in participants who were satisfied with treatment. There was a significant positive association between improvement in the numerical rating scale score and improvement in the Somatic Symptom Scale-8 at three months. [Conclusion] Strict adjustment of the pillow height using the Set-up for the Spinal Sleep method significantly improved both physical neck pain and somatic symptoms related to psychological and social problems.

The Unknown Prevalence of Postrandomization Bias in 15 Physical Therapy Journals: A Methods Review

OBJECTIVES

To determine the prevalence of prospective clinical trial registration and postrandomization bias in published musculoskeletal physical therapy randomized clinical trials (RCTs).

DESIGN

A methods review.

LITERATURE SEARCH

Articles indexed in MEDLINE and published between January 2016 and July 2020 were included.

STUDY SELECTION CRITERIA

Two independent blinded reviewers identified the RCTs using Covidence. We included RCTs related to musculoskeletal interventions that were published in International Society of Physiotherapy Journal Editors member journals.

DATA SYNTHESIS

Data were extracted independently for the variables of interest from the identified RCTs by 2 blinded reviewers. The data were presented descriptively or in frequency tables.

RESULTS

One hundred thirty-eight RCTs were identified. One third of RCTs were consistent with their prospectively registered intent (49/138); consistency with prospectively registered intent could not be determined for two thirds (89/138) of the RCTs. Four RCTs (8%)reported inconsistent results with the primary aims and 7 (14%) with the outcomes from the prospective clinical trial registry, despite high methodological quality (Physiotherapy Evidence Database [PEDro] scale score). Differences between prospectively registered and non-prospectively registered RCTs for PEDro scale scores had a medium effect size (r = 0.30). Two of 15 journals followed their clinical trial registration policy 100% of the time; in 1 journal, the published RCTs were consistent with the clinical trial registration.

CONCLUSION

Postrandomization bias in musculoskeletal physical therapy RCTs could not be ruled out, due to the lack of prospective clinical trial registration and detailed data analysis plans. J Orthop Sports Phys Ther 2021;51(11):542-550. Epub 21 Sep 2021. doi:10.2519/jospt.2021.10491.

The effects of pillow designs on neck pain, waking symptoms, neck disability, sleep quality and spinal alignment in adults: A systematic review and meta-analysis

BACKGROUND

Neck pain is a prevalent condition that can adversely affect quality of life, productivity at work, and sleep quality. The aim of this systematic review and meta-analysis was to identify clinical trials assessing the effect of different types of pillows on neck pain, waking symptoms, neck disability, sleep quality, and spinal alignment.

METHODS

We systematically searched CINAHL Complete, Cochrane Library, EMBASE, Medline, Pubmed and Psychinfo databases from inception to September 2020. Two reviewers independently assessed the articles and evaluated the methodological quality using PEDro.

FINDINGS

Thirty-five articles fulfilled the inclusion criteria of the study. There were nine high-quality studies involving 555 participants. The meta-analysis revealed significant differences favouring the use of rubber pillows to reduce neck pain [standardized mean difference (SMD): -0.263; P < 0.001). Moreover, waking pain (SMD: -0.228; P < 0.001) and neck disability (SMD: -0.506; P = 0.020) were reduced while the satisfaction rate was enhanced (SMD: 1.144; P < 0.001) with pillow use. Pillow designs did not influence sleep quality (SMD = 0.047; P = 0.703) in patients with chronic neck pain.

INTERPRETATION

The use of spring and rubber pillows are effective in reducing neck pain, waking symptoms, and disability and enhancing pillow satisfaction in patients with chronic neck pain. Moreover, there may be no change in the alignment of the cervical spine in the side-lying position, regardless of the use of rubber or feather pillows. Rather, the cervical alignment may be significantly impacted by the shape and height of the pillow.