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Jones LB, Jadhakhan F, Falla D. The influence of exercise on pain, disability and quality of life in office workers with chronic neck pain: A systematic review and meta-analysis. APPLIED ERGONOMICS 2024; 117:104216. [PMID: 38219373 DOI: 10.1016/j.apergo.2023.104216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Exercise is recommended for office workers with neck pain. However, recent reviews evaluated the effectiveness of workplace interventions only. OBJECTIVES To evaluate the effect of exercise on pain, disability, and quality of life (QoL) in office workers with chronic neck pain. DESIGN Systematic review with meta-analysis. METHODS Electronic databases were searched from inception to April 30, 2022, to identify studies in which participants were adults aged ≥18 years undergoing any form of neck exercises (e.g., strengthening, motor control) or physical activity (e.g., aerobic exercise) performed for a minimum of two-weeks without any other additional treatment besides advice or education. Two reviewers independently screened papers and determined the certainty of the evidence. RESULTS Eight randomised controlled trials met the eligibility criteria. Seven studies reported a significant decrease in Visual Analogue Scale (VAS) scores for neck pain intensity and five studies reported a significant decrease in Neck Disability Index (NDI) scores following strengthening exercises. Only one study assessed the effect of strengthening exercises on QoL and reported no significant effect. All eight included studies had a high risk of bias and the overall certainty of evidence was low. Meta-analyses demonstrated a significant decrease of neck pain intensity and disability for strengthening exercises compared to a control (p < 0.01). CONCLUSION There is low certainty of evidence that strengthening of the neck, shoulder and scapular musculature is effective at reducing neck pain and disability in office workers. Further research evaluating the effect of exercise on QoL is required.
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Affiliation(s)
- Luke Broady Jones
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - Ferozkhan Jadhakhan
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.
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Karimian R, Burton K, Naghizadeh MM, Karimian M, Xirouchaki CE, Sobhanipur M, Gholami T. Home schooling during the COVID-19 pandemic: A randomized controlled trial of online exercise and ergonomics advice protocols on upper body symptoms. PM R 2023. [PMID: 37924525 DOI: 10.1002/pmrj.13102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 06/20/2023] [Accepted: 10/26/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Understanding of students' musculoskeletal health under home-schooling during the COVID-19 pandemic is limited. OBJECTIVES (1) To investigate the prevalence and severity of musculoskeletal symptoms in home-schooled adolescents during the COVID-19 pandemic. (2) To evaluate the effect of an online exercise + ergonomics advice protocol on symptoms, compared with ergonomics advice alone. DESIGN Cross-sectional symptom survey identifying eligible participants, followed by a pragmatic randomized controlled trial. SETTING Online classes. PARTICIPANTS Survey: 354 students (mean 16.6 years). TRIAL 188 students with upper body musculoskeletal symptoms. INTERVENTIONS Randomization to three groups (physical therapy exercises + ergonomics postural advice, ergonomics postural advice alone, nonintervention control) stratified by the site of symptoms (neck, shoulder, upper back). Interventions were orally delivered online (via WhatsApp) supplemented with written/illustrative material. Follow-up occurred at 8 weeks. OUTCOME MEASURES Survey: prevalence of symptoms (Nordic Questionnaire). TRIAL primary outcome = change in intensity of upper body symptoms (visual analogue scale); secondary outcome = number of participants reporting improvement in upper body symptoms. RESULTS The 12-month prevalence of musculoskeletal disorders in the survey was 38% neck, 28% shoulder, and 35% upper back, with mean pain intensity of 3.6, 3.9, and 3.8, respectively, on 0-10 visual analogue scale: Two-thirds reported symptoms in multiple anatomical regions. In the trial, there was no statistically significant difference between the exercise + ergonomics group and ergonomics alone group on the primary outcome, yet both groups showed reduced symptom intensity compared with control (p < .001). More participants in the exercise + ergonomics group reported improvement than in the ergonomics advice alone group (p < .02). CONCLUSIONS The prevalence of musculoskeletal symptoms was relatively high in home-schooled adolescents. Symptoms can be reduced by ergonomics advice with or without exercises, but the effect is enhanced by the addition of physical therapy exercises. The latter approach may be considered for improving schoolchildren's musculoskeletal health in the usual classroom setting.
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Affiliation(s)
- Razieh Karimian
- Department of Public Health, Fasa University of Medical Sciences and Healthcare Services, Fasa, 7461686688, Iran
| | - Kim Burton
- Centre for Applied Research in Health, University of Huddersfield, Huddersfield, UK
| | | | | | | | - Mostafa Sobhanipur
- Department of Public Health, Fasa University of Medical Sciences and Healthcare Services, Fasa, 7461686688, Iran
| | - Tahereh Gholami
- Department of Public Health, Fasa University of Medical Sciences and Healthcare Services, Fasa, 7461686688, Iran
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Cho WS, Park CB, Kim BG. Effects of exercise therapy on pain and disability in patients with non-specific neck pain: A systematic review and meta-analysis. J Bodyw Mov Ther 2023; 36:213-220. [PMID: 37949563 DOI: 10.1016/j.jbmt.2023.07.010] [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: 03/18/2022] [Revised: 05/07/2023] [Accepted: 07/04/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Existing systematic reviews and meta-analyses have only focused on patients with chronic non-specific neck pain (NNP), analyzing exercise therapy (ET) only as therapeutic exercise. Therefore, it is necessary to comprehensively review the effects of ET through a meta-analysis comprising a wide range of ETs that are not limited to therapeutic exercise. OBJECTIVES This study aimed to investigate the effects of ET on pain and disability in patients with NNP. DESIGN Systematic review and meta-analysis. METHOD The studies selected for this study were based on the PICO-SD tool as follows: P (patient)-acute, subacute, and chronic NNP patents, I (intervention)-ET, C (comparison)-control and other therapy groups, O (outcome)-pain and disability, and SD (study design)-randomized controlled trial. RESULTS Twenty-one studies were included. The effects of ET on pain and disability in patients with chronic NNP were significantly different (pain: SMD -1.47, 95% CI: -1.89 to -1.06, I2: 94%; disability: SMD -1.79, 95% CI: -2.31 to -1.27, I2: 94%). The effects of ET on pain (ET vs control: SMD: -1.60, 95% CI: -2.09 to -1.11, I2: 94%; ET vs sham therapy: SMD: -8.75, 95% CI: -10.71 to -6.79) and disability (ET vs control: SMD: -2.16, 95% CI: -2.80 to -1.52, I2: 94%; ET vs sham therapy: SMD: -1.73, 95% CI: -2.42 to -1.05) in NNP patients were significantly different. CONCLUSIONS This study verified the efficacy of ET in improving pain and disability in patients with chronic NNP. However, evidence supporting the efficacy of ET in patients with acute and subacute NNP is still lacking.
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Affiliation(s)
- Woon Su Cho
- Department of Physical Therapy, Nambu University, Gwangju, 62271, South Korea
| | - Chi Bok Park
- Department of Physical Therapy, Nambu University, Gwangju, 62271, South Korea
| | - Byeong Geun Kim
- Department of Physical Therapy, Nambu University, Gwangju, 62271, South Korea; Bareun Physiotherapy Research Institute, Gwangju, 62271, South Korea.
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Mueller J, Weinig J, Niederer D, Tenberg S, Mueller S. Resistance, Motor Control, and Mindfulness-Based Exercises Are Effective for Treating Chronic Nonspecific Neck Pain: A Systematic Review With Meta-Analysis and Dose-Response Meta-Regression. J Orthop Sports Phys Ther 2023; 53:420–459. [PMID: 37339388 DOI: 10.2519/jospt.2023.11820] [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] [Indexed: 06/22/2023]
Abstract
OBJECTIVE: We aimed to analyze the effects and dose-response relationship of the most effective exercises for improving pain and disability in people with chronic nonspecific neck pain. DESIGN: Intervention systematic review with meta-analysis. LITERATURE SEARCH: We searched the PubMed, PEDro, and CENTRAL databases from their inception to September 30, 2022. STUDY SELECTION CRITERIA: We included randomized controlled trials that involved people with chronic neck pain adopting a longitudinal exercise intervention and assessed one pain and/or disability outcome. DATA SYNTHESIS: Restricted maximum-likelihood random-effects meta-analyses were modeled separately for resistance, mindfulness-based, and motor control exercises; standardized mean differences (Hedge's g, standardized mean difference [SMD]) were effect estimators. Meta-regressions (dependent variable: effect sizes of the interventions; independent variables: training dose and control group effects) were conducted to explore the dose-response relationship for therapy success of any exercise type. RESULTS: We included 68 trials. Compared to true control, effects on pain and disability were significantly larger for resistance exercise (pain: SMD, -1.27; 95% confidence interval [CI]: -2.26, -0.28; |2 = 96%; disability: SMD, -1.76; 95% CI: -3.16, -0.37; |2 = 98%), motor control exercise (pain: SMD, -2.29; 95% CI: -3.82, -0.75; |2 = 98%; disability: SMD, -2.42; 95% CI: -3.38, -1.47; |2 = 94%), and Yoga/Pilates/Tai Chi/Qui Gong exercise (pain: SMD, 1.91; 95% CI:-3.28, -0.55; |2 = 96%; disability: SMD, -0.62; 95% CI: -0.85, -0.38; |2 = 0%). Yoga/Pilates/Tai Chi/Qui Gong exercise was more effective than other exercises (SMD, -0.84; 95% CI: -1.553, -0.13; |2 = 86%) for reducing pain. For disability, motor control exercise was superior to other exercises (SMD, -0.70; 95% CI: -1.23, -0.17; |2 = 98%). There was no dose-response relationship for resistance exercise (R2 = 0.32). Higher frequencies (estimate = -0.10) and longer durations (estimate = -0.11) of motor control exercise had larger effects on pain (R2 = 0.72). Longer sessions (estimate = -0.13) of motor control exercise had larger effects on disability (R2 = 0.61). CONCLUSION: Resistance, mindfulness-based, and motor control exercises were effective for reducing neck pain (very low- to moderate-certainty evidence). Higher frequencies and longer duration of sessions had a significant effect on pain for motor control exercise. J Orthop Sports Phys Ther 2023;53(8):1-41. Epub: 20 June 2023. doi:10.2519/jospt.2023.11820.
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Larinier N, Vuillerme N, Balaguier R. Effectiveness of warm-up interventions on work-related musculoskeletal disorders, physical and psychosocial functions among workers: a systematic review. BMJ Open 2023; 13:e056560. [PMID: 37130661 PMCID: PMC10163487 DOI: 10.1136/bmjopen-2021-056560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/12/2023] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVES The aim of this systematic review was to identify from published literature the available evidence regarding the effects of warm-up intervention implemented in the workplace on work -related musculoskeletal disorders (WMSDs) and physical and psychosocial functions. DESIGN Systematic review. DATA SOURCES The following four electronic databases were searched (from inception onwards to October 2022): Cochrane Central Register of Controlled Trials (CENTRAL), PubMed (Medline), Web of Science and Physiotherapy Evidence Database (PEDro). ELIGIBILITY CRITERIA Randomised and non-randomised controlled studies were included in this review. Interventions should include a warm-up physical intervention in real-workplaces. DATA EXTRACTION AND SYNTHESIS The primary outcomes were pain, discomfort, fatigue and physical functions. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and used the Grading of Recommendations, Assessment, Development and Evaluation evidence synthesis. To assess the risk of bias, the Cochrane ROB2 was used for randomised controlled trial (RCT) and the Risk Of Bias In Non-randomised Studies-of Interventions was used for the non-RCT studies. RESULTS Three studies met the inclusion criterion, one cluster RCT and two non-RCTs. There was an important heterogeneity in the included studies principally concerning population and warm-up intervention exercises. There were important risks of bias in the four selected studies, due to blinding and confounding factors. Overall certainty of evidence was very low. CONCLUSION Due to the poor methodological quality of studies and conflicting results, there was no evidence supporting the use of warm-up to prevent WMSDs in the workplace. The present findings highlighted the need of good quality studies targeting the effects of warm-up intervention to prevent WMSDs. PROSPERO REGISTRATION NUMBER CRD42019137211.
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Affiliation(s)
- Nicolas Larinier
- AGEIS, Université Grenoble Alpes, Saint-Martin-d'Heres, France
- Opti'Mouv, St Paul, France
| | - Nicolas Vuillerme
- AGEIS, Université Grenoble Alpes, Saint-Martin-d'Heres, France
- Opti'Mouv, St Paul, France
- Institut Universitaire de France, Paris, France
| | - Romain Balaguier
- AGEIS, Université Grenoble Alpes, Saint-Martin-d'Heres, France
- Opti'Mouv, St Paul, France
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GÜÇHAN TOPÇU Z, ANGIN E, DEPRELİ O, YATAR İ, MIHÇIOĞLU S, TOMAÇ H. Relationships of Mobile Phone Use with the Functions and Disabilities of Neck and Upper Extremity. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.38079/igusabder.983050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Aim: To determine the effects of mobile phone use on fine motor functions, neck, and upper limb disability values.Methods: Time duration of mobile phone use was recorded for a week. Rapid Upper Limb Assessment (RULA) was used to determine the risk level about posture while texting message on phones. Neck Disability Index (NDI) for neck pain and functional disability of neck on activities of daily life, Disabilities of the Arm, Shoulder, and Hand-Function/Symptom (DASH-FS) for the limitation in the functions of upper limb, Jebson Taylor Hand Function test for fine motor function.Results: Two hundred and seventy individuals (141 women, 129 men) whose mean ages were 21,48±1,86 years were included. While a significant correlation between duration of phone use and NDI score was specified (r=0,172; p=0,005), no significant correlation was found between duration of phone use and DASH-FS scores (r=0,092; p=0,130). It was found that there was a negative significant relationship between the duration of phone use and the total function score of the left hand and throwing small objects (p<0,01). According to RULA 95,6% of individuals have unacceptable phone usage postures, but no significant relationship was found between ergonomic risk level and NDI values, DASH-FS values, and hand functions (p>0,05).Conclusion: Although increased duration of phone use could cause neck problems, manual ability may be positively affected. In addition, since most participants have a poor posture while using a mobile phone, it is thought that this may be a risk factor for more musculoskeletal problems in older ages.
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Yin Y, Di N, Guo W, Ding W, Jia N, Wang Z, Yang F. Multi-Site Musculoskeletal Symptoms in the Electronics Manufacturing Industry in China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13315. [PMID: 36293896 PMCID: PMC9602541 DOI: 10.3390/ijerph192013315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/13/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND With the development of the electronics manufacturing industry, the demand for human resources has increased, which has also led to the frequent occurrence of multi-site work-related musculoskeletal disorders. METHOD The participants (n = 7307) were recruited from 30 enterprises in China in 2018. The prevalence of musculoskeletal disorders was estimated using a modified Chinese version of the Musculoskeletal Disorders Questionnaire. The multivariate logistic regression model was applied to evaluate the effects of risk factors on multi-site musculoskeletal symptoms. Additionally, the log-binomial model was established to examine the correlation between the various sites of musculoskeletal symptoms in the body. RESULTS The 12-month prevalence of musculoskeletal symptoms among participants was 40.6%. The proportion of musculoskeletal symptoms involving single-site and 2/>2 body sites were 11.6% and 29.0%, respectively. The results of logistic regression showed that female adults who smoked, had >5-year job tenure, and always stood or sat for long period at work had a higher risk in 2/>2 body sites of musculoskeletal symptoms (p < 0.05). However, physical exercise during leisure time and "Squatting or kneeling for long period at work" were more frequently protective factors. Furthermore, the log-binomial model indicated that the neck and shoulder were significantly related to each other (Prevalence Ratio, PR: 5.511 and 7.017). CONCLUSIONS Several demographic characteristics and work-related factors were associated with multi-site musculoskeletal symptoms in the electronics manufacturing industry in China. Improving the levels of physical exercise and reducing posture problems and force loads may help to promote the health of workers.
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Affiliation(s)
- Yan Yin
- Department of Occupational Health and Poisoning Control, Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Niu Di
- Department of Occupational Health and Poisoning Control, Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Weiwei Guo
- Department of Occupational Health and Poisoning Control, Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Wenbin Ding
- Department of Occupational Health and Poisoning Control, Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Ning Jia
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Zhongxu Wang
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Feng Yang
- Department of Occupational Health and Poisoning Control, Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
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Zhang X, Yang Y, Shen YW, Zhang KR, Ma LT, Ding C, Wang BY, Meng Y, Liu H. Quality of online video resources concerning patient education for neck pain: A YouTube-based quality-control study. Front Public Health 2022; 10:972348. [PMID: 36211682 PMCID: PMC9533122 DOI: 10.3389/fpubh.2022.972348] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 08/24/2022] [Indexed: 01/25/2023] Open
Abstract
Background More than 70 percent of the world's population is tortured with neck pain more than once in their vast life, of which 50-85% recur within 1-5 years of the initial episode. With medical resources affected by the epidemic, more and more people seek health-related knowledge via YouTube. This article aims to assess the quality and reliability of the medical information shared on YouTube regarding neck pain. Methods We searched on YouTube using the keyword "neck pain" to include the top 50 videos by relevance, then divided them into five and seven categories based on their content and source. Each video was quantitatively assessed using the Journal of American Medical Association (JAMA), DISCERN, Global Quality Score (GQS), Neck Pain-Specific Score (NPSS), and video power index (VPI). Spearman correlation analysis was used to evaluate the correlation between JAMA, GQS, DISCERN, NPSS and VPI. A multiple linear regression analysis was applied to identify video features affecting JAMA, GQS, DISCERN, and NPSS. Results The videos had a mean JAMA score of 2.56 (SD = 0.43), DISCERN of 2.55 (SD = 0.44), GQS of 2.86 (SD = 0.72), and NPSS of 2.90 (SD = 2.23). Classification by video upload source, non-physician videos had the greatest share at 38%, and sorted by video content, exercise training comprised 40% of the videos. Significant differences between the uploading sources were observed for VPI (P = 0.012), JAMA (P < 0.001), DISCERN (P < 0.001), GQS (P = 0.001), and NPSS (P = 0.007). Spearman correlation analysis showed that JAMA, DISCERN, GQS, and NPSS significantly correlated with each other (JAMA vs. DISCERN, p < 0.001, JAMA vs. GQS, p < 0.001, JAMA vs. NPSS, p < 0.001, DISCERN vs. GQS, p < 0.001, DISCERN vs. NPSS, p < 0.001, GQS vs. NPSS, p < 0.001). Multiple linear regression analysis suggested that a higher JAMA score, DISCERN, or GQS score were closely related to a higher probability of an academic, physician, non-physician or medical upload source (P < 0.005), and a higher NPSS score was associated with a higher probability of an academic source (P = 0.001) than of an individual upload source. Conclusions YouTube videos pertaining to neck pain contain low quality, low reliability, and incomplete information. Patients may be put at risk for health complications due to inaccurate, and incomplete information, particularly during the COVID-19 crisis. Academic groups should be committed to high-quality video production and promotion to YouTube users.
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Effect of manual soft tissue therapy on the pain in patients with chronic neck pain: A systematic review and meta-analysis. Complement Ther Clin Pract 2022; 49:101619. [DOI: 10.1016/j.ctcp.2022.101619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 11/19/2022]
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Soroush S, Arefi MF, Pouya AB, Barzanouni S, Heidaranlu E, Gholizadeh H, Salehi AR, Raei M, Poursadeqiyan M. The effects of neck, core, and combined stabilization practices on pain, disability, and improvement of the neck range of motion in elderly with chronic non-specific neck pain. Work 2022; 71:889-900. [DOI: 10.3233/wor-213646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Chronic non-specific neck pain is the most prevalent neck pain with notable impacts on the quality of life in the elderly. OBJECTIVE: The impacts of the neck, core, and combined stabilization practices on pain, disability, and improvement of the neck range of motion in the elderly with chronic non-specific neck pain were examined. METHOD: A quasi-experimental (open label) study was carried out through a cluster sampling in two phases in Tehran-Iran in 2017. Totally, 102 patients were randomly allocated to three groups of specific neck stabilization, specific core stabilization, and combined practices through envelope method. The intervention took 12 weeks. To measure the severity of pain and neck disability, the visual analog scale (VAS), neck disability index (NDI), and neck pain and disability scale (NPDS) was used. A goniometer was used to measure the range of the motion. To examine data, used SPSS (v.20). RESULT: The results, confirmed a significant decrease in pain over the time in the three therapeutic groups (p = 0.000). In addition, there was a significant difference between neck, core, and combined stabilization groups. Moreover, there was a significant increase in the angle of motion in all treatment groups with different treatment duration (P = 0.000). The highest increase in the angle of motion was after 12 weeks of practice in right lateral flexion (RLF) (p = 0.000). CONCLUSION: Twelve sessions of the neck, core, and combined stabilization practices can alleviate the pain and improve the strength in the elderly with chronic non-specific neck pain. In addition, compared to two other methods, the combined method was a more efficient way to improve the range of motion in patients.
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Affiliation(s)
- Sima Soroush
- Department of Nursing, Behbahan Faculty of Medical Sciences, Behbahan, Iran
| | - Maryam Feiz Arefi
- Department of Occupational Health Engineering, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Amin Babaei Pouya
- Department of Occupational Health and Safety Engineering, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Somayeh Barzanouni
- Vice Chancellery of Education and Research, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Esmail Heidaranlu
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hamed Gholizadeh
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Department of General Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Reza Salehi
- Clinical Research Development Center, Pastor Educational Hospital, Bam University of Medical Sciences, Bam, Iran
| | - Mehdi Raei
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohsen Poursadeqiyan
- Department of Occupational Health and Safety Engineering, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Specific versus Non-Specific Exercises for Chronic Neck or Shoulder Pain: A Systematic Review. J Clin Med 2021; 10:jcm10245946. [PMID: 34945241 PMCID: PMC8706212 DOI: 10.3390/jcm10245946] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/07/2021] [Accepted: 12/11/2021] [Indexed: 02/02/2023] Open
Abstract
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 non-specific exercise seems to be a better option for pain-relief for patients with chronic neck or shoulder pain. For short-term effects, there are no differences in pain between specific and non-specific exercises. Regarding long-term effects, specific exercises seem to be the best option. Nevertheless, more studies are warranted.
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Effects of Sling-Based Thoracic Active Exercise on Pain and Function and Quality of Life in Female Patients with Neck Pain: A Randomized Controlled Trial. Healthcare (Basel) 2021; 9:healthcare9111514. [PMID: 34828560 PMCID: PMC8622558 DOI: 10.3390/healthcare9111514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the effects of sling-based thoracic active exercise on pain, function, and quality of life in female patients with neck pain. A total of 27 female patients with neck pain were divided into the sling-based thoracic active exercise group (n = 14) and the control group (n = 13). The study group performed a sling-based thoracic active exercise with cervical manual therapy for 50 min a day, twice a week for 4 weeks, whereas the control group performed a placebo exercise with cervical manual therapy in the same manner as the study group. Evaluation of the degree of pain before and after treatment was based on the pressure pain threshold and numeric pain rating scale scores. The craniovertebral angle and neck disability index (NDI) were used to evaluate neck function, and quality of life was measured using the Short Form-36. Afterwards, the patients’ pressure pain thresholds were significantly increased, and the numeric pain rating scale score was significantly decreased in both groups (p < 0.05). In terms of function, the craniovertebral angle was significantly increased in both groups (p < 0.05), and neck dysfunction significantly decreased (p < 0.05). The quality of life significantly increased in both groups (p < 0.05). The pressure pain threshold, craniovertebral angle, neck dysfunction index, and quality of life scores (p < 0.05) were significantly different between groups, except the numeric pain scale score. Our results showed that sling-based thoracic active exercise is effective in reducing pain and improving function and quality of life in female patients with neck pain, thus emphasizing the need for thoracic treatment for such patients.
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Miller CT, Owen PJ, Than CA, Ball J, Sadler K, Piedimonte A, Benedetti F, Belavy DL. Attempting to Separate Placebo Effects from Exercise in Chronic Pain: A Systematic Review and Meta-analysis. Sports Med 2021; 52:789-816. [PMID: 34453277 DOI: 10.1007/s40279-021-01526-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Pain is the most disabling characteristic of musculoskeletal disorders, and while exercise is promoted as an important treatment modality for chronic musculoskeletal conditions, the relative contribution of the specific effects of exercise training, placebo effects and non-specific effects such as natural history are not clear. The aim of this systematic review and meta-analysis was to determine the relative contribution of these factors to better understand the true effect of exercise training for reducing pain in chronic primary musculoskeletal pain conditions. DESIGN Systematic review with meta-analysis DATA SOURCES: MEDLINE, CINAHL, SPORTDiscus, EMBASE and CENTRAL from inception to February 2021. Reference lists of prior systematic reviews. ELIGIBILITY CRITERIA Randomised controlled trials of interventions that used exercise training compared to placebo, true control or usual care in adults with chronic primary musculoskeletal pain. The review was registered prospectively with PROSPERO (CRD42019141096). RESULTS We identified 79 eligible trials for quantitative analysis. Pairwise meta-analysis showed very low-quality evidence (GRADE criteria) that exercise training was not more effective than placebo (g [95% CI]: 0.94 [- 0.17, 2.06], P = 0.098, I2 = 92.46%, studies: n = 4). Exercise training was more effective than true, no intervention controls (g [95% CI]: 0.99 [0.66, 1.32], P < 0.001, I2 = 92.43%, studies: n = 42), usual care controls (g [95% CI]: 0.64 [0.44, 0.83], P < 0.001, I2 = 76.52%, studies: n = 33), and when all controls combined (g [95% CI]: 0.84 [0.64, 1.04], P < 0.001, I2 = 90.02%, studies: n = 79). CONCLUSIONS There is very low-quality evidence that exercise training is not more effective than non-exercise placebo treatments in chronic pain. Exercise training and the associated clinical encounter are more effective than true control or standard medical care for reductions in pain for adults with chronic musculoskeletal pain, with very low quality of evidence based on GRADE criteria.
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Affiliation(s)
- Clint T Miller
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
| | - Patrick J Owen
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Christian A Than
- School of Biomedical Sciences, The University of Queensland, St. Lucia, Brisbane, Australia
| | - Jake Ball
- School of Medicine and Public Health, University of Newcastle, Callaghan, Newcastle, Australia
| | - Kate Sadler
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Alessandro Piedimonte
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Fabrizio Benedetti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.,Medicine and Physiology of Hypoxia, Plateau Rosà, Zermatt, Switzerland
| | - Daniel L Belavy
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.,Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
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Vambheim SM, Kyllo TM, Hegland S, Bystad M. Relaxation techniques as an intervention for chronic pain: A systematic review of randomized controlled trials. Heliyon 2021; 7:e07837. [PMID: 34485731 PMCID: PMC8405991 DOI: 10.1016/j.heliyon.2021.e07837] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/09/2020] [Accepted: 08/17/2021] [Indexed: 12/14/2022] Open
Abstract
Chronic pain increases the risk of sleep disturbances, depression and disability. Even though medical treatments have limited value, the use of prescription-based analgesics have increased over the recent years. It is therefore important to evaluate the effect of non-pharmacological treatments. A systematic search for studies evaluating the effect of relaxation techniques on chronic pain was conducted. Randomized controlled trials were included. Significant effects on pain, or on pain and one or more secondary outcome measure, were found in 21 studies. Four studies found significant effects on secondary outcome measures only. Four studies showed no significant effects on any outcome measure. Thus, most of the studies reported that relaxation techniques reduced pain and/or secondary outcome measures. However, the included studies have evaluated effects across a wide variety of chronic pain conditions and relaxation techniques. Hence, there is a large degree of heterogeneity among the included studies. This complicates the effect evaluation and makes it difficult to draw a clear and unambiguous conclusion. Relaxation techniques are probably most effective when used through regular and continued practice. Future studies should therefore investigate long-term effects of relaxation technique interventions, evaluate the dose-response relationship and examine efficacy differences across pain conditions and interventions.
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Affiliation(s)
- Sara Magelssen Vambheim
- Department of Psychology, UiT The Arctic University of Norway, Norway
- Department of Pain Management and Research, Emergency Clinic, Oslo University, Norway
| | | | - Sanne Hegland
- Department of Psychology, UiT The Arctic University of Norway, Norway
| | - Martin Bystad
- Department of Pain Management and Research, Emergency Clinic, Oslo University, Norway
- Department of Geropsychiatry, UNN University Hospital of North Norway, Norway
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Efficacy of Manual Therapy and Transcutaneous Electrical Nerve Stimulation in Cervical Mobility and Endurance in Subacute and Chronic Neck Pain: A Randomized Clinical Trial. J Clin Med 2021; 10:jcm10153245. [PMID: 34362029 PMCID: PMC8347502 DOI: 10.3390/jcm10153245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/12/2021] [Accepted: 07/15/2021] [Indexed: 11/23/2022] Open
Abstract
Neck pain is a frequent health problem. Manual therapy (MT) and transcutaneous electrical nerve stimulation (TENS) are recommended techniques for treatment of mechanical neck disorders (MND) in Spanish Public Primary Care Physiotherapy Services. The aim of this study was to compare the efficacy of MT versus TENS in active mobility and endurance in cervical subacute or chronic neck pain. Ninety patients with MND were randomly allocated to receive ten 30-min sessions of either MT or TENS, in a multi-centered study through 12 Primary Care Physiotherapy Units in the Madrid community. Active cervical range of motion (CD-ROM) and endurance (Palmer and Epler test) were evaluated pre- and post-intervention and at 6-month follow-up. A generalized linear model of repeated measures was constructed for the analysis of differences. Post-intervention MT yielded a significant improvement in active mobility and endurance in patients with subacute or chronic MND, and at 6-month follow-up the differences were only significant in endurance and in sagittal plane active mobility. In the TENS group, no significant improvement was detected. With regard to other variables, MT improved mobility and endurance more effectively than TENS at post-intervention and at 6-month follow-up in the sagittal plane. Only MT generated significant improvements in cervical mobility and endurance in the three movement planes.
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Areerak K, Waongenngarm P, Janwantanakul P. Factors associated with exercise adherence to prevent or treat neck and low back pain: A systematic review. Musculoskelet Sci Pract 2021; 52:102333. [PMID: 33529988 DOI: 10.1016/j.msksp.2021.102333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 01/10/2021] [Accepted: 01/17/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Much attention has been paid to the evaluation of the efficacy of exercise therapy or increasing physical activity with the aim to prevent or alleviate neck and low back pain. However, exercise adherence is necessary for the effective management of neck and low back pain. OBJECTIVE We aimed to systematically review randomized controlled trials and cohort studies to gain insights into the factors associated with adherence to exercise or physical activity programs to prevent or treat neck pain and low back pain. METHOD Publications were systematically searched from 1980-December 2019 in several databases. The following key words were used: neck pain or low back pain paired with exercise or physical activity and adherence or compliance. Relevant studies were retrieved and assessed for methodological quality by two independent reviewers. Quality of evidence was assessed and rated according to GRADE guidelines. RESULTS Nine randomized controlled trials and eight cohort studies were included in this review. Randomized controlled trials indicated moderate-quality evidence for the association between exercise adherence and self-efficacy. Cohort studies showed moderate-quality evidence for the association between exercise adherence and education level. CONCLUSIONS Literature investigating factors associated with exercise adherence to prevent or treat neck and low back pain was heterogeneous. Few factors were found to be associated with exercise adherence. More studies are needed before any firm conclusions can be reached.
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Affiliation(s)
- Kantheera Areerak
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand.
| | - Pooriput Waongenngarm
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
| | - Prawit Janwantanakul
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
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Hernando-Jorge A, Pérez-Del-Pozo D, Sánchez-Martín D, Beltran-Alacreu H. [Therapeutic exercise as treatment for spinal chronic pain: systematic review of randomized clinical trials]. Rehabilitacion (Madr) 2021; 55:49-66. [PMID: 32888707 DOI: 10.1016/j.rh.2020.06.005] [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: 11/11/2019] [Revised: 06/25/2020] [Accepted: 06/28/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The objective of the present review was to analyze and compare the effectiveness of different types of therapeutic exercise in people with chronic spinal pain. METHODS Data search was conducted using the electronic database MEDLINE. Randomized clinical trials, conducted in patients between 18 and 65 years old with chronic pain in the spine region, were included. RESULTS Two independent reviewers performed the analysis of methodological quality using the PEDro scale, with 13 studies finally selected. The different types of therapeutic exercise had significant effects on pain reduction, decrease of disability and improvement of the quality of life of the patients. CONCLUSIONS The results show that there is no modality of therapeutic exercise superior to others. The combination of different therapeutic exercise modalities could be a complete tool for the management of chronic pain in the spine.
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Affiliation(s)
- A Hernando-Jorge
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España
| | - D Pérez-Del-Pozo
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España
| | - D Sánchez-Martín
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España
| | - H Beltran-Alacreu
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España; CranioSPain Research Group. Centro Superior de Estudios Universitarios La Salle, Universidad Autonóma de Madrid, España.
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Larinier N, Balaguier R, Vuillerme N. How much do we know about the effectiveness of warm-up intervention on work related musculoskeletal disorders, physical and psychosocial functions: protocol for a systematic review. BMJ Open 2020; 10:e039063. [PMID: 33243796 PMCID: PMC7692815 DOI: 10.1136/bmjopen-2020-039063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Work-related musculoskeletal disorders (WMSDs) are a growing worldwide burden and effective interventions to prevent them are needed. Physical activity at the workplace is now recognised as a relevant component of WMSDs prevention. Along these lines, warm-up interventions are now offered in a large number of companies to manage WMSDs. Although benefits of warm-up have been previously documented in sports context, to the best of our knowledge, the effectiveness of such intervention in workplaces still remains to be established. Within this context, the aim of the present review is to identify from published literature the available evidence regarding the effects of warm-up on WMSDs and physical and psychosocial functions. METHODS The following electronic databases will be searched (from inception onwards to June 2020): Cochrane Central Register of Controlled Trials, PubMed (Medline), Web of Science and Physiotherapy Evidence Database. Randomised and non-randomised controlled studies will be included in this review. Participants should be adult employees without specific comorbidities. Interventions should include a warm-up physical intervention in real-workplaces. The primary outcomes will be pain, discomfort or fatigue. The secondary outcomes will be job control or motivation at work. This review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and two team members will independently screen all citations, full-text articles and abstract data. A systematic narrative synthesis will be provided with information presented in the text and tables to summarise the characteristics and findings of the included studies. ETHICS AND DISSEMINATION The approval of an ethical committee is not required. All the included studies will comply with the current ethical standards. The results of this review will summarise the effects of warm-up intervention on WMSDs, physical or psychosocial functions. This information could help professionals in decision making related to the use of these interventions to prevent WMSDs. Findings will be disseminated to academic audiences through peer-reviewed publications, as well as to policy-makers. PROSPERO REGISTRATION NUMBER CRD42019137211.
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Affiliation(s)
- Nicolas Larinier
- AGEIS, University Grenoble Alpes, Grenoble, France
- Opti'Mouv, St Paul, France
| | - Romain Balaguier
- AGEIS, University Grenoble Alpes, Grenoble, France
- Opti'Mouv, St Paul, France
| | - Nicolas Vuillerme
- AGEIS, University Grenoble Alpes, Grenoble, France
- Opti'Mouv, St Paul, France
- Institut Universitaire de France, Paris, France
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19
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de Zoete RM, Armfield NR, McAuley JH, Chen K, Sterling M. Comparative effectiveness of physical exercise interventions for chronic non-specific neck pain: a systematic review with network meta-analysis of 40 randomised controlled trials. Br J Sports Med 2020; 55:bjsports-2020-102664. [PMID: 33139256 DOI: 10.1136/bjsports-2020-102664] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To compare the effectiveness of different physical exercise interventions for chronic non-specific neck pain. DESIGN Systematic review and network meta-analysis. DATA SOURCES Electronic databases: AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Physiotherapy Evidence Database, PsycINFO, Scopus and SPORTDiscus. ELIGIBILITY CRITERIA Randomised controlled trials (RCTs) describing the effects of any physical exercise intervention in adults with chronic non-specific neck pain. RESULTS The search returned 6549 records, 40 studies were included. Two networks of pairwise comparisons were constructed, one for pain intensity (n=38 RCTs, n=3151 participants) and one for disability (n=29 RCTs, n=2336 participants), and direct and indirect evidence was obtained. Compared with no treatment, three exercise interventions were found to be effective for pain and disability: motor control (Hedges' g, pain -1.32, 95% CI: -1.99 to -0.65; disability -0.87, 95% CI: -1.45 o -0.29), yoga/Pilates/Tai Chi/Qigong (pain -1.25, 95% CI: -1.85 to -0.65; disability -1.16, 95% CI: -1.75 to -0.57) and strengthening (pain -1.21, 95% CI: -1.63 to -0.78; disability -0.75, 95% CI: -1.28 to -0.22). Other interventions, including range of motion (pain -0.98 CI: -2.51 to 0.56), balance (pain -0.38, 95% CI: -2.10 to 1.33) and multimodal (three or more exercises types combined) (pain -0.08, 95% CI: -1.70 to 1.53) exercises showed uncertain or negligible effects. The quality of evidence was very low according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. CONCLUSION There is not one superior type of physical exercise for people with chronic non-specific neck pain. Rather, there is very low quality evidence that motor control, yoga/Pilates/Tai Chi/Qigong and strengthening exercises are equally effective. These findings may assist clinicians to select exercises for people with chronic non-specific neck pain. PROSPERO REGISTRATION NUMBER CRD42019126523.
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Affiliation(s)
- Rutger Mj de Zoete
- RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Queensland, Australia
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, South Australia, Australia
| | - Nigel R Armfield
- RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Queensland, Australia
| | - James H McAuley
- Neuroscience Research Australia and School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Kenneth Chen
- RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Queensland, Australia
- Geriatric Education and Research Institute, Singapore
| | - Michele Sterling
- RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Queensland, Australia
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Frutiger M, Borotkanics R. Systematic Review and Meta-Analysis Suggest Strength Training and Workplace Modifications May Reduce Neck Pain in Office Workers. Pain Pract 2020; 21:100-131. [PMID: 32657531 DOI: 10.1111/papr.12940] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/05/2020] [Accepted: 07/08/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Neck pain is a burdensome musculoskeletal disorder in office workers. Workplace interventions aim to prevent and minimize the effect of neck pain and improve work quality. However, the summed effect of workplace interventions on neck pain in office workers remains unclear. This systematic review with meta-analysis and meta-regression evaluated the summed effect of workplace interventions on neck pain in office workers. METHODS We searched 7 electronic databases to January 2020 for randomized clinical trials. We selected studies, independently extracted data, and assessed risk of bias. Meta-analyses were carried out along with normalized trend plots. RESULTS Twenty-nine trials, including 8 of high quality, met our inclusion criteria. Normalized trend plots indicate that neck strengthening demonstrated the sharpest decrease in pain scores. The results of pre- and post-outcome measurement of the effect of activity performance and workplace modification showed significant improvements in self-reported neck pain (P ≤ 0.001). Meta-regression was used to evaluate the effect of time, but it was not significant. CONCLUSIONS There is low-quality evidence that neck strengthening and tailored workstation modifications are effective at reducing neck pain in office workers. Further high-quality research methodology, including clinicians, is important to evaluate this summed effect.
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Affiliation(s)
- Martin Frutiger
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, North Ryde, NSW, Australia
| | - Robert Borotkanics
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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21
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Price J, Rushton A, Tyros I, Tyros V, Heneghan NR. Effectiveness and optimal dosage of exercise training for chronic non-specific neck pain: A systematic review with a narrative synthesis. PLoS One 2020; 15:e0234511. [PMID: 32520970 PMCID: PMC7286530 DOI: 10.1371/journal.pone.0234511] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 05/26/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Clinical guidelines make vague recommendations as to exercise training (ET) type and dosage to manage chronic non-specific neck pain (CNSNP). OBJECTIVE To synthesise evidence on the effectiveness of different ET programmes to reduce CNSNP and associated disability, and whether dosage affects outcomes. METHODS A systematic review and data synthesis was conducted according to a published registered protocol (PROSPERO CRD42018096187). A sensitive topic-based search was conducted of CINAHL, MEDLINE, EMBASE, PEDro, grey literature sources and key journals from inception to 6th January 2020 for randomised controlled trials, investigating ET for CNSNP or disability. Two reviewers independently completed eligibility screening, data extraction, risk of bias assessment (Cochrane Risk of Bias Tool) and rated the overall strength of evidence using Grading of Recommendations Assessment, Development and Evaluation. Data was tabulated for narrative synthesis and grouped by intervention, outcome and time point to compare across studies. RESULTS Twenty-six trials from 3990 citations (n = 2288 participants) investigated fifteen ET programmes. High RoB and low sample sizes reduced evidence quality. Clinical heterogeneity prevented meta-analyses. A range of ET programmes reduce pain/disability in the short term (low to moderate evidence). Pillar exercises reduce pain/disability in the intermediate term (low level evidence). Moderate to very large pain reduction is found with ET packages that include motor control + segmental exercises (low to moderate evidence). No high-quality trials investigated long term outcomes. Increased frequency of motor control exercises and progressively increased load of pillar exercise may improve effectiveness. CONCLUSIONS Motor control + segmental exercises are the most effective ET to reduce short term pain/disability, but long-term outcomes have not been investigated. Optimal motor control + segmental exercise variables and dosage is unknown and requires clarification. An adequately powered, low RoB trial is needed to evaluate the effectiveness and optimal dosage of motor control + segmental on long term outcomes. TRIAL REGISTRATION PROSPERO CRD42018096187.
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Affiliation(s)
- Jonathan Price
- Musculoskeletal Physiotherapy Services, Birmingham Community Healthcare NHS Foundation Trust, Birmingham, England, United Kingdom
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine) School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, England, United Kingdom
| | - Alison Rushton
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine) School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, England, United Kingdom
| | - Isaak Tyros
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine) School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, England, United Kingdom
- Edgbaston Physiotherapy Clinic, Birmingham, England, United Kingdom
| | - Vasileios Tyros
- Edgbaston Physiotherapy Clinic, Birmingham, England, United Kingdom
| | - Nicola R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine) School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, England, United Kingdom
- * E-mail:
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Muñoz-Poblete C, Bascour-Sandoval C, Inostroza-Quiroz J, Solano-López R, Soto-Rodríguez F. Effectiveness of Workplace-Based Muscle Resistance Training Exercise Program in Preventing Musculoskeletal Dysfunction of the Upper Limbs in Manufacturing Workers. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:810-821. [PMID: 31183588 DOI: 10.1007/s10926-019-09840-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Aims Given the high levels of absenteeism due to musculoskeletal disorders of the upper limbs, there is a need for preventive strategies to protect workers exposed to high risk levels. The purpose of this study was to determine the effect of a workplace-based muscle resistance training exercise program in the presence of pain and musculoskeletal dysfunction of the upper extremities in manufacturing workers exposed to repetitive movements and excessive effort in the workplace. Method Randomized controlled trial in manufacturing workers. A sample of 120 healthy workers was allocated at random to an experimental group, which received a resistance-based exercise program, and a control group, which performed stretching exercises. Results The muscle resistance training exercise had a protective effect on the intensity of pain perceived by workers in their upper limbs (RR: 0.62 95% CI 0.44-0.87) compared with the group of workers who performed stretching exercises. Conclusion A workplace-based muscle resistance training exercise program is an effective preventive strategy in factory workers exposed to risk; however, it is necessary for companies initially to adopt mechanisms to minimize exposure as a prevention strategy.
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Affiliation(s)
- C Muñoz-Poblete
- Depto. Salud Pública, Universidad de La Frontera, Temuco, Chile.
| | | | | | - R Solano-López
- Depto. Especialidades Médicas, Universidad de La Frontera, Temuco, Chile
| | - F Soto-Rodríguez
- Depto. Medicina Interna, Universidad de La Frontera, Temuco, Chile
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Oliva-Pascual-Vaca Á, González-González C, Oliva-Pascual-Vaca J, Piña-Pozo F, Ferragut-Garcías A, Fernández-Domínguez JC, Heredia-Rizo AM. Visceral Origin: An Underestimated Source of Neck Pain. A Systematic Scoping Review. Diagnostics (Basel) 2019; 9:diagnostics9040186. [PMID: 31726685 PMCID: PMC6963844 DOI: 10.3390/diagnostics9040186] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/01/2019] [Accepted: 11/06/2019] [Indexed: 12/12/2022] Open
Abstract
The diagnosis of neck pain is challenging. Many visceral disorders are known to cause it, and clinical practice guidelines recommend to rule them out during neck pain diagnosis. However, the absence of suspicion of any cause impedes one from establishing that specific aetiology as the final diagnosis. To investigate the degree of consideration given to visceral aetiology, a systematic search of trials about neck pain was carried out to evaluate their selection criteria. The search yielded 309 eligible articles, which were screened by two independent reviewers. The PEDro scale score was used to assess the methodological quality of the studies. The following information was retrieved: number of authors affiliated to a clinical or non-clinical institution, number of citations in the Web of Science, study aims, characteristics of participants, and eligibility criteria. The top 15 most cited trials, and the 15 most recent studies about treatment efficacy in neck pain, published in first quartile journals of the Journal Citation Reports, were selected. Females represented 67.5% of participants. A single study was of poor methodological quality (4/10). Based on the eligibility criteria of the articles that were systematically reviewed, it would appear that visceral aetiology was not considered in eighty percent of the trials on neck pain, showing a low level of suspicion both in research and clinical settings.
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Affiliation(s)
- Ángel Oliva-Pascual-Vaca
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain; (Á.O.-P.-V.); (C.G.-G.); (A.M.H.-R.)
| | - Carlos González-González
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain; (Á.O.-P.-V.); (C.G.-G.); (A.M.H.-R.)
| | - Jesús Oliva-Pascual-Vaca
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain; (Á.O.-P.-V.); (C.G.-G.); (A.M.H.-R.)
- Escuela de Osteopatía de Madrid, 28002 Madrid, Spain
- Department of Physiotherapy, Universitary School of Osuna, University of Sevilla, 41640 Sevilla, Spain;
- Correspondence:
| | - Fernando Piña-Pozo
- Department of Physiotherapy, Universitary School of Osuna, University of Sevilla, 41640 Sevilla, Spain;
| | - Alejandro Ferragut-Garcías
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07112 Palma de Mallorca, Spain; (A.F.-G.); (J.C.F.-D.)
| | - Juan Carlos Fernández-Domínguez
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07112 Palma de Mallorca, Spain; (A.F.-G.); (J.C.F.-D.)
| | - Alberto Marcos Heredia-Rizo
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain; (Á.O.-P.-V.); (C.G.-G.); (A.M.H.-R.)
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Huhtela OS, Koivisto N, Hägg V, Sipilä K. Effectiveness of applied relaxation method vs splint in treatment of temporomandibular disorders in Finnish students. J Oral Rehabil 2019; 47:123-131. [DOI: 10.1111/joor.12884] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 08/13/2019] [Accepted: 08/23/2019] [Indexed: 01/24/2023]
Affiliation(s)
- Outi S. Huhtela
- Institute of Dentistry University of Eastern Finland Kuopio Finland
- Department of Oral and Maxillofacial Diseases Kuopio University Hospital Kuopio Finland
- Oral and Maxillofacial Department Medical Research Center Oulu Oulu University Hospital Oulu Finland
- Finnish Student Health Service Oulu Finland
| | - Nina Koivisto
- Institute of Dentistry University of Eastern Finland Kuopio Finland
- Oral Health Care Jyväskylä Finland
| | | | - Kirsi Sipilä
- Oral and Maxillofacial Department Medical Research Center Oulu Oulu University Hospital Oulu Finland
- Research Unit of Oral Health Sciences Faculty of Medicine University of Oulu Oulu Finland
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Abstract
Objective To assess the impact of repetitive movements of the thumb caused by playing a smartphone game continuously for 30 min. Methods This study recruited healthy volunteers. They were instructed to play a game called Subway Surfers, which ran continuously. Subjects played the game for 30 min. The function of the abductor pollicis brevis and extensor pollicis brevis muscles was assessed by surface electromyography and the signals were obtained at 10 min, 20 min and 30 min. The median frequency (MDF) was used as an indicator of muscle fatigue. A visual analogue scale (VAS) was used to assess the subjective discomfort of the volunteers. Results Twelve subjects participated in this study. The MDF of the abductor pollicis brevis and extensor pollicis brevis muscles decreased significantly over the test period. The MDF of the extensor pollicis brevis had decreased significantly by 10 min after the start of the gaming session, while the abductor pollicis brevis had decreased significantly by 20 min. The VAS scores significantly increased after 30 min of continuous gaming. Conclusions This study suggests that playing continuous games on a smartphone might result in chronic muscle injury. Continuous gaming time should be kept below 20 minutes.
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Affiliation(s)
- Dong Wang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liang Tang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huihui Wu
- School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China.,Engineering Research Centre of Digital Medicine and Clinical Translation, Ministry of Education of P. R. China, Shanghai, China
| | - Dongyun Gu
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China.,Engineering Research Centre of Digital Medicine and Clinical Translation, Ministry of Education of P. R. China, Shanghai, China
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26
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Lytras D, Sykaras E, Christoulas K, Myrogiannis I, Kellis E. Effects of an integrated neuromuscular inhibition technique program on neck muscle strength and endurance in individuals with chronic mechanical neck pain. J Bodyw Mov Ther 2019; 23:643-651. [PMID: 31563383 DOI: 10.1016/j.jbmt.2019.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 01/24/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of this study was to investigate whether the application of the integrated neuromuscular inhibition technique (INIT) combined with therapeutic exercise (TE) can provide faster and greater improvement in maximum isometric strength and isometric endurance of the neck muscles in patients with chronic mechanical neck pain (CMNP). METHODS In this 10-week, single-blind clinical trial, 40 participants (men and women) with CMNP were divided into two groups. The intervention group (IG) followed a TE program in combination with the INIT, while the control group (CG) followed the same TE program without the INIT technique. Changes in maximum isometric strength and isometric endurance of the neck muscles were evaluated before, during, and after the intervention, with follow-up measurements taken at 1, 3, and 6 months after the intervention. Analysis of variance with repeated measures was applied. RESULTS Both groups showed a significant improvement in all dependent measures after the intervention (p < .05). These changes were maintained for both groups 6 months after the intervention. However, the IG showed a greater improvement in the maximum isometric strength of neck flexion and an improved craniocervical flexion test score compared with the CG. CONCLUSION The combination of TE and INIT had a positive effect on neck muscle strength and endurance in individuals suffering from CMNP as compared with TE alone.
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Affiliation(s)
- Dimitrios Lytras
- Department of Physical Education and Sports Sciences, Aristotle University of Thessaloniki, 57001, Thermi, Thessaloniki, Greece.
| | - Evaggelos Sykaras
- Department of Physical Education and Sports Sciences, Aristotle University of Thessaloniki, 57001, Thermi, Thessaloniki, Greece
| | - Kosmas Christoulas
- Laboratory of Ergophysiology, Department of Physical Education and Sports Sciences, Aristotle University of Thessaloniki, 57001, Thermi, Thessaloniki, Greece
| | - Ioannis Myrogiannis
- Department of Medical School, Laboratory of Hygiene-Medical Statistics, School of Medicine, University Campus, 54124, Thessaloniki, Greece
| | - Eleftherios Kellis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloníki, 62110, Agios Ioannis, Serres, Greece
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27
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Tsang SMH, So BCL, Lau RWL, Dai J, Szeto GPY. Comparing the effectiveness of integrating ergonomics and motor control to conventional treatment for pain and functional recovery of work-related neck-shoulder pain: A randomized trial. Eur J Pain 2019; 23:1141-1152. [PMID: 30793422 DOI: 10.1002/ejp.1381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 01/26/2019] [Accepted: 02/17/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND Work-related neck and shoulder pain (WRNSP) is highly prevalent among patients who seek physiotherapy treatment. Clinicians may tend to focus on teaching home exercises and provide general advice about workplace improvement. The present study investigates the short- and long-term impact of an intervention approach that emphasizes on integrating the motor control re-education with ergonomic advice. METHODS Participants diagnosed with WRNSP (n = 101) were randomly assigned into two groups in this randomized controlled trial. The Ergo-motor Group (EM, n = 51) received an integrated intervention with ergonomic advice/modifications and motor control training individualized for each participant based on their specific work demands. Control Group (CO, n = 50) received treatment for pain relief and general exercises of their necks at a designated physiotherapy clinic. Neck pain intensity and functional outcome measures were assessed before, immediately and 1-year after the 12-week intervention programmes. Global Rating of Change Score was used to evaluate the perceived recovery at 1-year follow-up. RESULTS Both groups reported significant reductions in pain and functional disability scores at post-intervention (EM, n = 44; CO, n = 42) and 1-year follow-up (EM, n = 40; CO, n = 38); however, no significant between-group differences were found (p > 0.05). Significantly higher rating in global recovery score was reported in EM group at 1-year follow-up (p < 0.05). CONCLUSIONS Intervention integrating ergonomic advice/modification with motor control exercise was found to be equally effective as pain relief and general exercise for pain and functional recovery. However, at 1-year follow-up, such integrated approach resulted in significantly better global recovery perceived by people with WRNSP. SIGNIFICANCE Integrating ergonomic intervention and motor control training achieved similar reduction in pain and functional outcomes compared to conventional physiotherapy at post-intervention and at 1-year follow-up, for patients with moderate level of work-related neck-shoulder pain and mild degree of functional disability. The Ergo-motor Group reported significantly better perceived overall recovery at 1-year follow-up.
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Affiliation(s)
- Sharon M H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Billy C L So
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Rufina W L Lau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.,School of Medical and Health Sciences, Tung Wah College, Hong Kong SAR, China
| | - Jie Dai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Grace P Y Szeto
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.,School of Medical and Health Sciences, Tung Wah College, Hong Kong SAR, China
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Polaski AM, Phelps AL, Kostek MC, Szucs KA, Kolber BJ. Exercise-induced hypoalgesia: A meta-analysis of exercise dosing for the treatment of chronic pain. PLoS One 2019; 14:e0210418. [PMID: 30625201 PMCID: PMC6326521 DOI: 10.1371/journal.pone.0210418] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 12/21/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Increasing evidence purports exercise as a first-line therapeutic for the treatment of nearly all forms of chronic pain. However, knowledge of efficacious dosing respective to treatment modality and pain condition is virtually absent in the literature. The purpose of this analysis was to calculate the extent to which exercise treatment shows dose-dependent effects similar to what is seen with pharmacological treatments. METHODS A recently published comprehensive review of exercise and physical activity for chronic pain in adults was identified in May 2017. This report reviewed different physical activity and exercise interventions and their effectiveness in reducing pain severity and found overall modest effects of exercise in the treatment of pain. We analyzed this existing data set, focusing specifically on the dose of exercise intervention in these studies. We re-analyzed data from 75 studies looking at benefits of time of exercising per week, frequency of exercise per week, duration of intervention (in weeks), and estimated intensity of exercise. RESULTS Analysis revealed a significant positive correlation with exercise duration and analgesic effect on neck pain. Multiple linear regression modeling of these data predicted that increasing the frequency of exercise sessions per week is most likely to have a positive effect on chronic pain patients. DISCUSSION Modest effects were observed with one significant correlation between duration and pain effect for neck pain. Overall, these results provide insufficient evidence to conclude the presence of a strong dose effect of exercise in pain, but our modeling data provide tes predictions that can be used to design future studies to explicitly test the question of dose in specific patient populations.
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Affiliation(s)
- Anna M. Polaski
- Department of Biological Sciences, Duquesne University, Pittsburgh, Pennsylvania, United States of America
- Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, United States of America
| | - Amy L. Phelps
- Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, United States of America
- Palumbo Donahue School of Business, Duquesne University, Pittsburgh, Pennsylvania, United States of America
| | - Matthew C. Kostek
- Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, United States of America
- Department of Physical Therapy, Duquesne University, Pittsburgh, Pennsylvania, United States of America
| | - Kimberly A. Szucs
- Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, United States of America
- Department of Occupational Therapy, Duquesne University, Pittsburgh, Pennsylvania, United States of America
| | - Benedict J. Kolber
- Department of Biological Sciences, Duquesne University, Pittsburgh, Pennsylvania, United States of America
- Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, United States of America
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Neck and Scapula-Focused Exercise Training on Patients With Nonspecific Neck Pain: A Randomized Controlled Trial. J Sport Rehabil 2018; 27:403-412. [PMID: 28605288 DOI: 10.1123/jsr.2017-0024] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the effects of additional 6-week scapular stabilization training in patients with nonspecific neck pain (NNP). MATERIALS AND METHODS A total of 30 patients with NNP were randomly allocated to the study. Fifteen participants in the intervention group received neck-focused exercise and scapular stabilization training, whereas 15 participants in the control group received neck-focused exercise training. All groups were evaluated at baseline and after 6 weeks of rehabilitation. The pain intensity on the neck was measured with the visual analog scale (VAS). The self-reported disability status was measured with the neck disability index (NDI). Three-dimensional scapular kinematics were recorded during dynamic shoulder elevation trials using an electromagnetic tracking device, and data were further analyzed at 30°, 60°, 90°, and 120° of humerothoracic elevations. RESULTS Comparisons revealed that, regardless of the received treatment, after 6 weeks of training both groups showed significant improvements in VAS (P < .001) and NDI (P < .001) scores. Both VAS and NDI outcomes have a large effect size (r = .618 and r = .619, respectively). For scapular kinematics, there were no group differences, especially for scapular upward-downward rotation and anterior-posterior tilt (P > .05). However, in the intervention group, the scapula was more externally rotated at 120° humerothoracic elevation (P = .04). CONCLUSION Findings of this study showed that both manual therapy and active interventions, including neck-focused exercise and scapular stabilization training, are effective in decreasing pain and disability level in patients with NNP. More comprehensive studies with longer follow-up durations are needed to better understand the potential effects of scapular stabilization training in patients with NNP.
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Maissan F, Pool J, de Raaij E, Mollema J, Ostelo R, Wittink H. The clinical reasoning process in randomized clinical trials with patients with non-specific neck pain is incomplete: A systematic review. Musculoskelet Sci Pract 2018; 35:8-17. [PMID: 29413949 DOI: 10.1016/j.msksp.2018.01.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 01/25/2018] [Accepted: 01/31/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Primarily to evaluate the completeness of the description of the clinical reasoning process in RCTs with patients with non-specific neck pain with an argued or diagnosed cause i.e. an impairment or activity limitation. Secondly, to determine the association between the completeness of the clinical reasoning process and the degree of risk of bias. DATA SOURCES Pubmed, Cinahl and PEDro were systematically searched from inception to July 2016. STUDY SELECTION RCTs (n = 122) with patients with non-specific neck pain receiving physiotherapy treatment published in English were included. DATA EXTRACTION Data extraction included study characteristics and important features of the clinical reasoning process based on the Hypothesis-Oriented Algorithm for Clinicians II (HOAC II)]. DATA SYNTHESIS Thirty-seven studies (30%) had a complete clinical reasoning process of which 8 (6%) had a 'diagnosed cause' and 29 (24%) had an 'argued cause'. The Spearmans rho association between the extent of the clinical reasoning process and the risk of bias was -0.2. CONCLUSIONS In the majority of studies (70%) the described clinical reasoning process was incomplete. A very small proportion (6%) had a 'diagnosed cause'. Therefore, a better methodological quality does not necessarily imply a better described clinical reasoning process.
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Affiliation(s)
- Francois Maissan
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands; Department of Health Sciences, VU University, Amsterdam, The Netherlands; Amsterdam Movement Sciences, The Netherlands.
| | - Jan Pool
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Edwin de Raaij
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands; Department of Health Sciences, VU University, Amsterdam, The Netherlands; Amsterdam Movement Sciences, The Netherlands
| | - Jürgen Mollema
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Raymond Ostelo
- Department of Health Sciences, VU University, Amsterdam, The Netherlands; Amsterdam Movement Sciences, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands
| | - Harriet Wittink
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
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Becker JJ, Copeland SL, Botterbusch EL, Cohen RG. Preliminary evidence for feasibility, efficacy, and mechanisms of Alexander technique group classes for chronic neck pain. Complement Ther Med 2018; 39:80-86. [PMID: 30012397 DOI: 10.1016/j.ctim.2018.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 10/16/2022] Open
Abstract
OBJECTIVES To determine feasibility and potential of Alexander technique (AT) group classes for chronic neck pain and to assess changes in self-efficacy, posture, and neck muscle activity as potential mechanisms for pain reduction. DESIGN A single-group, multiple-baseline design, with two pre-tests to control for regression toward the mean, a post-test immediately after the intervention, and another post-test five weeks later to examine retention of benefits. Participants were predominately middle-aged; all had experienced neck pain for at least six months. INTERVENTION Participants attended ten one-hour group classes in AT, an embodied mindful approach that may reduce habitual overactivation of muscles, including superficial neck muscles, over five weeks. OUTCOME MEASURES (1) self-reports: Northwick Park Questionnaire (to assess neck pain and associated disability) and Pain Self-Efficacy Questionnaire; (2) superficial neck flexor activation and fatigue (assessed by electromyography and power spectral analysis) during the cranio-cervical flexion test; (3) posture during a video game task. RESULTS There were no significant changes in outcomes between pre-tests. All participants completed the intervention. After the intervention: (1) participants reported significantly reduced neck pain; (2) fatigue of the superficial neck flexors during the cranio-cervical flexion test was substantially lower; (3) posture was marginally more upright, as compared to the second pre-intervention values. Changes in pain, self-efficacy, and neck muscle fatigue were retained at the second post-test and tended to be correlated with one another. CONCLUSIONS Group AT classes may provide a cost-effective approach to reducing neck pain by teaching participants to decrease excessive habitual muscle contraction during everyday activity.
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Affiliation(s)
- Jordan J Becker
- Department of Psychology & Communication, University of Idaho, USA
| | | | | | - Rajal G Cohen
- Department of Psychology & Communication, University of Idaho, USA.
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Laux RC, Corazza ST, Andrade A. WORKPLACE PHYSICAL ACTIVITY PROGRAM: AN INTERVENTION PROPOSAL. REV BRAS MED ESPORTE 2018. [DOI: 10.1590/1517-869220182403179971] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Contemporary workstations have been transformed by technological advances, meaning that employees are less physically active. Physical exercise programs are a tool to combat this sedentary lifestyle and prevent possible work-related illnesses. The aim of this study consisted of drafting an intervention proposal through physical exercise - the Workplace Physical Activity Program / WPAP - to be applied in the workplace, covering physical, mental and social aspects. The trial was methodologically structured in three stages: a) contextualization of the WPAP; b) implementation of the program; and c) the intervention proposal. It is believed that this type of program should receive investments, as it has a quick return and effectively improves the health of workers. Level of Evidence V; Expert opinion.
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Kelly D, Shorthouse F, Roffi V, Tack C. Exercise therapy and work-related musculoskeletal disorders in sedentary workers. Occup Med (Lond) 2018; 68:262-272. [DOI: 10.1093/occmed/kqy054] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Kelly
- Occupational Health Physiotherapy, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - F Shorthouse
- Occupational Health Physiotherapy, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - V Roffi
- Occupational Health Physiotherapy, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - C Tack
- Occupational Health Physiotherapy, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
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Effects of combining ergonomic interventions and motor control exercises on muscle activity and kinematics in people with work-related neck–shoulder pain. Eur J Appl Physiol 2018; 118:751-765. [DOI: 10.1007/s00421-018-3802-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 01/08/2018] [Indexed: 11/25/2022]
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Ilkevitch A, Lawler T, Rindfleisch JA. Neck Pain. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00068-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Chen X, Coombes BK, Sjøgaard G, Jun D, O'Leary S, Johnston V. Workplace-Based Interventions for Neck Pain in Office Workers: Systematic Review and Meta-Analysis. Phys Ther 2018; 98:40-62. [PMID: 29088401 DOI: 10.1093/ptj/pzx101] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 10/01/2017] [Indexed: 02/09/2023]
Abstract
Abstract
Background
At present, there is no consolidated evidence for workplace-based interventions for the prevention and reduction of neck pain in office workers.
Purpose
The purpose of this review was to investigate the effectiveness of workplace-based interventions for neck pain in office workers.
Data Sources
MEDLINE, PEDro, CINAHL, and CENTRAL were searched for trials published since inception and before May 31, 2016.
Study Selection
Randomized controlled trials (RCTs) were considered when they met the following criteria: population consisted of office workers, intervention(s) was performed at the workplace, outcome measures included neck and/or neck/shoulder pain intensity and incidence/prevalence, and comparator groups included no/other intervention.
Data Extraction
Data were extracted by 1 reviewer using predefined data fields and checked by a second reviewer. Risk of bias was assessed by 2 independent reviewers using the 2015 Cochrane Back and Neck Group guidelines. Evidence quality was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation system.
Data Synthesis
Twenty-seven RCTs were included. There was moderate-quality evidence that neck/shoulder strengthening exercises and general fitness training were effective in reducing neck pain in office workers who were symptomatic, although the effect size was larger for strengthening exercises. Greater effects were observed with greater participation in exercise. Ergonomic interventions were supported by low-quality evidence.
Limitations
Data could not be obtained from some studies for meta-analysis and assessment of risk of bias. Reporting bias might have been present because only studies in the English language were included.
Conclusions
Workplace-based strengthening exercises were effective in reducing neck pain in office workers who were symptomatic, and the effect size was larger when the exercises were targeted to the neck/shoulder. Future RCTs of ergonomic interventions targeted at office workers who are symptomatic are required. More research on neck pain prevention is warranted.
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Affiliation(s)
- Xiaoqi Chen
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane St Lucia, Queensland 4072, Australia
| | | | - Gisela Sjøgaard
- Department of Sport Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Deokhoon Jun
- School of Health and Rehabilitation Sciences, University of Queensland
| | - Shaun O'Leary
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, and Department of Physiotherapy, Royal Brisbane and Women's Hospital, Queensland Health, Brisbane St. Lucia, Queensland
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, University of Queensland
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Louw S, Makwela S, Manas L, Meyer L, Terblanche D, Brink Y. Effectiveness of exercise in office workers with neck pain: A systematic review and meta-analysis. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2017; 73:392. [PMID: 30135909 PMCID: PMC6093121 DOI: 10.4102/sajp.v73i1.392] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 10/21/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Non-specific neck pain is a common health problem of global concern for office workers. This systematic review ascertained the latest evidence for the effectiveness of therapeutic exercise versus no therapeutic exercise on reducing neck pain and improving quality of life (QoL) in office workers with non-specific neck pain. METHOD Seven electronic databases using keywords, that is, 'office workers', 'non-specific neck pain', 'exercise' and/or 'exercise therapy', 'QoL', 'strengthening', 'stretching', 'endurance', 'physiotherapy' and/or 'physical therapy', were searched from inception until March 2017. Heterogeneous data were reported in narrative format and comparable homogenous data were pooled using Revman. RESULTS Eight randomised control trials were reviewed and scored on average 6.63/10 on the Physiotherapy Evidence Database (PEDro) scale. Five studies performed strengthening exercise, one study had a strengthening and an endurance exercise group, one study performed stretching exercise and one study had an endurance intervention group and a stretching intervention group. Five and four studies reported significant improvement in neck pain and QoL, respectively, when conducting strengthening exercise. When performing endurance exercises, one and two studies reported significant changes in neck pain and QoL, respectively. The one study incorporating stretching exercise reported significant improvement in neck pain. The meta-analysis revealed that there is a clinically significant difference favouring strengthening exercise over no exercise in pain reduction but not for QoL. CONCLUSION There is level II evidence recommending that clinicians include strengthening exercise to improve neck pain and QoL. However, the effect of endurance and stretching exercise needs to be explored further.
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Affiliation(s)
- Shereen Louw
- Department of Health and Rehabilitation Sciences, Stellenbosch University, South Africa
| | - Shale Makwela
- Department of Health and Rehabilitation Sciences, Stellenbosch University, South Africa
| | - Lorisha Manas
- Department of Health and Rehabilitation Sciences, Stellenbosch University, South Africa
| | - Lyle Meyer
- Department of Health and Rehabilitation Sciences, Stellenbosch University, South Africa
| | - Daniele Terblanche
- Department of Health and Rehabilitation Sciences, Stellenbosch University, South Africa
| | - Yolandi Brink
- Department of Health and Rehabilitation Sciences, Stellenbosch University, South Africa
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Comparison of the effectiveness of resistance training in women with chronic computer-related neck pain: a randomized controlled study. Int Arch Occup Environ Health 2017; 90:673-683. [DOI: 10.1007/s00420-017-1230-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 05/12/2017] [Indexed: 11/28/2022]
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Shearer HM, Carroll LJ, Wong JJ, Côté P, Varatharajan S, Southerst D, Sutton DA, Randhawa KA, Yu H, Mior SA, van der Velde GM, Nordin MC, Stupar M, Taylor-Vaisey AL. Are psychological interventions effective for the management of neck pain and whiplash-associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Spine J 2016; 16:1566-1581. [PMID: 26279388 DOI: 10.1016/j.spinee.2015.08.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 05/27/2015] [Accepted: 08/06/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT In 2008, the lack of published evidence prevented the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders (Neck Pain Task Force [NPTF]) from commenting on the effectiveness of psychological interventions for the management of neck pain. PURPOSE This study aimed to update findings of the NPTF and evaluate the effectiveness of psychological interventions for the management of neck pain and associated disorders (NAD) or whiplash-associated disorders (WAD). STUDY DESIGN/SETTING This study used systematic review and best-evidence synthesis. SAMPLE Randomized controlled trials, cohort studies, and case-control studies comparing psychological interventions to other non-invasive interventions or no intervention were the samples used in this study. OUTCOME MEASURES The outcome measures are (1) self-rated recovery; (2) functional recovery; (3) clinical outcomes; (4) administrative outcomes; and (5) adverse effects. METHODS We searched six databases from 1990 to 2015. Randomized controlled trials, cohort studies, and case-control studies meeting our selection criteria were eligible for critical appraisal. Random pairs of independent reviewers used the Scottish Intercollegiate Guidelines Network criteria to critically appraise eligible studies. Studies with a low risk of bias were synthesized following best evidence synthesis principles. This study was funded by the Ontario Ministry of Finance. RESULTS We screened 1,919 articles, 19 were eligible for critical appraisal and 10 were judged to have low risk of bias. We found no clear evidence supporting relaxation training or cognitive behavioral therapy (CBT) for persistent grades I-III NAD for reducing pain intensity or disability. Similarly, we did not find evidence to support the effectiveness of biofeedback or relaxation training for persistent grade II WAD, and there is conflicting evidence for the use of CBT in this population. However, adding a progressive goal attainment program to functional restoration physiotherapy may benefit patients with persistent grades I-III WAD. Furthermore, Jyoti meditation may help reduce neck pain intensity and bothersomeness in patients with persistent NAD. CONCLUSIONS We did not find evidence for or against the use of psychological interventions in patients with recent onset NAD or WAD. We found evidence that a progressive goal attainment program may be helpful for the management of persistent WAD and that Jyoti meditation may benefit patients with persistent NAD. The limited evidence of effectiveness for psychological interventions may be due to several factors, such as interventions that are ineffective, poorly conceptualized, or poorly implemented. Further methodologically rigorous research is needed.
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Affiliation(s)
- Heather M Shearer
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada.
| | - Linda J Carroll
- School of Public Health, University of Alberta, 4075 RTF, 8308-114 Street, Edmonton, AB, T6G 2E1, Canada
| | - Jessica J Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
| | - Pierre Côté
- Canada Research Chair in Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe Street North, Oshawa, Ontario, L1H 7K4, Canada; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe Street North, Oshawa, Ontario, L1H 7K4, Canada; UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, 6100 Leslie St., Toronto, Ontario, M2H 3J1, Canada
| | - Sharanya Varatharajan
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Division of Undergraduate Education, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario, M2H 3J1, Canada
| | - Danielle Southerst
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada
| | - Deborah A Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada
| | - Kristi A Randhawa
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Division of Undergraduate Education, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario, M2H 3J1, Canada
| | - Hainan Yu
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada
| | - Silvano A Mior
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe Street North, Oshawa, Ontario, L1H 7K4, Canada
| | - Gabrielle M van der Velde
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, Leslie Dan Pharmacy Building, University of Toronto, 6th Floor, Room 658, 144 College Street, Toronto, Ontario, M5S 3M2, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, Ontario, M5S 3M2, Canada; Institute for Work and Health, 481 University Ave, Toronto, Ontario, M5G 2E9, Canada
| | - Margareta C Nordin
- Department of Orthopedic Surgery, Occupational and Industrial Orthopedic Center, NYU School of Medicine, New York University, 63 Downing Street, New York, 10014, USA
| | - Maja Stupar
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada; UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, 6100 Leslie St., Toronto, Ontario, M2H 3J1, Canada
| | - Anne L Taylor-Vaisey
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada
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Southerst D, Nordin MC, Côté P, Shearer HM, Varatharajan S, Yu H, Wong JJ, Sutton DA, Randhawa KA, van der Velde GM, Mior SA, Carroll LJ, Jacobs CL, Taylor-Vaisey AL. Is exercise effective for the management of neck pain and associated disorders or whiplash-associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Spine J 2016; 16:1503-1523. [PMID: 24534390 DOI: 10.1016/j.spinee.2014.02.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 01/20/2014] [Accepted: 02/03/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT In 2008, the Neck Pain Task Force (NPTF) recommended exercise for the management of neck pain and whiplash-associated disorders (WAD). However, no evidence was available on the effectiveness of exercise for Grade III neck pain or WAD. Moreover, limited evidence was available to contrast the effectiveness of various types of exercises. PURPOSE To update the findings of the NPTF on the effectiveness of exercise for the management of neck pain and WAD grades I to III. STUDY DESIGN/SETTING Systematic review and best evidence synthesis. SAMPLE Studies comparing the effectiveness of exercise to other conservative interventions or no intervention. OUTCOME MEASURES Outcomes of interest included self-rated recovery, functional recovery, pain intensity, health-related quality of life, psychological outcomes, and/or adverse events. METHODS We searched eight electronic databases from 2000 to 2013. Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria. The results of scientifically admissible studies were synthesized following best-evidence synthesis principles. RESULTS We retrieved 4,761 articles, and 21 randomized controlled trials (RCTs) were critically appraised. Ten RCTs were scientifically admissible: nine investigated neck pain and one addressed WAD. For the management of recent neck pain Grade I/II, unsupervised range-of-motion exercises, nonsteroidal anti-inflammatory drugs and acetaminophen, or manual therapy lead to similar outcomes. For recent neck pain Grade III, supervised graded strengthening is more effective than advice but leads to similar short-term outcomes as a cervical collar. For persistent neck pain and WAD Grade I/II, supervised qigong and combined strengthening, range-of-motion, and flexibility exercises are more effective than wait list. Additionally, supervised Iyengar yoga is more effective than home exercise. Finally, supervised high-dose strengthening is not superior to home exercises or advice. CONCLUSIONS We found evidence that supervised qigong, Iyengar yoga, and combined programs including strengthening, range of motion, and flexibility are effective for the management of persistent neck pain. We did not find evidence that one supervised exercise program is superior to another. Overall, most studies reported small effect sizes suggesting that a small clinical effect can be expected with the use of exercise alone.
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Affiliation(s)
- Danielle Southerst
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1.
| | - Margareta C Nordin
- Department of Orthopedic Surgery, Occupational and Industrial Orthopedic Center, NYU School of Medicine, New York University, 63 Downing Street, New York, New York, USA, 10014
| | - Pierre Côté
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe Street North, Science building, Room 3000, Oshawa, Ontario, Canada, L1H 7K4
| | - Heather M Shearer
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Sharanya Varatharajan
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Hainan Yu
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Jessica J Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Deborah A Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Kristi A Randhawa
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Gabrielle M van der Velde
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, Leslie Dan Pharmacy Building, University of Toronto, 6th Floor, Room 658, 144 College Street, Toronto, Ontario, Canada, M5S 3M2; Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, Ontario, Canada, M5S 3M2; Institute for Work and Health, 481 University Ave, Toronto, Ontario, Canada, M5G 2E9
| | - Silvano A Mior
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe Street North, Science building, Room 3000, Oshawa, Ontario, Canada, L1H 7K4; Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Linda J Carroll
- Department of Public Health Sciences and Alberta Centre for Injury Prevention and Research, School of Public Health, University of Alberta, 4075 RTF, 8308-114 Street, Edmonton, Alberta, Canada, T6G 2E1
| | - Craig L Jacobs
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1; Division of Clinical Education, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Anne L Taylor-Vaisey
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
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O'Riordan C, Van De Ven P, Nelson J, McCreesh K, Clifford A. Reliability of a measurement method for the cross-sectional area of the longus colli using real-time ultrasound imaging. ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2016; 24:154-162. [PMID: 27867408 DOI: 10.1177/1742271x16659099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 06/16/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Real-time ultrasound imaging is an established objective outcome measurement with proven reliability. However, it is still largely biased by user-ability. Published research in the area of real-time ultrasound imaging reliability in the cervical region and in particular the deep cervical flexors is quite sparse. The purpose of this investigation was to examine if a novice ultrasound user could agree favourably with an experienced ultrasound sonographer in measuring the cross-sectional area of the longus colli. METHODS Ultrasound images were captured from 22 healthy subjects on two different occasions, one week apart, by a novice ultrasound user. They were acquired using a GE Healthcare LOGIQe ultrasound machine, at a depth of 3-4 cm with the transducer frequency set to 8 MHz, in line with previous research guidelines. Cross-sectional area was then measured on-screen by both a novice and experienced ultrasound user to determine inter-rater reliability. Intra-rater reliability was also analysed using cross-sectional area figures from days one and two. RESULTS Intra-rater reliability for real-time ultrasound imaging for the cross-sectional area of the longus colli was "excellent" (intra-class correlation 0.90, 95% CI 0.82-0.95). Inter-rater reliability was "moderate" but in keeping with previous published research (intra-class correlation 0.61, 95% CI 0.37-0.77). CONCLUSION Difficulties in identifying the borders of the longus colli muscle due to its deep anatomical location and surrounding structures make it difficult for assessors to agree favourably on cross-sectional area measurements, leading to "moderate" levels of inter-rater reliability and poor agreement. Intra-rater reliability is excellent, and in this instance indicates that a novice user can be just as reliable as a more experienced ultrasound user.
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Affiliation(s)
- Cliona O'Riordan
- Department of Clinical Therapies, University of Limerick, Limerick, Ireland
| | - Pepijn Van De Ven
- Department of Science and Engineering, University of Limerick, Limerick, Ireland
| | - John Nelson
- Department of Science and Engineering, University of Limerick, Limerick, Ireland
| | - Karen McCreesh
- Department of Clinical Therapies, University of Limerick, Limerick, Ireland
| | - Amanda Clifford
- Department of Clinical Therapies, University of Limerick, Limerick, Ireland
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Kim SY, Koo SJ. Effect of duration of smartphone use on muscle fatigue and pain caused by forward head posture in adults. J Phys Ther Sci 2016; 28:1669-72. [PMID: 27390391 PMCID: PMC4932032 DOI: 10.1589/jpts.28.1669] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 12/12/2015] [Indexed: 12/01/2022] Open
Abstract
[Purpose] The effect of duration of smartphone use on neck and shoulder muscle fatigue
and pain was investigated in adults with forward head posture. [Subjects and Methods]
Thirty-four adults with forward head posture were classified into groups by duration of
smartphone use: 11 used a smartphone for 10 minutes each (group 1), 12 for 20 minutes each
(group 2), and 11 for 30 minutes each (group 3). Fatigue cervical erector spinae and upper
trapezius muscles was measured by electromyography, and pain before and after the
experiment was evaluated using Visual Analog Scale (VAS) scores. [Results] There was a
significant difference in the degree of fatigue in the left upper trapezius muscles in
group 2 and left cervical erector spinae and bilateral upper trapeziuses group 3. There
was a significant difference in fatigue in the left upper trapezius in groups 1 and 3. The
VAS showed significant differences in all groups before and after the experiment and
between groups 1 and 3. [Conclusion] Pain and fatigue worsened with longer smartphone use.
This study provided data on the proper duration of smartphone use. Correct posture and
breaks of at least 20 minutes are recommend when using smartphones.
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Affiliation(s)
- Seong-Yeol Kim
- Department of Physical Therapy, Kyungnam University, Republic of Korea
| | - Sung-Ja Koo
- Department of Physical Therapy, Kyungnam University, Republic of Korea
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Jeffrey S, McClelland T, Carus C, Graham C. Relaxation and chronic pain: A critical review. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2016. [DOI: 10.12968/ijtr.2016.23.6.289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sarah Jeffrey
- Physiotherapy lecturer and undergraduate admissions tutor, Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Tracy McClelland
- Senior lecturer, Research and Knowledge Transfer and Health Team Lead – Nursing, University of Bradford, Bradford, UK
| | - Catherine Carus
- Physiotherapy lecturer, programme lead for SSPRD and Certificate of Higher Education in Professional Support, University of Bradford, Bradford, UK
| | - Claire Graham
- Programme lead and lecturer for Sport Rehabilitation, University of Bradford, Bradford, UK
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Metikaridis TD, Hadjipavlou A, Artemiadis A, Chrousos G, Darviri C. Effect of a stress management program on subjects with neck pain: A pilot randomized controlled trial. J Back Musculoskelet Rehabil 2016; 30:BMR709. [PMID: 27232086 DOI: 10.3233/bmr-160709] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Studies have shown that stress is implicated in the cause of neck pain (NP). OBJECTIVES The purpose of this study is to examine the effect of a simple, zero cost stress management program on patients suffering from NP. METHODS This study is a parallel-type randomized clinical study. People suffering from chronic non-specific NP were chosen randomly to participate in an eight week duration program of stress management (N= 28) (including diaphragmatic breathing, progressive muscle relaxation) or in a no intervention control condition (N= 25). Self-report measures were used for the evaluation of various variables at the beginning and at the end of the eight-week monitoring period. Descriptive and inferential statistic methods were used for the statistical analysis. RESULTS At the end of the monitoring period, the intervention group showed a statistically significant reduction of stress and anxiety (p= 0.03, p= 0.01), report of stress related symptoms (p= 0.003), percentage of disability due to NP (p= 0.000) and NP intensity (p= 0.002). At the same time, daily routine satisfaction levels were elevated (p= 0.019). No statistically significant difference was observed in cortisol measurements. CONCLUSIONS Stress management has positive effects on NP patients.
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Affiliation(s)
- T Damianos Metikaridis
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, Greece
| | - Alexander Hadjipavlou
- Department of Orthopaedic Surgery and Traumatology, School of Health Sciences, University of Crete, Crete, Greece
| | - Artemios Artemiadis
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, Greece
| | - George Chrousos
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, Greece
- First Department of Pediatrics, Children's Hospital Aghia Sofia, School of Medicine, University of Athens, Athens, Greece
| | - Christina Darviri
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, Greece
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Choi SY, Choi JH. The effects of cervical traction, cranial rhythmic impulse, and Mckenzie exercise on headache and cervical muscle stiffness in episodic tension-type headache patients. J Phys Ther Sci 2016; 28:837-43. [PMID: 27134368 PMCID: PMC4842449 DOI: 10.1589/jpts.28.837] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 12/02/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to examine the effects of cervical traction
treatment, cranial rhythmic impulse treatment, a manual therapy, and McKenzie exercise, a
dynamic strengthening exercise, on patients who have the neck muscle stiffness of the
infrequent episodic tension-type (IETTH) headache and frequent episodic tension-type
headache(FETTH), as well as to provide the basic materials for clinical interventions.
[Subjects] Twenty-seven subjects (males: 15, females: 12) who were diagnosed with IETTH
and FETTH after treatment by a neurologist were divided into three groups: (a cervical
traction group (CTG, n=9), a cranial rhythmic contractiongroup (CRIG, n=9), and a McKenzie
exercise group (MEG, n=9). An intervention was conducted for each group and the
differences in their degrees of neck pain and changes in muscle tone were observed.
[Results] In the within-group comparison of each group, headache significantly decreased
in CTG. According to the results of the analysis of the muscle tone of the upper
trapezius, there was a statistically significant difference in MEG on the right side and
in CRIG on the left side. According to the results of the analysis of the muscle tone of
the sternocleidomastoid muscle, there was a statistically significant difference in MEG on
the right side and in CRIG on the left side. [Conclusion] In the comparison of the
splenius capitis muscle between the groups, there was a statistically significant
difference on the right side. Hence, compared to the other methods, cervical traction is
concluded to be more effective at reducing headaches in IETTH and FETTH patients.
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Affiliation(s)
- Sung-Yong Choi
- Department of Physical Therapy, Namseoul University: 21 Maeju-ri, Sungwan-eup, Seobuk-Gu, Chonan-Si 331-707, Republic of Korea
| | - Jung-Hyun Choi
- Department of Physical Therapy, Namseoul University: 21 Maeju-ri, Sungwan-eup, Seobuk-Gu, Chonan-Si 331-707, Republic of Korea
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Exercises for mechanical neck disorders: A Cochrane review update. ACTA ACUST UNITED AC 2016; 24:25-45. [PMID: 27317503 DOI: 10.1016/j.math.2016.04.005] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 04/13/2016] [Indexed: 11/22/2022]
Abstract
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 radiculopathy. 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 -0.45 [95%CI: -0.72 to -0.18]) and function improvement; 4) cervico-scapulothoracic strengthening/stabilisation exercises for pain and function at intermediate-term (IT) (SMDp -14.90 [95%CI: -22.40 to -7.39]). 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.
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Management of neck pain and associated disorders: A clinical practice guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2016; 25:2000-22. [PMID: 26984876 DOI: 10.1007/s00586-016-4467-7] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 02/15/2016] [Accepted: 02/15/2016] [Indexed: 01/24/2023]
Abstract
PURPOSE To develop an evidence-based guideline for the management of grades I-III neck pain and associated disorders (NAD). METHODS This guideline is based on recent systematic reviews of high-quality studies. A multidisciplinary expert panel considered the evidence of effectiveness, safety, cost-effectiveness, societal and ethical values, and patient experiences (obtained from qualitative research) when formulating recommendations. Target audience includes clinicians; target population is adults with grades I-III NAD <6 months duration. RECOMMENDATION 1 Clinicians should rule out major structural or other pathologies as the cause of NAD. Once major pathology has been ruled out, clinicians should classify NAD as grade I, II, or III. RECOMMENDATION 2 Clinicians should assess prognostic factors for delayed recovery from NAD. RECOMMENDATION 3 Clinicians should educate and reassure patients about the benign and self-limited nature of the typical course of NAD grades I-III and the importance of maintaining activity and movement. Patients with worsening symptoms and those who develop new physical or psychological symptoms should be referred to a physician for further evaluation at any time during their care. RECOMMENDATION 4 For NAD grades I-II ≤3 months duration, clinicians may consider structured patient education in combination with: range of motion exercise, multimodal care (range of motion exercise with manipulation or mobilization), or muscle relaxants. In view of evidence of no effectiveness, clinicians should not offer structured patient education alone, strain-counterstrain therapy, relaxation massage, cervical collar, electroacupuncture, electrotherapy, or clinic-based heat. RECOMMENDATION 5 For NAD grades I-II >3 months duration, clinicians may consider structured patient education in combination with: range of motion and strengthening exercises, qigong, yoga, multimodal care (exercise with manipulation or mobilization), clinical massage, low-level laser therapy, or non-steroidal anti-inflammatory drugs. In view of evidence of no effectiveness, clinicians should not offer strengthening exercises alone, strain-counterstrain therapy, relaxation massage, relaxation therapy for pain or disability, electrotherapy, shortwave diathermy, clinic-based heat, electroacupuncture, or botulinum toxin injections. RECOMMENDATION 6 For NAD grade III ≤3 months duration, clinicians may consider supervised strengthening exercises in addition to structured patient education. In view of evidence of no effectiveness, clinicians should not offer structured patient education alone, cervical collar, low-level laser therapy, or traction. RECOMMENDATION 7: For NAD grade III >3 months duration, clinicians should not offer a cervical collar. Patients who continue to experience neurological signs and disability more than 3 months after injury should be referred to a physician for investigation and management. RECOMMENDATION 8: Clinicians should reassess the patient at every visit to determine if additional care is necessary, the condition is worsening, or the patient has recovered. Patients reporting significant recovery should be discharged.
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Comparative Effectiveness of Conservative Interventions for Nonspecific Chronic Spinal Pain: Physical, Behavioral/Psychologically Informed, or Combined? A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2016; 17:755-74. [PMID: 26844416 DOI: 10.1016/j.jpain.2016.01.473] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 12/05/2015] [Accepted: 01/14/2016] [Indexed: 12/11/2022]
Abstract
UNLABELLED Nonspecific chronic spinal pain (NSCSP) is highly disabling. Current conservative rehabilitation commonly includes physical and behavioral interventions, or a combination of these approaches. Physical interventions aim to enhance physical capacity by using methods such as exercise, manual therapy, and ergonomics. Behavioral/psychologically informed interventions aim to enhance behaviors, cognitions, or mood by using methods such as relaxation and cognitive behavioral therapy. Combined interventions aim to target physical and also behavioral/psychological factors contributing to patients' pain by using methods such as multidisciplinary pain management programs. Because it remains unclear whether any of these approaches are superior, this review aimed to assess the comparative effectiveness of physical, behavioral/psychologically informed, and combined interventions on pain and disability in patients with NSCSP. Ten electronic databases were searched for randomized controlled trials (RCTs) including participants reporting NSCSP. Studies were required to have an "active" conservative treatment control group for comparison. Studies were not eligible if the interventions were from the same domain (eg, if the study compared 2 physical interventions). Study quality was assessed used the Cochrane Back Review Group risk of bias criteria. The treatment effects of physical, behavioral/psychologically informed, and combined interventions were assessed using meta-analyses. Twenty-four studies were included. No clinically significant differences were found for pain and disability between physical, behavioral/psychologically informed, and combined interventions. The simple categorization of interventions into physical, behavioral/psychologically informed, and combined could be considered a limitation of this review, because these interventions may not be easily differentiated to allow accurate comparisons to be made. Further work should consider investigating whether tailoring rehabilitation to individual patients and their perceived risk of chronicity, as seen in recent RCTs for low back pain, can enhance outcomes in NSCSP. PERSPECTIVE In this systematic review of RCTs in NSCSP, only small differences in pain or disability were observed between physical, behavioral/psychologically informed, and combined interventions.
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Celenay ST, Kaya DO, Akbayrak T. Cervical and scapulothoracic stabilization exercises with and without connective tissue massage for chronic mechanical neck pain: A prospective, randomised controlled trial. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.math.2015.07.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Jay K, Friborg MK, Sjøgaard G, Jakobsen MD, Sundstrup E, Brandt M, Andersen LL. The Consequence of Combined Pain and Stress on Work Ability in Female Laboratory Technicians: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:15834-42. [PMID: 26690466 PMCID: PMC4690960 DOI: 10.3390/ijerph121215024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 12/02/2015] [Accepted: 12/08/2015] [Indexed: 11/16/2022]
Abstract
Musculoskeletal pain and stress-related disorders are leading causes of impaired work ability, sickness absences and disability pensions. However, knowledge about the combined detrimental effect of pain and stress on work ability is lacking. This study investigates the association between pain in the neck-shoulders, perceived stress, and work ability. In a cross-sectional survey at a large pharmaceutical company in Denmark 473 female laboratory technicians replied to questions about stress (Perceived Stress Scale), musculoskeletal pain intensity (scale 0-10) of the neck and shoulders, and work ability (Work Ability Index). General linear models tested the association between variables. In the multi-adjusted model, stress (p < 0.001) and pain (p < 0.001) had independent main effects on the work ability index score, and there was no significant stress by pain interaction (p = 0.32). Work ability decreased gradually with both increased stress and pain. Workers with low stress and low pain had the highest Work Ability Index score (44.6 (95% CI 43.9-45.3)) and workers with high stress and high pain had the lowest score (32.7 (95% CI 30.6-34.9)). This cross-sectional study indicates that increased stress and musculoskeletal pain are independently associated with lower work ability in female laboratory technicians.
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Affiliation(s)
- Kenneth Jay
- Department of Physical Activity and Health, Institute for Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense 5230, Denmark.
- National Research Centre for the Working Environment, Copenhagen 2100, Denmark.
| | | | - Gisela Sjøgaard
- Department of Physical Activity and Health, Institute for Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense 5230, Denmark.
| | - Markus Due Jakobsen
- National Research Centre for the Working Environment, Copenhagen 2100, Denmark.
| | - Emil Sundstrup
- National Research Centre for the Working Environment, Copenhagen 2100, Denmark.
| | - Mikkel Brandt
- National Research Centre for the Working Environment, Copenhagen 2100, Denmark.
- Physical Activity and Human Performance group, SMI Department of Health Science and Technology, Aalborg University, Aalborg 9220, Denmark.
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Copenhagen 2100, Denmark.
- Physical Activity and Human Performance group, SMI Department of Health Science and Technology, Aalborg University, Aalborg 9220, Denmark.
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