[Effectiveness of an individualised physiotherapy program versus group therapy on neck pain and disability in patients with acute and subacute mechanical neck pain]

OBJECTIVE

To compare the efficacy in reducing neck pain and disability in an individualised physiotherapy treatment with group treatment in acute and subacute mechanical neck pain.

DESIGN

Randomised clinical trial.

LOCATION

Health Area of University Hospital Virgen del Rocío, Seville, Spain.

PARTICIPANTS

A total of 90 patients diagnosed with mechanical neck pain of up to one month onset, distributed randomly into two groups: (i)individualised treatment; (ii)group treatment.

INTERVENTION

The treatment consisted of 15 sessions of about 60minutes for both groups. Individual treatment consisted of 15minutes of infrared heat therapy, 17minutes of massage, and analytical passive stretching of the trapezius muscles and angle of the scapula. The group treatment consisted of a program of active mobilisation, isometric contractions, self-stretching, and postural recommendations.

MAIN MEASURES

Pain was measured at the beginning and end of treatment pain using a Visual Analogue Scale (VAS) and an algometer applied on the trapezius muscles and angle of the scapula, and neck disability using the Neck Disability Index.

RESULTS

Both treatments were statistically significant (P<.001) in improving all variables. Statistically significant differences (P<.001) were found for all of them in favour of individualised treatment compared to group treatment.

CONCLUSIONS

Patients with acute or subacute mechanical neck pain experienced an improvement in pain and neck disability after receiving either of the physiotherapy treatments used in our study, with the individual treatment being more effective than collective.

Design and validation of GCH System 1.0 which measures the weight-bearing exerted on forearm crutches during aided gait

Normally, when the patient's functional recovery involves partial weight-bearing aided walking using forearm crutches, it is not possible to control the amount of weight-bearing objectively that the individuals carry out and its progression. This leads to significant errors in accuracy and, consequently, complications and after effects in pathologies. To compensate for this deficiency, we have set out to design and validate a measurement system and a computerized record of the loads exerted on Canadian crutches in aided walking as well as incorporating a mechanism for acoustic and visual biofeedback that will inform the subject if said charges are correct, so that they are able correct their errors and avoid problems in their recovery. We analyzed the validity and reliability of the system through a concordance study with the AMTI OR6-7-2000 force plate, extensively validated previously, while finding a correlation coefficient of 0.99 with a significance (p<0.001). We have designed and developed a measurement system with a computerized record, analysis and wireless graphical display of real-time data, incorporating a mechanism for acoustic and visual biofeedback to measure the loads exerted on forearm crutches during aided walking. The device, called "GCH System 1.0" is a reliable and valid instrument.

Discriminating power of CPPQ-Mohedo: a new questionnaire for chronic pelvic pain

OBJECTIVES

In the absence of a gold-standard tool to measure chronic pelvic pain (CPP), most studies on the prevalence of CPP use the NIH-chronic prostatitis symptom index (CPSI) questionnaire. However, its suitability and relevance for use in both sexes have not yet been evaluated, and generalized interpretation of the results is therefore questionable. Accordingly, we designed a questionnaire that discriminates between patients with and without symptoms of CPP.

METHODS

We undertook a study to test the discriminating capacity for chronic pelvic pain questionnaire (CPPQ)-Mohedo test for CPP among healthy and unhealthy individuals, and if this discrimination was similar for men and women. We did a matched study - 40 unhealthy men were matched by age with 40 unhealthy women - and each of those was matched with six healthy controls by age and sex (480 in total). To elaborate the questionnaire (CPPQ-Mohedo), we started with the NIH-CPSI, adapting the items referring to anatomic areas for women, changing the type of response and including various items on pelvic pain not previously recorded.

RESULTS

The NIH-CPSI questionnaire [area under the receiver operating characteristic (ROC curve), 0.946] was very similar to that of the CPPQ-Mohedo questionnaire (area under the ROC curve, 0.968), but the first required more items. CPPQ-Mohedo showed similar discriminant capacity between men and women. The dimensions involved (pain and quality of life) showed internal consistency (Cronbach's alpha: 0.75).

CONCLUSIONS

The CPPQ-Mohedo questionnaire presented discriminating power in men and women with symptoms of CPP. This questionnaire may be used as a screening tool to identify patients and include them in treatment programmes, as an outcome assessment tool for treatment and clinical trials, or as a tool to assess the prevalence of CPP in epidemiologic studies.