000110732 001__ 110732 000110732 005__ 20230519145622.0 000110732 0247_ $$2doi$$a10.7717/peerj.12546 000110732 0248_ $$2sideral$$a127201 000110732 037__ $$aART-2021-127201 000110732 041__ $$aeng 000110732 100__ $$aRodríguez-Sanz, J. 000110732 245__ $$aComparison of an exercise program with and without manual therapy for patients with chronic neck pain and upper cervical rotation restriction. Randomized controlled trial 000110732 260__ $$c2021 000110732 5060_ $$aAccess copy available to the general public$$fUnrestricted 000110732 5203_ $$aBackground: Cervical exercise has been shown to be an effective treatment for neck pain, but there is still a need for more clinical trials evaluating the effectiveness of adding manual therapy to the exercise approach. There is a lack of evidence on the effect of these techniques in patients with neck pain and upper cervical rotation restriction. Purpose: To compare the effectiveness of adding manual therapy to a cervical exercise protocol for the treatment of patients with chronic neck pain and upper cervical rotation restriction. Methods: Single-blind randomized clinical trial. Fifty-eight subjects: 29 for the Manual Therapy+Exercise (MT+Exercise) Group and 29 for the Exercise group. Neck disability index, pain intensity (0-10), pressure pain threshold (kPa), flexion-rotation test (°), and cervical range of motion (°) were measured at the beginning and at the end of the intervention, and at 3-and 6-month follow-ups. The MT+Exercise Group received one 20-min session of manual therapy and exercise once a week for 4 weeks and home exercise. The Exercise Group received one 20-min session of exercise once a week for 4 weeks and home exercise. Results: The MT+Exercise Group showed significant better values post-intervention in all variables: neck disability index: 0% patient with moderate, severe, or complete disability compared to 31% in the Exercise Group (p = 0.000) at 6-months; flexion-rotation test (p = 0.000) and pain intensity (p = 0.000) from the first follow-up to the end of the study; cervical flexion (p = 0.002), extension (p = 0.002), right lateral-flexion (p = 0.000), left lateral-flexion (p = 0.001), right rotation (p = 0.000) and left rotation (p = 0.005) at 6-months of the study, except for flexion, with significative changes from 3-months of follow up; pressure pain threshold from the first follow-up to the end of the study (p values range: 0.003-0.000). Conclusion: Four 20-min sessions of manual therapy and exercise, along with a home-exercise program, was found to be more effective than an exercise protocol and a home-exercise program in improving the neck disability index, flexion-rotation test, pain intensity, and pressure pain threshold, in the short, medium, and medium-long term in patients with chronic neck pain and upper rotation restriction. Cervical range of motion improved with the addition of manual therapy in the medium and medium-long term. The high dropout rate may have compromised the external validity of the study. Copyright © 2021 Rodríguez-Sanz et al. 000110732 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/ 000110732 590__ $$a3.061$$b2021 000110732 592__ $$a0.766$$b2021 000110732 594__ $$a4.7$$b2021 000110732 591__ $$aMULTIDISCIPLINARY SCIENCES$$b33 / 74 = 0.446$$c2021$$dQ2$$eT2 000110732 593__ $$aAgricultural and Biological Sciences (miscellaneous)$$c2021$$dQ1 000110732 593__ $$aNeuroscience (miscellaneous)$$c2021$$dQ1 000110732 593__ $$aBiochemistry, Genetics and Molecular Biology (miscellaneous)$$c2021$$dQ1 000110732 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000110732 700__ $$0(orcid)0000-0001-9080-0543$$aMalo-Urriés, M.$$uUniversidad de Zaragoza 000110732 700__ $$0(orcid)0000-0002-9930-3903$$aLucha-López, M.O.$$uUniversidad de Zaragoza 000110732 700__ $$aLópez-De-Celis, C. 000110732 700__ $$aPérez-Bellmunt, A. 000110732 700__ $$aCorral-De-Toro, J.$$uUniversidad de Zaragoza 000110732 700__ $$0(orcid)0000-0001-7667-2178$$aHidalgo-García, C.$$uUniversidad de Zaragoza 000110732 7102_ $$11006$$2413$$aUniversidad de Zaragoza$$bDpto. Fisiatría y Enfermería$$cÁrea Fisioterapia 000110732 773__ $$g9 (2021), e12546 [28 pp]$$pPeerJ$$tPeerJ$$x2167-8359 000110732 8564_ $$s11697231$$uhttps://zaguan.unizar.es/record/110732/files/texto_completo.pdf$$yVersión publicada 000110732 8564_ $$s2542701$$uhttps://zaguan.unizar.es/record/110732/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000110732 909CO $$ooai:zaguan.unizar.es:110732$$particulos$$pdriver 000110732 951__ $$a2023-05-18-16:16:44 000110732 980__ $$aARTICLE