110732 20230519145622.0 doi 10.7717/peerj.12546 sideral 127201 ART-2021-127201 eng Rodríguez-Sanz, J. Comparison of an exercise program with and without manual therapy for patients with chronic neck pain and upper cervical rotation restriction. Randomized controlled trial 2021 Access copy available to the general public Unrestricted Background: 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. info:eu-repo/semantics/openAccess by http://creativecommons.org/licenses/by/3.0/es/ 3.061 2021 MULTIDISCIPLINARY SCIENCES 33 / 74 = 0.446 2021 Q2 T2 0.766 2021 Agricultural and Biological Sciences (miscellaneous) 2021 Q1 Neuroscience (miscellaneous) 2021 Q1 Biochemistry, Genetics and Molecular Biology (miscellaneous) 2021 Q1 4.7 2021 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Malo-Urriés, M. Universidad de Zaragoza (orcid)0000-0001-9080-0543 Lucha-López, M.O. Universidad de Zaragoza (orcid)0000-0002-9930-3903 López-De-Celis, C. Pérez-Bellmunt, A. Corral-De-Toro, J. Universidad de Zaragoza Hidalgo-García, C. Universidad de Zaragoza (orcid)0000-0001-7667-2178 1006 413 Universidad de Zaragoza Dpto. Fisiatría y Enfermería Área Fisioterapia 9 (2021), e12546 [28 pp] PeerJ PeerJ 2167-8359 11697231 http://zaguan.unizar.es/record/110732/files/texto_completo.pdf Versión publicada 2542701 http://zaguan.unizar.es/record/110732/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:110732 articulos driver 2023-05-18-16:16:44 ARTICLE