Comparison of an exercise program with and without manual therapy for patients with chronic neck pain and upper cervical rotation restriction. Randomized controlled trial

Rodríguez-Sanz, J. ; Malo-Urriés, M. (Universidad de Zaragoza) ; Lucha-López, M.O. (Universidad de Zaragoza) ; López-De-Celis, C. ; Pérez-Bellmunt, A. ; Corral-De-Toro, J. (Universidad de Zaragoza) ; Hidalgo-García, C. (Universidad de Zaragoza)

Resumen: 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.

Idioma: Inglés

DOI: 10.7717/peerj.12546

Año: 2021

Publicado en: PeerJ 9 (2021), e12546 [28 pp]
ISSN: 2167-8359

Factor impacto JCR: 3.061 (2021)

Categ. JCR: MULTIDISCIPLINARY SCIENCES rank: 33 / 74 = 0.446 (2021) - Q2 - T2

Factor impacto CITESCORE: 4.7 - Agricultural and Biological Sciences (Q1) - Medicine (Q2) - Neuroscience (Q2) - Biochemistry, Genetics and Molecular Biology (Q2)

Factor impacto SCIMAGO: 0.766 - Agricultural and Biological Sciences (miscellaneous) (Q1) - Neuroscience (miscellaneous) (Q1) - Biochemistry, Genetics and Molecular Biology (miscellaneous) (Q1)

Tipo y forma: Article (Published version)

Área (Departamento): Área Fisioterapia (Dpto. Fisiatría y Enfermería)