A randomized controlled trial on the efficacy of longwave diathermy on pain, disability and range of motion in the patients with neck pain

BACKGROUND AND PURPOSE: Nonspecific neck pain (NS-NP) which is described as neck pain without specific underlying disease is the most common neck pain presentation. This study aimed to compare the influence of the Mulligan sustained apophyseal glides (SNAG’s) with exercise, versus myofascial release (MFR) with exercise, on pain, neck range of motion (ROM), and functional disability in people with NS-NP. METHODS: A single blinded randomized control trial was used. Seventy participants with NS-NP were allocated randomly into three groups, the SNAG’s group received SNAG’s with exercise, the MFR group received MFR with exercise and the control group received exercise only. The selected exercises included strengthening exercises, stretching of the posterior neck muscles, and neck straightening exercises. The total treatment included 12 sessions, 3 sessions per week for 4 consecutive weeks. Pain, neck ROM and neck function was assessed prior to the first treatment and at the end of the 4-week trial. RESULTS: There were statistically significant, time-by-group effects (mixed-design MANOVA) on pain, neck ROM and NDI for all groups ( P < 0.0001). SNAG’s with exercise and MFR with exercise yielded significant reduction in pain and neck disability, and increase in neck ROM. Control group reported lesser reduction in pain and neck disability, and lesser increase in neck ROM. CONCLUSION: SNAG’s with exercise and MFR with exercise offered short-term statistically significant improvements in pain, neck ROM and functional disability in NS-NP. However, there is need to ascertain the long-term effects of these treatment approaches, before any further clinical recommendations can be made.

This study investigated the correlation between the neck disability index (NDI) and visual analogue scale (VAS), which are indicators of neck pain, shoulder joint range of motion (ROM), and muscle strength in women with a slight forward head posture. This study was carried out on 42 female college students attending Uiduk University in Gyeongju, Korea. The neck pain and disability index for each subject was measured using VAS and NDI, respectively. Two physiotherapists measured the shoulder joint ROM and muscle strengths of the subjects using a goniometer and a dynamometer, respectively. External rotation, internal rotation, and abduction of the shoulder joint were measured for each subject. A significant negative correlation between neck pain and shoulder joint ROM in external rotation and the muscle strength of the shoulder joint in abduction was found in the subjects. In addition, a significant positive correlation was observed between ROM in external rotation and muscle strength in abduction. This study showed a significant negative correlation between neck pain and ROM in external rotation as well as between neck pain and the muscle strength in abduction.

Introduction: Lifestyle and the constant use of communication technologies have led to the upper crossed syndrome. The purpose of this study was to investigate of the effect of comprehensive corrective exercises carried out in water on pain, neck flexors muscles endurance and neck and upper extremity Range of Motion (ROM) in the patients with upper crossed syndrome (UCS). Methods: In this semi-experimental study, after initial screening, 30 students with upper crossed syndrome were selected and assigned randomly into experimental (n=14) and control (n=16) groups. Before and after the intervention, measurements performed to measure the level of pain by VAS scale, neck and shoulder ROM by inclinometer and neck flexors endurance by deep neck flexors endurance test. To analyze the data, SPSS Inc., Chicago, IL; version 18 software was used. The significance level was 0.05. Paired sample t-test was used to compare the mean of the pretest to posttest and independent t-test was used to compare the differences between groups. Results: The experimental group had significant improvement for endurance of neck flexors (P< 0.0001), neck ROM (P< 0.0001), shoulder ROM (P< 0.0001) and neck pain (P< 0.0001). Moreover, the results showed that there were significant differences for endurance of neck flexors (P< 0.0001), neck ROM (P< 0.0001), shoulder ROM (P< 0.0001), and neck pain (P< 0.0001) between groups. Conclusion: According to the results, we can say using water-based corrective exercises could have additional effect on increasing muscles endurance, upper extremity ROM and pain reduction in the patients with upper crossed syndrome, and could be as an effective method for the specialist

Multi-wave locked system (MLS) laser therapy has shown efficacy in reducing pain in various musculoskeletal conditions. However, its standalone effects on pain and function in patients with chronic non-specific neck pain (CNNP) remain unclear. The aim of this study was to evaluate the effects of MLS laser therapy on pain, function, and disability in patients with CNNP compared to a placebo treatment. Randomized controlled study. Outpatient. Patients aged 20-65 years with CNNP and a neck pain score between 4 and 7 on a Visual Analogue Scale. Forty-seven patients were randomized into two groups: MLS Laser and Sham Laser, receiving 8 sessions of their respective treatments. Assessments were conducted at baseline (T0), end of therapy (T1), and one month post-therapy (T2) for neck pain (VAS), function (kinematics and electromyography of head movements), and disability (Neck Disability Index, NDI). Within- and between-group differences were analyzed across these time points. The MLS Laser group showed significant improvements (P<0.05) in the range of motion for head lateral bending and rotation compared to the Sham Laser group, which exhibited no changes. Both groups demonstrated increased movement velocity (P<0.05) and reduced pain and disability scores (P<0.05). However, either VAS and NDI did not reach the thresholds for minimal clinically important differences (MCID). At T2, a trend towards greater pain reduction was observed in the MLS Laser group (P=0.05). Both MLS Laser and Sham Laser therapies resulted in statistically significant improvements in pain, disability, and movement velocity. However, these changes were not clinically meaningful. MLS Laser therapy provided more pronounced and sustained pain relief and improved range of motion in head movements. MLS Laser therapy improves neck range of motion as a standalone treatment for chronic non-specific neck pain, despite similar effects on pain and disability reduction with placebo.

Objective: The purpose of this study was to examine the effects of cervical stabilization exercise(CSE) combined with breathing pattern re-education exercise(BPRE) compared CSE on pain, disability, muscle activity, and range of motion(ROM) in neck pain(NP) patients with forward head posture(FHP). Method: BPRE+CSE(n=15) and Conservative physical therapy(CT)+CSE(n=15) groups were received treatment three times per week for four weeks, respectively. A numeric pain rating scale(NPRS), neck disability index(NDI), ROM, and surface electromyography(SEMG) activities of sternocleidomastoid (SCM) muscle and scalene muscle were measured before and after the treatments for each group. A paired t-test was conducted to test the changes before and after the treatments and an independent t-test was performed to evaluate the difference between groups. Results: In NPRS, NDI, ROM and muscle activity both BPRE+CSE and CT+CSE showed differences (p&lt;.05). BPRE+CSE showed more reduction in NPRS, NDI and muscle activity more increase in ROM(p&lt;.05). Conclusion: These results suggest that the BPRE can pain relief, recovery from neck disability, ROM, and muscle activity for NP patients with a FHP.

Background/aimThis was a randomized, double-blind, sham-controlled study.Thyroidectomy is a frequently performed surgical procedure and head and neck extension during this operation facilitates surgery. Patients may experience postoperative neck pain and cervical range of motion (ROM) limitation due to the surgical position following thyroidectomy. It was aimed herein to investigate the short-term effects of kinesiotaping (KT) applied to the cervical spine on neck pain, ROM, and disability in patients following thyroidectomy. Materials and methodsA total of 74 patients were randomly assigned to be treated with either KT (Group 1, n = 37) or sham taping (Group 2, n = 37) using a computer-generated random number list. Neck pain, cervical ROM, and neck disability were evaluated with a visual analog scale (VAS), inclinometer, and the Neck Disability Index (NDI) questionnaire, respectively. ResultsThere were no significant differences with respect to age, sex, educational background, or body mass index between the groups.While there were no significant differences with respect to improvement of the VAS and change of the ROM and NDI values between the groups, patients in Group 1 needed less paracetamol than patients in Group 2 (P = 0.011). ConclusionThis study showed that cervical KT application following thyroidectomy does not have a positive effect on neck pain, ROM, or disability, but nonetheless, it reduces analgesic consumption.

To conduct a comprehensive assessment of shoulder and neck function following the pectoralis major pedicled flap (PMPF) for head and neck reconstruction. Case-control study. The study group consisted of laryngectomized patients who underwent PMPF and a control group of those who underwent standard laryngectomy. Bilateral quantitative measurements of shoulder strength and range of motion (ROM) and neck ROM by a blinded physiotherapist and subjective quality-of-life assessment using the Shoulder Pain and Disability Index (SPADI) and Neck Disability Index (NDI) questionnaires were collected. Lateral cervical radiographs in the neutral, flexion, and extension positions were evaluated by a blinded neuroradiologist. The main outcome measures were shoulder ROM, strength, and SPADI scores; physical and radiologic measurements of neck ROM; and NDI Score. Shoulder analysis showed a significantly reduced flexion angle (P = .043) and combined internal/external rotation angle on the operated side (P = .027) and a significant strength reduction for the flexion, external rotation, and adduction domains (P < .05). SPADI score analysis showed a significantly higher disability score (P = .017) and total score (P = .009) on the PMPF side. Neck physical analysis showed significant differences in extension (P = .013) and total ROM distances (P = .002) but not flexion (P = .184). The total flexion/extension angular ROM was reduced in the PMPF population (P = .05) due to a reduced neck extension excursion angle from a neutral position (P = .04). The PMPF for head and neck reconstruction is associated with a limitation in neck ROM attributed to a loss in extension and reduced shoulder strength and ROM.

Neck pain is a common musculoskeletal condition frequently managed with numerous conservative interventions. The McKenzie method of mechanical diagnosis and therapy (MMDT)is a form of physical therapy evaluation and treatment that aims to improve pain and disability in patients with musculoskeletal pain, including neck pain. To date, no systematic review with meta-analysis has examined the use of the McKenzie MMDT for neck pain. This study aimed to examine the effectiveness of the McKenzie MMDT in adult patients with neck pain. A systematic review and meta-analysis were performed using PubMed, ScienceDirect, MEDLINE, CINAHL, Web of Science, and Google Scholar. Full search terms were "McKenzie method" OR "McKenzie approach" OR "McKenzie treatment" AND "neck pain." Inclusion criteria were the use of the McKenzie MMDT, level I randomized control trials (RCTs), adults, and outcomes of pain (0-10 scale) and disability (neck disability index). A total of 11 RCTs met the final selection criteria from 1,955 articles on initial search with 289 patients receiving the McKenzie MMDT out of 677 total patients. For meta-analysis, there was a clinically insignificant but statistically significant improvement in pain (1.14/10 points) in patients receiving the McKenzie MMDT versus control interventions (p<0.02). There was no significant improvement in the neck disability index score between the McKenzie MMDT versus control interventions (p=0.19). For severity of pain, there was a clinically and statistically significant improvement in moderate or severe pain (2.06/10 points; p<0.01), but not in mild-to-moderate pain (p=0.84) when comparing the McKenzie MMDT to control interventions. Overall, the McKenzie MMDT provides very small but statistically significant improvements in neck pain of all severity compared to control interventions. However, the McKenzie MMDT does provide clinically and statistically significant pain improvement in moderate-to-severe neck pain. Use of the McKenzie MMDT did not provide any significant improvement in disability compared to control interventions. This study is the first systematic review with meta-analysis on the effectiveness of the McKenzie MMDT for adult patients with neck pain.

The effect of remote self-myofascial release and stretch on range of motion and chronic neck pain: A randomized control trial.

Background:To compare the efficacy of high- and low-energy extracorporeal shock wave therapy (ESWT) for patients with myofascial pain syndrome (MPS) of the upper trapezius.Methods:Thirty patients (3 men, 27 women) were randomly assigned to receive either high-energy ESWT (0.210 mJ/mm2) or low-energy ESWT (0.068 mJ/mm2). Both groups received 1500 pulses of ESWT once a week, for 2 weeks. Outcome measurement was assessed by verbal numeric pain scale (VNS), neck disability index (NDI), neck range of motion (ROM) (flexion, extension, rotation, lateral bending), and pressure threshold (PT). Statistical analysis was performed with significance level of P < .05.Results:No statistically significant differences of demographic and clinical characteristics existed between the 2 groups. VNS, NDI, neck ROM (rotation to sound side, lateral bending to affected side, lateral bending to sound side), and PT were improved in both groups. In contrast, statistically significant improvements in neck flexion and neck extension were observed only in the high-energy group. We also found significant differences in post-treatment NDI (4.20 ± 1.78 vs 6.47 ± 2.48) and post-treatment neck flexion ROM (65.47 ± 10.09 vs 55.93 ± 11.07) between high-energy and low-energy group.Conclusion:ESWT effectively improves VNS, NDI, neck ROM, and PT to patients with MPS of the upper trapezius. High-energy ESWT was more effective in improving NDI and neck flexion ROM compared to the low-energy ESWT, suggesting superiority in functional improvement. Further studies are required to specify the effect of ESWT by energy intensity.

To compare the effects of muscle energy techniques, facet joint mobilisation and conventional physical therapy on pain, disability, cervical lordosis and range of motion in patients with chronic neck pain. The parallel-design randomised controlled trial was conducted at the Physical Therapy and Rehabilitation Department of the Heavy Industries Taxila Hospital, Taxila Cantt, Pakistan, from December 2020 to May 2021, and comprised patients of either gender aged 35-50 years who had chronic neck pain, recurrent neck pain, and cervical spine curve. The participants were randomised into muscle energy techniques group A, facet joint mobilisation group B and conventional physical therapy group C. The outcome measures were cervical lordosis, pain intensity, neck disability index and cervical range of motions. Data was analysed using SPSS 21. Of the 115 patients initially assessed, 105(91.3%) were included; 67(63.8%) females and 38(36.2%) males. There were 35(33.3%) subjects in group A with mean age 40.09± 4.29 years, 35(33.3%) in group B with mean age 40.14±4.57 years and 35(33.3%) in group C with men age 39.26±5.19 years. There were no significant differences among the groups at baseline in terms of mean age, weight, height, body mass index, neck disability index, cervical lordosis and range of motion (p>0.05). Of the total, 6(5.7%) were lost to follow-up and the study was completed by 99(94.3%) subjects. Outcome variables in group A were superior to those in groups B and C with respect to flexion, rotation and side-bending (p<0.05). There was no significant difference between groups A and B related to numeric pain rating scale and neck disability index (p>0.05). Muscle energy techniques and facet joint mobilisation showed significant improvement in neck pain, disability and cervical range of motions compared to conventional physical therapy. Muscle energy techniques and facet joint mobilisation produced similar outcomes with respect to pain intensity and functional disability. The study was prospectively registered with clinicaltrials.gov (NCT05040477).

To determine the relationship among pain, disability, range of motion, isometric strength, and muscle tenderness in persons with chronic nonradicular neck pain and to compare them with healthy controls without neck pain. Cross-sectional study of 30 subjects with and 14 without chronic neck pain. All subjects were administered pain scales, the neck disability index, isometric cervical strength, cervical range of motion, and a quantitated muscle tenderness measure. In addition, an uncontrolled trial of neck strengthening was performed on a subset of 14 subjects with the same outcome variables. Tenderness correlated with pain, neck disability index, and headache in the pain group, and statistically, significantly differed from the subjects without neck pain. Males were stronger than females. Strength was less in the group with neck pain, but did not reach statistical significance. Range of motion was less in the group with pain. Neither range of motion nor strength correlated with neck disability index or pain scores in the neck pain group. In the strengthening trial, strength in left and right rotation significantly improved. Range of motion, pain, and neck disability index changed in a positive direction, but did not reach statistical significance. Muscle tenderness did not change. Muscle tenderness and disability (but not range of motion or muscle strength) is closely related to average pain in the previous week in neck pain subjects. Neck flexor muscle strengthening resulted in positive changes in pain, neck disability index, range of motion, and strength, but not tenderness.

The intensification of treatment for head and neck cancers (HNCs) has created a cohort of patients living with short- and long-term comorbidities and functional deficits. This study aimed to determine whether there is a relationship between patient-reported outcomes (PROs) and objective measures of neck function in survivors of HNCs. Cross-sectional study. Thirty-one subjects (aged 64 ± 8.7 years; 28 males and three females) were recruited and completed the Neck Disability Index (NDI) and a numeric pain scale. At the same visit, subjects were fitted with two portable motion sensors to collect range of motion (ROM) and velocity data. Differences between ROM, velocity, and PRO subgroups were assessed using a one-tailed t test (*P < .05). The Pearson correlation coefficient (r) was calculated between the NDI values and the ROM and velocity values for each motion. A moderate correlation (r=0.507) was observed between NDI and neck pain. Patients with no disability according to the NDI had significantly higher ROM and velocity than patients with mild to moderate disability. Velocity in all degrees of freedom (axial rotation, flexion and extension, and lateral bending) was significantly lower for patients who perceived higher levels of neck pain and neck disability. This study notes that patients who report neck disability and pain have more limited ROM and velocity following HNC treatment. These data may improve treatment planning and care delivery by facilitating an understanding of the experiences of HNC survivors and the pathophysiology that must be targeted to address their psychosocial and functional deficits. 4 Laryngoscope, 131:2015-2022, 2021.

ObjectivesThis study aims to compare the efficacy of neck stabilization exercises versus a conventional exercise program on pain, range of motion, disability, and depression in patients with chronic neck pain.Patients and methodsThis prospective, single-blind, randomized controlled study included 60 patients with chronic neck pain, 58 (21 males, 37 females; mean age: 36.7±8.5 years; range, 18 to 55 years) of whom completed the study. The patients were randomized into two groups. Patients in one group were given neck stabilization exercises, while the patients in the other group were given conventional neck exercises. Neck pain due to activities of daily living (Visual Analog Scale), neck range of motion in sagittal, transverse, and frontal planes, disability (Neck Disability Index), and depression (Beck Depression Inventory) were evaluated at the beginning, at the end of the treatment, and at the first and third months after the end of treatment.ResultsSignificant improvement was achieved in both groups in terms of Visual Analog Scale, Neck Disability Index, neck range of motion in the sagittal, transverse, and frontal planes, and Beck Depression Inventory compared to the beginning of treatment (p<0.05). In the stabilization exercise group, statistically significant improvement was found in the range of motion of the neck in the transverse plane (p<0.05).ConclusionStabilization exercise programs, which show their effect by maintaining segmental stabilization, postural control, and balance between the superficial and deep muscles of the neck region, contribute to reduced pain in daily activities and improved function similar to conventional exercise programs.

Background and Aim: Prevalence of neck pain in nursing professionals (NPs) is much higher than in the general population. However, concrete evidence is not available regarding the efficacy of the therapeutic intervention for treating neck pain among them. The purpose of this study was to compare the efficacy of Mulligan's self-sustained natural apophyseal glides (SNAGs) and conventional physiotherapy in the management of work-related neck pain (WRNP) among the NPs. Materials and Methods: A total of 38 NPs with WRNP were recruited using the simple random sampling (lottery method) to participate in this two group such as pretest–posttest and single-blinded randomized controlled study from recognized tertiary care teaching hospital. Recruited NPs were randomly allocated into two groups such as Group A and Group B. NP in Group A taught self-SNAGs with a towel and instructed to perform 10 repetitions ×1 set/two hour ×4 times/day for 5 days/week ×2 weeks. Whereas in Group B, NPs received conventional physiotherapy treatment, consist of neck isometrics, and performed for 10 s ×10 repetitions ×1 set/day ×5 days/week ×2 weeks. Both groups were asked to use the hot pack for 15 min, before their intervention. Visual Analog Scale (VAS) score, neck disability index (NDI), and cervical range of motion (ROM) were documented at baseline, 2nd-week postintervention, and 4th-week follow-up period and analyzed. Results: Group A revealed statistical significance difference (P < 0.05) in VAS, NDI, and neck ROM when compared to Group B. Conclusion: Mulligan's self-SNAGs have proved to be more beneficial over the conventional physiotherapy in the management of WRNP among the NPs.