Abstract
BackgroundMechanical neck pain is a highly prevalent problem in primary healthcare settings. Many of these patients have restricted mobility of the cervical spine. Several manual techniques have been recommended for restoring cervical mobility, but their effectiveness in these patients is unknown. The aim of the present study is to compare the effectiveness of two types of specific techniques of the upper neck region: the pressure maintained suboccipital inhibition technique (PMSIT) and the translatory dorsal glide mobilization (TDGM) C0-C1 technique, as adjuncts to a protocolized physiotherapy treatment of the neck region in subjects with chronic mechanical neck pain and rotation deficit in the upper cervical spine.MethodsA randomized, prospective, double-blind (patient and evaluator) clinical trial. The participants (n = 78) will be randomly distributed into three groups. The Control Group will receive a protocolized treatment for 3 weeks, the Mobilization Group will receive the same protocolized treatment and 6 sessions (2 per week) of the TDGM C0-C1 technique, and the Pressure Group will receive the same protocolized treatment and 6 sessions (2 per week) of the PMSIT technique. The intensity of pain (VAS), neck disability (NDI), the cervical range of motion (CROM), headache intensity (HIT-6) and the rating of clinical change (GROC scale) will be measured. The measurements will be performed at baseline, post-treatment and 3 months after the end of treatment, by the same physiotherapist blinded to the group assigned to the subject.DiscussionWe believe that an approach including manual treatment to upper cervical dysfunction will be more effective in these patients. Furthermore, the PMSIT technique acts mostly on the musculature, while the TDGM technique acts on the joint. We expect to clarify which component is more effective in improving the upper cervical mobility.Trial registrationClinicalTrials.gov NCT02832232. Registered on July 13th, 2016.
Highlights
Mechanical neck pain is a highly prevalent problem in primary healthcare settings
Most cases of pain in the neck region are of mechanical origin [1]
This study aims to compare the effectiveness of the specific manual approach to the suboccipital region, comparing between two manual techniques added to a protocolized treatment, which follows Sant Ildefons Rehabilitation Service policy, in subjects with chronic mechanical neck pain presenting restricted mobility of the upper cervical spine evaluated with the flexion-rotation test
Summary
Mechanical neck pain is a highly prevalent problem in primary healthcare settings. Many of these patients have restricted mobility of the cervical spine. An annual prevalence of 19.5% has been calculated in the Spanish population [5]. It lasts for 6 months or longer in 14% of cases [6], leading to difficulties at work and in everyday life, at home and in leisure activities [7]. The healthcare costs generated are high, mostly as a result of compensation for sick leave [8, 9]
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