Abstract
Background: Chronic nonspecific neck pain is the most frequent form of neck pain. It is more prevalent in women, and a costly public health issue. It is commonly associated with biomechanical, functional, proprioceptive, and postural impairments. The aim of this trial is to compare the effects of global postural exercises versus specific therapeutic exercises on neck pain, disability, mobility, pressure pain threshold, kinesiophobia, pain catastrophizing, postural control, and neuromuscular efficiency in women with chronic nonspecific neck pain. Methods and analysis: This study is a randomized, parallel-group and single blinded clinical trial. Sixty-two women with nonspecific chronic neck pain were recruited from the community of Guarda, Portugal, and randomly assigned to one of two intervention groups: (1) global postural reeducation (GPR group), (2) specific therapeutic exercises (STE group). The intervention was carried out over 4 weeks, with two sessions per week (eight sessions), and applied by a physiotherapist and paired with a daily individual at-home-exercise program. Primary outcomes are neck pain intensity and disability (Numerical Pain Rating Scale, Neck Disability Index). Secondary outcomes are cervical mobility and pressure pain threshold (CROM, algometry), attitude to pain (kinesiophobia, pain catastrophizing), standing postural control (Center of Pressure (COP) displacements), and neuromuscular efficiency (electromyography). There are four points of evaluation where the outcomes were assessed twice before the intervention, 1 week apart, and the two post-intervention assessments will be carried out after four and eight sessions. The objective was to increase scientific knowledge of different exercise modalities, such as global postural reeducation, in musculoskeletal disorders. Trial registration: ClínicalTrials.gov (NCT04402463), prospectively registered (data 22 May 2020).
Highlights
Nonspecific neck pain is an increasingly frequent musculoskeletal condition [1,2,3]affecting 22% to 70% of the population [4,5] that is more prevalent in women than in men [6]
In our study we address the Global postural reeducation (GPR), which due to the heterogeneity of the results of some studies, it presents some lack of evidence that we address in our study, on parameters in the application protocols and the effects on some outcome variables not sufficiently assessed in previous studies as patterns or neuromuscular efficiency, postural control and psychosocial factors, and compare these effects with those caused by other therapies in this study factor (CNSNP)
The secondary objective is to assess the effectiveness of the two interventions on cervical range of motion (CROM), pressure pain threshold (PPT) in the cervical region, kinesiophobia, pain catastrophizing, standing postural control, and neuromuscular efficiency of superficial cervical flexor muscles
Summary
Nonspecific neck pain is an increasingly frequent musculoskeletal condition [1,2,3]. affecting 22% to 70% of the population [4,5] that is more prevalent in women than in men [6]. Even though the interventions were not designed to improve balance, they both aimed to enhance neuromuscular and sensorimotor control which could potentially enhance postural stability considering its neurophysiological mechanisms [19,21,22,23,83] This is the first study investigating the effects of GPR on the activity of cervical flexor muscles in patients with chronic neck pain by comparing it to an exercise mode that promotes coordination between the superficial and deep cervical muscles [84]. The secondary objective is to assess the effectiveness of the two interventions on cervical range of motion (CROM), pressure pain threshold (PPT) in the cervical region, kinesiophobia, pain catastrophizing, standing postural control, and neuromuscular efficiency of superficial cervical flexor muscles
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