Pattern-specific physiotherapy for chronic neck pain based on functional impairment

Abstract

Objective To explore the effect of pattern-specific physical therapy based on functional impairment on chronic neck pain (CNP). Methods Ninety-three CNP patients treated in the outpatient department of our hospital between March 2016 and November 2017 were randomly divided into a study group (n=46) and a control group (n=47). The control group received routine physical treatment, while the study group was treated with pattern-specific physical therapy involving local pain management, traction, soft tissue relaxation, mobilization, strength training, posture control training and active exercise as well as health education. Each was based on a physical examination and pattern classification by doctors and therapists. The subjects in both groups were required to complete 3 to 6 ninety-minute sessions of outpatient treatment and 6 thirty-minute sessions of self-training at home over 2 weeks. Pain intensity and cervical dysfunction were rated using a visual analogue scale (VAS) and a neck disability index (NDI) before and after the two-week intervention and one month later. Before the intervention and during the follow-up, postural analyses for the head and neck in a standing position were performed. The cranial vertebral angle (CVA), protracted shoulder angle (PSA) and sagittal head elevation were measured. Results Eighty-seven participants completed the treatments and follow-up. After the 2-week intervention, the average VAS rating at the end of cervical anteflection in the study group was significantly lower than that in the control group (P≤0.05). Significantly greater improvement in the NDI scores was observed in the study group than the control group (P≤0.05). During the follow-up, it was found that the average CVA score had improved more significantly in the study group than with the control group (P≤0.01), but there were no significant differences in the other measurements between the two groups. Conclusion This pattern-specific physical therapy process is more effective for relieving the end pain during cervical anteflection quickly. It can improve functioning and ability in daily activities to some degree, as well as correct head and neck posture in the long term. It may be helpful in regulating physical therapy for neck pain and for developing a standardized treatment protocol for CNP. Key words: Neck pain; Standardized treatment; Pattern-specific treatment; Posture analysis