Non-specific Neck Research Articles

Jaw Kinematics and Muscle Activation in Patients With Non-specific Chronic Neck Pain

Jaw Kinematics and Muscle Activation in Patients With Non-specific Chronic Neck Pain

Laterality Discrimination in Patients With Non-specific Chronic Neck Pain

Laterality Discrimination in Patients With Non-specific Chronic Neck Pain

Efficacy and safety of polydioxanone thread embedded at specific acupoints for non-specific chronic neck pain: a study protocol for a randomized, subject-assessor-blinded, sham-controlled pilot trial

BackgroundThis study aims to evaluate the efficacy and safety of thread-embedding acupuncture (TEA) with polydioxanone thread embedded at various acupoints, compared with sham TEA, for the treatment of non-specific chronic neck pain.Methods/designThis study will be an 8-week-long, two-armed, parallel, randomized, subject-assessor-blinded, sham-controlled pilot trial. Fifty eligible patients will be randomly allocated into the real TEA group or the sham TEA group. The real TEA group will receive TEA treatment at 14 fixed acupoints in the neck region. The sham TEA group will receive the same treatment as the real TEA group, but with a sham device with the thread removed. Both groups will receive treatment once a week for a total of four sessions. The primary outcome will be the mean change in the visual analog scale (VAS) from baseline to week 6 (2 weeks post intervention). Clinical relevance (ratio of the number of patients with decreases on the VAS of ≥15 mm or with percentiles ≥ 30% and ≥ 50% relative to baseline to the total number of patients), Neck Disability Index, pressure pain threshold, the Hospital Anxiety and Depression Scale, EuroQol 5-Dimensions questionnaire, Patient Global Impression of Change, blinding test, and adverse events will be used to assess secondary outcomes.DiscussionThe results of this study will provide valuable data for a large-scale clinical trial to evaluate the clinical effects of polydioxanone TEA in the treatment of patients with non-specific chronic neck pain.Trial registrationClinical Research Information Service (CRIS), Republic of Korea, KCT0002452. Registered on 6 September 2017.

2016 JOSPT Awards: Additive Effects and Biological Mechanisms of Interventions Offer Important Insights.

During the American Physical Therapy Association's Combined Sections Meeting in San Antonio, TX in February 2017, JOSPT recognized the authors of the most outstanding research and clinical practice manuscripts published in JOSPT during 2016. The 2016 JOSPT Excellence in Research Award was presented to Carol A. Courtney, Alana D. Steffen, César Fernández-de-las-Peñas, John Kim, and Samuel J. Chmell, MD, for their March 2016 article "Joint Mobilization Enhances Mechanisms of Conditioned Pain Modulation in Individuals With Osteoarthritis of the Knee." The 2016 George J. Davies-James A. Gould Excellence in Clinical Inquiry Award was presented to Seyda Toprak Celenay, Turkan Akbayrak, and Derya Ozer Kaya for their February 2016 article "A Comparison of the Effects of Stabilization Exercises Plus Manual Therapy to Those of Stabilization Exercises Alone in Patients With Nonspecific Mechanical Neck Pain: A Randomized Clinical Trial." J Orthop Sports Phys Ther 2017;47(4):225-227. doi:10.2519/jospt.2017.0104.

Prevalence of myofascial trigger points in non-specific neck or shoulder pain among University students

Prevalence of myofascial trigger points in non-specific neck or shoulder pain among University students

Spinal Disorders as a Cause of Locomotive Syndrome: The Influence on Functional Mobility and Activities of Daily Living

Spinal disorders are one of the most common causes of locomotive syndrome because the spine plays an important role as the locomotive organs which provide the three functions: body frames, junction sites, and motors/regulators. Previous reports have shown that low back pain or leg pain and/or intermittent claudication due to spinal stenosis in lumbar spine disorders, gait abnormality due to degenerative cervical myelopathy in cervical spine disorders, and trunk imbalance due to adult spinal deformity have negative effects on walking speed, walking distance, and movement ability, thereby increasing the risk of falling. Patients for whom conservative managements have failed are considered for surgical treatment. However, degenerative changes on radiographical examinations are sometimes observed in asymptomatic elderly people, which suggests that degenerative changes are not always the cause of pain or disability in the elderly, particularly non-specific low back pain and neck pain. Therefore, the evidence is insufficient regarding how effective surgical treatments can be for improving walking and movement ability and social participation of elderly patients. In addition to better evidence for the efficacy of various treatments, more attention concerning checkups and prevention of locomotive syndrome are urgently needed in aging populations.

The effect of traditional wet cupping on shoulder pain and neck pain: A pilot study

ObjectivesWet cupping therapy (WCT) is a traditional complementary method recommended to decrease the symptoms of a lot of diseases and used in the treatment of pain syndromes. In this pilot study, the possible effects of wet cupping therapy on nonspecific neck and upper shoulder pain were investigated. MethodsSixty one eligible volunteer participants with nonspecific neck and upper shoulder pain for at least 3 months were allocated. The Numeric Rating Scale (NRS) was used to assess pain scores. Pain scores were recorded before and after wet cupping therapy. ResultsThe mean scores of neck pain in study group were 7.02 (SD = 1.8) before and 3.70 (SD = 2.2) after cupping therapy. The decrease of pain scores between pre- and post-test was statistically significant (p < 0.05). DiscussionIt can be stated that WCT has potential therapeutic effect in nonspecific neck and upper shoulder pain. Future full-scale randomized controlled trials will be needed to provide firm evidence of the effectiveness of this intervention.

Efficacy of Combination Therapy in Reliving Non-Specific Cervical Neck Pain

Efficacy of Combination Therapy in Reliving Non-Specific Cervical Neck Pain

Neck Training @ home with Intelligent Headset

Context: Non-specific neck and shoulder pain (NSS) is an increasingly common disorder in Denmark and has statistically been experienced by half of the adult population within the last six months [1, 2]. The estimated societal and personal costs related to NSS amount to at least 13 billion DKR yearly. The reason for the NSS disorder reaching epidemic levels in Denmark and worldwide is primarily the introduction of computers, tablets and smartphones in peoples’ private and professional lives and the resulting work habits and physical postures imposed by such devices [3]. Curing NSS often requires several visits to physiotherapists or chiropractic clinics and in most cases the patients receive treatment as well as instructions in rehabilitative exercises that can be performed at home. Purpose: With this M.Sc. project we propose a tele-medical training assistant that will instruct and monitor the patient in doing these home exercises in the correct manner. The training assistant consists of the motion-sensor-equipped 3D audio headset, Intelligent Headset, developed by GN [4]. This headset is connected with a smartphone and controlled by the training assistant app developed. Using this headset, we can monitor the head movements of the patient very closely as well as give immediate auditory instructions and feedback. Methods: We first validate the precision of the headset motion sensors and the resulting ability to detect certain patterns of movement using the high-precision 3D motion capture system, Vicon, as a reference. We then develop and implement an application which is able to recognize and give feedback on three common and scientifically approved types of neck rehabilitation exercises. We do this through a user-centred process involving both healthy users and users with neck problems, while receiving continuous feedback from domain experts, such as chiropractors and physiotherapists.

Dose Optimization for Spinal Treatment Effectiveness: A Randomized Controlled Trial Investigating the Effects of High and Low Mobilization Forces in Patients With Neck Pain

Randomized controlled trial. Objective To determine if force magnitude during posterior-to-anterior mobilization affects immediate and short-term outcomes in patients with chronic, nonspecific neck pain. The optimal dose of mobilization to effectively treat patients with neck pain is not known. Patients with neck pain of at least 3 months in duration (n = 64) were randomized to receive a single treatment of posterior-to-anterior mobilization applied with 30 N or 90 N of mean peak force (3 sets of 30 seconds) or a placebo (detuned laser) on the spinous process at the painful spinal level. Pressure pain threshold, pain measured with a visual analog scale (range, 0-100 mm), cervical range of motion, and spinal stiffness at the painful spinal level (measured with a custom device and normalized as a percentage of C7 stiffness) were assessed before, immediately after, and at a mean ± SD follow-up of 4.0 ± 1.8 days following treatment. Repeated-measures analysis of covariance and Bonferroni-adjusted post hoc tests determined group differences for each outcome measure after treatment and at follow-up. At follow-up, the 90-N group had less pain than the 30-N group (mean difference, 11.3 mm; 95% confidence interval: 0.1, 22.6 mm; P = .048) and lower stiffness than the placebo group (mean difference, 17.5%; 95% confidence interval: 4.2%, 30.9%; P = .006). These differences were not present immediately after treatment. There were no significant between-group differences in pressure pain threshold or range of motion after treatment or at follow-up. A specific dose of mobilization, in terms of applied force, appears necessary for reducing stiffness and potentially pain in patients with chronic neck pain. Changes were not observed immediately after mobilization, suggesting that its effects are not directly mechanical. Australian and New Zealand Clinical Trials Registry ( http://www.anzctr.org.au/): ACTRN12611000374965. Therapy, level 1b-.

A psychometric evaluation of the Swedish version of the Multidimensional Pain Inventory (MPI-S): a gender differentiated evaluation.

A need to consider possible gender differences in pain research has been recognized by researchers during the last decades. As part of a psychometric evaluation of the Swedish version of the Multidimensional Pain Inventory (MPI-S), we performed gender-differentiated analyses of the internal consistency, validity and sensitivity to change of the MPI-S in a sample of 235 individuals (129 females, 106 males) suffering from long-term non-specific pain from the lower back and/or neck region. The construct validation and sensitivity analyses were performed by using validated self-report measures and direct observational assessment techniques as external constructs. For sections 1 and 2 of the MPI-S, the results support the internal consistency (alpha coefficients ranged from 0.74 to 0.85 for females and 0.62 to 0.89 for males) and construct validity across gender. The General Activity (GA) scale of section 3 of the MPI-S displayed acceptable internal consistency across gender (alpha = 0.79 for females, 0.80 for males) but not a satisfactory construct validity. Furthermore, the results yielded some support for the sensitivity to change of the Pain Severity (PS), Interference (I), Life Control (LC) and Affective Distress (AD) scales (from section 1) across gender. Unfortunately, the GA scale did not display a satisfactory sensitivity either for females or males. Altogether, the results showed a similar pattern across gender, although some divergences were detected, such as the substantially weaker negative correlation between perceived supportive behaviour from significant others and punishing responses for males compared to females. In conclusion, we recommend the use of sections 1 and 2 of the MPI-S as a psychometrically evaluated and comprehensive instrument in the assessment of individuals suffering from chronic non-specific low back pain or neck pain. Copyright 1999 European Federation of Chapters of the International Association for the Study of Pain.

Implementation of neck/shoulder exercises for pain relief among industrial workers: A randomized controlled trial

BackgroundAlthough leisure-time physical activity is important for health, adherence to regular exercise is challenging for many adults. The workplace may provide an optimal setting to reach a large proportion of the adult population needing regular physical exercise. This study evaluates the effect of implementing strength training at the workplace on non-specific neck and shoulder pain among industrial workers.MethodsCluster-randomized controlled trial involving 537 adults from occupations with high prevalence of neck and shoulder pain (industrial production units). Participants were randomized to 20 weeks of high-intensity strength training for the neck and shoulders three times a week (n = 282) or a control group receiving advice to stay physically active (n = 255). The strength training program followed principles of progressive overload and periodization. The primary outcome was changes in self-reported neck and shoulder pain intensity (scale 0-9).Results85% of the participants followed the strength training program on a weekly basis. In the training group compared with the control group, neck pain intensity decreased significantly (-0.6, 95% CI -1.0 to -0.1) and shoulder pain intensity tended to decrease (-0.2, 95% CI -0.5 to 0.1, P = 0.07). For pain-cases at baseline (pain intensity > = 3) the odds ratio - in the training group compared with the control group - for being a non-case at follow-up (pain intensity < 3) was 2.0 (95% CI 1.0 to 4.2) for the neck and 3.9 (95% CI 1.7 to 9.4) for the shoulders.ConclusionHigh-intensity strength training relying on principles of progressive overload can be successfully implemented at industrial workplaces, and results in significant reductions of neck and shoulder pain.Trial registrationNCT01071980.

The clinical effectiveness of a myofeedback-based teletreatment service in patients with non-specific neck and shoulder pain: a randomized controlled trial

We investigated the effectiveness and efficiency of a four-week myofeedback-based teletreatment service in subjects with non-specific neck and shoulder pain. Subjects were recruited in Belgium, Germany and the Netherlands and randomly allocated to the intervention or conventional care. Subjects in the intervention group received four weeks of myofeedback training. Pain intensity and disability were evaluated by questionnaires at baseline, immediately after four weeks of treatment and at follow-up 3 months later. To investigate efficiency, the time-investment of both therapists and patients were assessed. Seventy-one subjects were included in the study (36 in the intervention group and 35 in the conventional care group). Myofeedback-based teletreatment was at least as effective clinically as conventional care. Pain intensity and disability decreased after 4 weeks of treatment in both groups and part of the effect remained at 3 months' follow-up. The teletreatment also increased efficiency for therapists by almost 20% and patients experienced the benefits of less travel time and travel costs by remote consultation. Myofeedback-based teletreatment has the potential to ensure more efficient treatment for patients with non-specific neck and shoulder pain.

Prognostic factors for the effect of a myofeedback-based teletreatment service

We investigated the potential prognostic factors for clinically relevant improvements in pain intensity and pain-related disability after myofeedback-based teletreatment. Sixty-five female computer users, 56 female patients with whiplash-associated disorders and 18 female patients with non-specific neck and shoulder pain participated in the study. They received myofeedback-based teletreatment or usual treatment. Questionnaires concerning prognostic factors, pain and disability were completed before the start of the intervention (baseline) and at follow-ups at the end of the intervention, and after 3 and 6 months. Logistic regression analyses were performed in order to investigate prognostic factors for clinically relevant improvement. In the intervention group, improvement in pain intensity was predicted by baseline pain intensity. Baseline pain intensity and disability, and fear-avoidance and endurance related pain coping responses were prognostic factors for outcome in pain-related disability in this group. There were few differences between the intervention groups; fear-avoidance coping responses influenced the outcome after teletreatment only. Myofeedback-based teletreatment appears to be an useful telemedicine intervention, especially for participants with moderate to high levels of pain and disability, high perceived help/hopelessness, and those who tend to deal with their pain by avoiding social and physical activities.

Feldenkrais ® therapy as group treatment for chronic pain – A qualitative evaluation

This qualitative study describes and analyses the experiences and self-reported effects of those participating in a Feldenkrais group intervention. Fourteen women with non-specific neck and shoulder pain participated in a group treatment design using the Feldenkrais Awareness Through Movement (ATM) method. Data were collected in two ways: diary notes directly after the sessions and thematic interviews 4-6 months after the intervention. Data were analysed with a Grounded Theory approach. One core category and two sub-categories emerged. The core category "Feldenkrais is wholesome, but difficult" represents the participants' major opinions about the group intervention. The sub-categories "More erect without effort", and "Extended space for myself", represent participants' descriptions of effects of the movement therapy. The women described changes in posture and balance, a feeling of release and increased self-confidence. Some ambivalence about the method was expressed, especially regarding the difficulty to continue the exercises at home. The women feelings of improved body awareness remained after 4-6 months. They were also more aware of their attitudes towards activities in daily life. This resulted in them not "sacrificing themselves" as they did before. In addition, the bodily and psychological changes and the concept of empowerment are discussed. Positive experiences from the Feldenkrais group treatment were reported, especially concerning movement ability and body awareness. The exercises were however regarded as difficult to perform as self-training on a daily basis.

Position sense acuity of the upper extremity and tracking performance in subjects with non-specific neck and upper extremity pain and healthy controls

We aimed to investigate whether position sense acuity of the upper extremity and tracking performance, pen pressure and muscle activity in a tracking task are affected in subjects with neck and upper extremity pain. Twenty-three subjects with neck and upper extremity pain and 26 healthy controls participated in the study. Position sense acuity of the upper extremity was measured while subjects pointed at targets, without vision of their arm and hand. In the computer tracking task, subjects were instructed to position a cursor within a moving target dot, using a pen on a tablet. Position sense acuity of the upper extremity was impaired in subjects with pain. Their variable error was 20-30% larger than in healthy controls. Subjects with pain also showed reduced tracking precision. Both the mean and the standard deviation of the distance to target were significantly larger in subjects with pain than in healthy controls, 10% and 13% respectively. No differences between groups were found in pen pressure and muscle activity during tracking. The results suggest that subjects with pain are limited in performing precision tasks due to impaired position sense of the upper extremity, but do not compensate with increased effort.

Prevalence of Self-Reported Neck-Shoulder-Arm Pain and Concurrent Low Back Pain or Psychological Distress

Analysis of repeated cross-sectional surveys. To investigate the prevalence of neck-shoulder-arm pain and concurrent low back pain and psychological distress in a geographical area over a 16-year period. A large number of studies have shown that nonspecific neck, shoulder, and arm pain is a very common symptom in the general population. However, few studies have followed the prevalence of neck-shoulder-arm pain within a geographical area, in order to investigate time-trends. This study provides an analysis of questionnaire data collected every 4 years between 1990 and 2006 on the prevalence of neck-shoulder-arm pain and concurrent low back pain or psychological distress in the County of Stockholm, Sweden (response rate: 61%-69%). All individuals aged 21 to 64 years (n = 1976-26,611) were included in the study. Over the 16-year period, the prevalence of self-reported neck-shoulder-arm pain rose slightly, from 22.8% to 25.0% among females (prevalence rate ratio [PRR]: 1.10) and from 12.8% to 15.4% among males (PRR: 1.21). The prevalence of neck-shoulder-arm pain with concurrent low back pain also rose slightly, from 8.4% to 10.8% among females (PRR: 1.28) and from 5.3% to 6.6% among males (PRR: 1.24). In contrast, the prevalence of neck-shoulder-arm pain with concurrent psychological distress rose more substantially, from 4.4% to 8.5% among females (PRR: 1.91) and from 2.0% to 4.3% among males (PRR: 2.18). All prevalence rates rose between 1990 and 2002, and decreased in 2006 compared to 2002. The gender gap in prevalence did not change over time. Although the prevalence of neck-shoulder-arm pain and concurrent symptoms decreased in 2006 compared to 2002, it is still too early to conclude that we have reached and passed the peak of the "epidemic" of neck-shoulder-arm pain.

Grip force control in patients with neck and upper extremity pain and healthy controls

ObjectiveTo investigate whether sensory and motor problems in patients with non-specific neck and upper extremity pain can be ascribed to a deficit of sensory–motor integration. MethodsGrip force control and adaptation were measured in 81 cases, 32 former cases and 39 healthy controls, during repetitive lifting and holding of an object. The object (300g) was lifted vertically over 20cm and held for 5s, using the dominant arm (the affected arm in all cases). The object was novel to the subjects when lifted for the first time, and was lifted five times consecutively. Grip forces orthogonal to the object’s surface and its vertical acceleration were measured. ResultsCases used significantly higher grip forces than both other groups, while vertical acceleration was not different. After the initial lift, all groups significantly reduced the maximum grip force. ConclusionsSubjects with neck and upper extremity pain consistently use higher grip forces than controls, but adjust grip forces by a similar amount after the first lift. Compensation of impaired sensory information rather than a general deficit in sensory–motor integration seems to account for these findings. SignificanceNon-specific neck and upper extremity pain coincides with objectifiable changes in control of grip force.

Minimal Clinically Important Change of the Neck Disability Index and the Numerical Rating Scale for Patients With Neck Pain

Prospective, single-cohort study. To assess the minimal clinically important change (MCIC) on the Neck Disability Index (NDI) and the Numerical Rating Scale (NRS) for pain in patients with neck pain. Both measurement instruments are frequently used in research and clinical practice, but which changes are clinically relevant is still unknown. The MCIC was estimated with 2 different methods, both integrating an anchor-based and distribution-based approach: the minimal detectable change (MDC) and the optimal cutoff point of the ROC curve. The study population consisted of 183 patients with nonspecific neck pain. The results show an MDC of 10.5 points for the NDI (scale range, 0-50) and 4.3 points for the NRS (scale range, 0-10), and optimal cutoff points of the ROC curve of 3.5 for the NDI and 2.5 for the NRS. The estimated MCIC should be used as an indication for relevant changes in clinical practice. Using the optimal cutoff point of the ROC curve, false positives and false negatives are equally weighted; and if there are no objections doing so, the optimal cutoff point of the ROC curve may be a good choice.

Physiotherapy management of non-specific back and neck pain

Physiotherapy management of non-specific back and neck pain