Northwick Park Neck Pain Questionnaire Research Articles

A Randomized Control Trial of Dexketoprofen/Vitamin B (Thiamine, Pyridoxine and Cyanocobalamin) Fixed-Dose Combination in Post-Traumatic Grade I-II Cervical Sprains.

Musculoskeletal disorders are an important cause of work absence. Clinical practice guidelines recommend nonsteroidal anti-inflammatory drugs (NSAIDs) for grade I-II cervical sprains. The combination of thiamine + pyridoxine + cyanocobalamin vitamins has been used, alone and in combination with NSAIDs, for pain and inflammation in musculoskeletal disorders. The objective of this study was to demonstrate the analgesic synergy of dexketoprofen, and the combination of vitamins thiamine + pyridoxine + cyanocobalamin in a fixed-dose combination (FDC) for the treatment of acute pain caused by grade I-II cervical sprains. We conducted a multicentre, prospective, randomized, double-blind, phase IIIb clinical study comparing two treatment groups: (1) dexketoprofen 25 mg/vitamin B (thiamine 100mg, pyridoxine 50mg and cyanocobalamin 0.50mg) in an FDC (two or more active ingredients combined in a single dosage form) versus (2) dexketoprofen 25mg monotherapy (single drug to treat a particular disease), one capsule or tablet orally, every 8h for 7 days. Final mean, average change, and percentage change in pain perception (measured using a visual analogue scale [VAS]) were compared with baseline between groups. A p value < 0.05 was considered statistically significant. Analyses were conducted using SPSS software, v.29.0. A statistically significant reduction in pain intensity was observed from the third day of treatment with the FDC compared with monotherapy (- 3.1±- 1.5 and - 2.6±- 1.1 cm, respectively) measured using the VAS (p=0.011). Regarding the degree of disability, using the Northwick Park Neck Pain Questionnaire (NPQ), statistical difference was observed for the final measurement (7.5%, interquartile range [IQR] 2.5, 10.5; vs. 7.9%, IQR 5.0, 13.8; p=0.028). A lower proportion of adverse events was reported when using the FDC. The FDC of dexketoprofen/thiamine + pyridoxine + cyanocobalamin vitamins demonstrated superior efficacy and a better safety profile compared with dexketoprofen monotherapy for pain treatment in patients with grade I-II cervical sprains. NCT05001555, registered 29 July 2021 ( https://clinicaltrials.gov/study/NCT05001555 ).

Unsupervised machine learning for clustering forward head posture, protraction and retraction movement patterns based on craniocervical angle data in individuals with nonspecific neck pain

ObjectivesThe traditional understanding of craniocervical alignment emphasizes specific anatomical landmarks. However, recent research has challenged the reliance on forward head posture as the primary diagnostic criterion for neck pain. An advanced relationship exists between neck pain and craniocervical alignment, which requires a deeper exploration of diverse postures and movement patterns using advanced techniques, such as clustering analysis. We aimed to explore the complex relationship between craniocervical alignment, and neck pain and to categorize alignment patterns in individuals with nonspecific neck pain using the K-means algorithm.MethodsThis study included 229 office workers with nonspecific neck pain who applied unsupervised machine learning techniques. The craniocervical angles (CCA) during rest, protraction, and retraction were measured using two-dimensional video analysis, and neck pain severity was assessed using the Northwick Park Neck Pain Questionnaire (NPQ). CCA during sitting upright in a comfortable position was assessed to evaluate the resting CCA. The average of midpoints between repeated protraction and retraction measures was considered as the midpoint CCA. The K-means algorithm helped categorize participants into alignment clusters based on age, sex and CCA data.ResultsWe found no significant correlation between NPQ scores and CCA data, challenging the traditional understanding of neck pain and alignment. We observed a significant difference in age (F = 140.14, p < 0.001), NPQ total score (F = 115.83, p < 0.001), resting CCA (F = 79.22, p < 0.001), CCA during protraction (F = 33.98, p < 0.001), CCA during retraction (F = 40.40, p < 0.001), and midpoint CCA (F = 66.92, p < 0.001) among the three clusters and healthy controls. Cluster 1 was characterized by the lowest resting and midpoint CCA, and CCA during pro- and -retraction, indicating a significant forward head posture and a pattern of retraction restriction. Cluster 2, the oldest group, showed CCA measurements similar to healthy controls, yet reported the highest NPQ scores. Cluster 3 exhibited the highest CCA during protraction and retraction, suggesting a limitation in protraction movement.DiscussionAnalyzing 229 office workers, three distinct alignment patterns were identified, each with unique postural characteristics; therefore, treatments addressing posture should be individualized and not generalized across the population.

Effects of scapular treatment on chronic neck pain: a systematic review and meta-analysis of randomized controlled trials

BackgroundChronic neck pain (CNP) is a common public health problem that affects daily living activities and quality of life. There is biomechanical interdependence between the neck and scapula. Studies have shown that shoulder blade function might be related to chronic neck pain. We therefore evaluated the effects of scapular targeted therapy on neck pain and function in patients with CNP.MethodsDatabases, including MEDLINE (via PubMed), EMBASE (via Ovid), Ovid, Web of Science, and Scopus, were systematically searched for randomized controlled trials published in English investigating treatment of the scapula for CNP before July 16, 2023.ResultsA total of 313 participants were included from 8 RCTs. Compared with those in the control group, the intervention in the scapular treatment group exhibited greater improvement in pain intensity (standardized mean difference (SMD) = 2.55; 95% CI = 0.97 to 4.13; P = 0.002), with moderate evidence. Subgroup analysis for pain intensity revealed a significant difference between the sexes, with only the female population (SMD = 6.23, 95% CI = 4.80 to 7.65) showing better outcomes than those with both sexes (SMD = 1.07, 95% CI = 0.57 to 1.56) (p < 0.00001). However, moderate evidence demonstrated no improvement in neck disability after scapular treatment (SMD of 0.24[-0.14, 0.62] of Neck Disability Index or Northwick Park Neck Pain Questionnaire). No effect of scapular treatment was shown on the pressure pain threshold (PPT). The cervical range of motion (CROM) and electromyographic activity of neck muscles could not be conclusively evaluated due to limited support in the articles, and further study was needed. However, the patient’s head forward posture appeared to be corrected after scapular treatment.ConclusionScapular therapy was beneficial for relieving pain intensity in patients with CNP, especially in women. Head forward posture might also be corrected with scapular therapy. However, scapular therapy may have no effect on the PPT or neck disability. However, whether scapular therapy could improve CROM and cervical muscle activation in patients with CNPs had not been determined and needed further study.

Prevalence of Neck Pain and Disability in Medical Students of Sialkot

Neck pain is a pervasive musculoskeletal disorder and one of the leading causes of disability worldwide. It ranks as the fourth most typical cause of disability. Objectives: To determine the prevalence of neck pain and disability in medical students of Sialkot. Methods: It was cross-sectional study and simple random sampling technique was used. 465 male/female medical student 18–25-year-old were participated. Subjects with other neck pathologies like cervical stenosis were excluded. Data were collected from three different institutes of Sialkot i.e., University of Sialkot, Sialkot College of Physical Therapy and University of Management and Technology. Northwick Park Neck Pain Questionnaire was used to collect data. Study ran from 20 May to 22 September 2021.Statsitical analysis done through SPSS version 20. Histogram, bar charts used to display data. Ethical approval obtained from institute before conducting research. Results: Results were calculated using Northwick Park Neck Pain Questionnaire (NPQ) percentages. 15.9% had no disability, 58.1% had mild disability, and 19.4% had moderate disability while 6.7% were suffering from severe disability. The overall neck pain prevalence was 58.1% and it caused mild disability in medical students. Conclusions: It is concluded that neck pain is quite common among medical students as more than half of participants were suffering from this issue. Lifting heavy objects being in uncomfortable posture during daily activities and reading for extended hours aggravate the pain. Occasional disturbance of sleep was also noted.

Northwick Park Neck Pain Questionnaire: Reliability and Validity of a Hindi Adaptation for Patients with Non-inflammatory Neck Pain

Northwick Park Neck Pain Questionnaire: Reliability and Validity of a Hindi Adaptation for Patients with Non-inflammatory Neck Pain

Cross-cultural adaptation and validation of the Northwick park neck pain questionnaire to Urdu language

BackgroundDespite its widespread use for assessing pain and disability in patients suffering from neck pain, the Northwick Park Neck Pain Questionnaire (NPQ) has yet to be translated and validated in Urdu. The purpose of the present study was to translate and cross-culturally adapt the NPQ into Urdu language (NPQ-U), and to investigate the NPQ-U’s psychometric properties in patients with non-specific neck pain (NSNP).MethodsThe NPQ was translated and cross-culturally adapted into Urdu in accordance with the previously described guidelines. The study included 150 NSNP patients and 50 healthy participants. The NPQ-U, Urdu version of neck disability index (NDI-U), neck pain and disability scale (NPDS), and numerical pain rating scale (NPRS) were completed by all participants on first visit. After three weeks of physical therapy, the patients completed all of the questionnaires listed above, along with the global rating of change scale. Test-retest reliability was determined on 46 randomly selected patients who completed the NPQ-U again two days after the first response. The NPQ-U was evaluated for internal consistency, content validity, construct (convergent and discriminative) validity, factor analysis, and responsiveness.ResultsThe NPQ-U demonstrated excellent test-retest reliability (intra-class correlation coefficient = 0.96) and high internal consistency (Cronbach’s alpha = 0.89). There were no floor or ceiling effects for the NPQ-U total score, indicating good content validity. A single factor was extracted, which explained 54.56% of the total variance. For convergent validity, the NPQ-U showed a strong correlation with NDI-U (r = 0.89, P < 0.001), NPDS (r = 0.71, P < 0.001), and NPRS (r = 0.73, P < 0.001). The results revealed a significant difference between patients and healthy controls in the NPQ-U total scores (P < 0.001) demonstrating significant discriminative validity. A significant difference in the NPQ-U change scores between the stable and the improved groups (P < 0.001) confirmed its responsiveness. Furthermore, the NPQ-U change score showed a moderate correlation with NPDS change score (r = 0.60, P < 0.001) and NPRS change score (r = 0.68, P < 0.001), but a strong correlation with NDI-U change score (r = 0.75, P < 0.001).ConclusionThe NPQ-U is a reliable, valid, and responsive tool for assessing neck pain and disability in Urdu-speaking patients with NSNP.

The Hausa Northwick Park Neck Pain Questionnaire: translation, cross-cultural adaptation and psychometric assessment in patients with non-specific neck pain

Purpose To translate and cross-culturally adapt the Northwick Park Neck Pain Questionnaire (NPQ) into Hausa and assess its psychometric properties. Materials and Methods The NPQ was translated and cross-culturally adapted into Hausa using recommended guidelines. A consecutive sample of 92 Hausa-speaking patients with non-specific neck pain recruited from three tertiary hospitals in north-western Nigeria, completed the questionnaire to assess factorial validity (using confirmatory factor analysis), convergent validity (by correlating the Hausa-NPQ with the Numerical Pain Rating Scale [NPRS]), and internal consistency (using Cronbach’s α). A subsample of 50 patients completed the questionnaire again 3 days after the first administration to assess relative reliability using intraclass correlation coefficients (ICC) and absolute reliability using standard error of measurement (SEM), smallest detectable change (SDC), and 95% limits of agreement (LOA). Results The factor analysis confirmed a single-factor structure with excellent internal consistency (α = 0.94). The questionnaire showed a strong positive correlation with the NPRS (rho = 0.68). The ICC was 0.86, with SEM and SDC of 6.32 and 17.5, respectively. The LOA was − 29.3 to + 37.1 with no evidence of proportional bias. Conclusions The Hausa-NPQ is a valid and reliable measure of disability due to neck pain.

Is Neck Pain Related to Sagittal Head and Neck Posture?: A Systematic Review and Meta-analysis.

Neck pain (NP) is common in all age groups and adversely affects the patients' entire lifestyle. There exists inconclusive evidence relating faulty craniocervical posture with pain-related disability. This review aims to determine whether sagittal head and neck posture differs in NP and pain-free subjects, to critically appraise the correlation of posture with NP. Of 3796 articles identified at primary search from CINAHL, PubMed, Google Scholar, EMBASE, 26 were included based on eligibility criteria. Mean pooled difference (MPD) and effect size (ES) were calculated to establish relationship among studies, to assess postural correlation with NP measures [Visual Analogue Scale (VAS), Numeric Pain Rating Scale (NPRS), neck disability index (NDI), Northwick Park NP Questionnaire (NPQ)] and for age- and gender-wise variation. Risk of bias was assessed using Newcastle-Ottawa Quality Assessment Scale. Craniovertebral angle (CVA) had a significant MPD of -2.93(95% CI -4.95 to -0.91). Sagittal head angle (SHA) and forward head posture (FHP) had an insignificant MPD of 1.15 (95% CI -1.16 to 3.46) and -0.26 (95% CI -1.89 to 1.36), respectively. Age- and gender-wise CVA difference was found to be 2.36° and 2.57°, respectively. ES was significant for correlation between CVA and pain intensity [NPRS: -0.44 (95% CI -0.61 to -0.26); VAS: -0.31 (95% CI -0.46 to -0.16)], and between CVA and disability [NDI: -0.18 (95% CI -0.31 to -0.05); NPQ: -0.47 (95% CI -0.61 to -0.320)]. CVA differs for age, gender, and pain vs pain-free subjects, and correlates negatively with NP measures. Other surrogate measures (SHA, cranial and cervical angles, FHP) warrant further research. PROSPERO 2021 CRD42021275485.

Efektivitas penambahan mobilisasi sendi dan pelatihan stabilisasi pada non-specific neck pain

Background: Neck pain is a common complaint that often occurs in the community with a total prevalence of 86%. Non-specific neck pain cause problems such as: range of motion limitation, increased neck disability, and increased in the angle of forward head posture.Objective: The purpose of this study was to determine the effectiveness of adding joint mobilization and stabilization exercise to ultrasound therapy (UST) intervention and stretching exercise in reducing neck pain and disability in non-specific neck pain.Methods: This study is an experimental study with a randomized controlled trial group design. Study participants were randomly divided into two groups. The control group (n=14) was given UST + stretching exercise while the treatment group (n=14) was given UST + stretching exercise + joint mobilization + stabilization exercise. This study measures the effectiveness of therapy in terms of reducing pain as measured by a visual analogue scale, as well as neck disability with the Indonesian version of the Modified Northwick Park neck pain Questionnaire (MNPQ).Results: The results of the comparison test between groups showed that there was a significant difference (p&lt;0.05) in the reduction in pain and disability scores between the control and treatment groups.Conclusion: The addition of joint mobilization and neck stabilization exercises to the intervention of ultrasound therapy and stretching training was more significant than the administration of ultrasound therapy and stretching training alone in reducing neck pain and disability in non-specific neck pain.

Cross-Cultural Translation, Validity and Reliability of the Turkish Version of the Northwick Park Neck Pain Questionnaire

Cross-Cultural Translation, Validity and Reliability of the Turkish Version of the Northwick Park Neck Pain Questionnaire

Preliminary evidence of safety and effectiveness of Loxoprofen Sodium Cataplasm combined with physiotherapy for myofascial pain syndrome treatment: A randomized controlled pilot clinical trial.

Myofascial pain syndrome (MPS) is one of the most common causes of chronic skeletal muscle pain, which is closely related to skeletal muscle myofascial trigger point (MTRP). Since there is no first-line treatment for MPS, we investigated Loxoprofen Sodium Cataplasm combined with physiotherapy as a non-invasive therapy in patients at different levels to a protocol with superior efficacy that is safe and easy to promote. Moreover, this treatment could represent an alternative therapeutic strategy for low-income patients to a safer, more convenient, and more economical treatment scheme. A randomized clinical study was aimed at evaluating the safety and efficacy of Loxoprofen Sodium Cataplasm combined with physiotherapy in patients diagnosed with MPS in the pain clinic. We screened 100 patients with MPS, and using a computer-generated random allocation sequence, we stratified patients in a ratio of 2:1:1:1 (A: B: C: D) to one of the four treatment groups. Group A received Loxoprofen Sodium Cataplasm combined with extracorporeal shock wave therapy (ESWT) and transcutaneous electrical nerve stimulation (TENS). Group B received Loxoprofen Sodium Cataplasm alone. Group C received physiotherapy alone. Group D received Flurbiprofen Cataplasm combined with physiotherapy. After 2 weeks of treatment, the overall efficiency and secondary assessment indicators, including visual analog scale (VAS) scores, chronic soft tissue injury (CSTI) scores, Oswestry Disability Index (ODI) scores, or Northwick Park Neck Pain Questionnaire (NPQ) scores, were evaluated before and after treatment to analyze the difference in efficacy of each group. All groups were well tolerated with no reported adverse events. Significant treatment differences in the change from baseline in overall efficiency (primary efficacy endpoint) (P = 0.0078) were observed in subjects of groups A and C. Showing valuable data of efficacy in primary and secondary endpoints, Loxoprofen Sodium Cataplasm combined with physiotherapy is superior in the treatment of MPS. https://www.chictr.org.cn/ (ChiCTR2100054756).

Role of mini access during carotid endarterectomy: a prospective observational study.

Data from literature confirmed the non-trivial risk associated with carotid revascularization. The purpose of this study is to evaluate carotid endarterectomy (CEA) via a mini-invasive access (3-6 cm longitudinal) incision as a viable alternative to the traditional access via a cutaneous incision (˃6 cm) in terms of nerve sparing and neck pain/disability for patients. We performed a prospective, observational, cohort study on 796 consecutive patients who underwent CEAs. A number of 730 patients was included in the final analysis. Patients entered in two different cohorts: CEA with 3-6 cm incision was performed in N.=398 (Group A); CEA with>6 cm incision was performed in N.=398 (Group B). Entire data set is available from 382 in group A and 348 in group B. Adverse events were recorded at 30 days, 3 and 6 months after surgery. The primary purpose of this study was to identify the incidence of cranial nerve injuries and related pain (by Northwick Park Neck Pain Questionnaire [NPq]) in both groups. Differences between groups were exploratory, only, and considered significative for P≤0.05. Secondary objectives were: death, major and minor stroke, transient ischemic attack (TIA), myocardial infarction (MI) and main duration of operation. The cumulative incidence of transient deficit of peripheral nerve in group A was 1.7% at 30 days and 19.4% in group B (RR: 0.10, 95% CI 0.07-0.1, P=0.0001) suggesting a possible benefit from mini-skin incision on nerve injuries reduction. Cranial nerve permanent injuries were identified in 0.17% of mini-incision group and 0.23% of standard group. Exploratory comparison did not demonstrate significative differences between the groups (RR: 0.72, 95% CI 0.19-2.71, P=0.63). The median NPq postoperative score was 40% in GROUP A and 79% in GROUP B (exploratory difference 39%, 95% CI 32.22-45.20%, P=0.0001, χ2: 114.007). At 6 months, NPq was 20% and 42%, respectively; exploratory differences were still present. The need to prolong the mini-incision in GROUP A to preserve the surgical outcome was 1.3%, only. According to these results the mini skin incision allows a sufficient vessels exposure for dissection, endarterectomy, reconstruction of carotid artery and shunt positioning, minimizing surgical invasiveness, decreasing the incidence of temporary cervical nerve dysfunction and improving the aesthetic result with significative less pain suffered by the patients. Transverse cervical and great auricular nerves sparing decreased postoperative hypo-paresthesia in the neck, improving patient's satisfaction. These data suggest that this procedure can be considered safe. Exploratory analysis suggested that it could possibly be considered a safety alternative to standard carotid endarterectomy. A randomized controlled trial is ongoing for definitive conclusions.

Efficacy of Ayurveda formulations, Panchamrit Lauha Guggulu and Panchguna Taila in the management of Cervical Spondylosis (Greevagraha)

BACKGROUND: Cervical spondylosis (CS) is a degenerative disease of intervertebral discs with the formation of osteophytes in the cervical vertebrae. Based on the similarity in symptoms such as intermittent neck and shoulder pain, pain and stiffness radiating to the shoulder or occipital region, restricted neck movements, numbness, and weakness in arms, hands, and fingers, CS can be correlated with Greevagraha—a disease of the neck narrated in Ayurveda. In Ayurveda, the formulations Panchamrit Lauha Guggulu (PLG) and Panchguna Taila (PGT) have been narrated in treating musculoskeletal disorders. OBJECTIVE: The objective of the study was to evaluate the clinical efficacy and safety of PLG and PGT in the management of CS. MATERIALS AND METHODS: It was a prospective, single-arm, open-label clinical study. A total of 63 patients aged 30–60 years diagnosed with CS have been treated with PLG 250 mg twice a day orally with lukewarm water after food and an external application of PGT at the neck region. The total duration of the treatment was 12 weeks, with a follow-up every 2 weeks and a post treatment follow-up after 2 weeks of the treatment. The outcome measures include change in Northwick Park Neck Pain Questionnaire (NPNPQ) score, Visual Analog Scale (VAS) score for cardinal features, SF-36 (research and development [RAND]) Health Survey Score, and incidence of adverse events (if any). RESULTS: At baseline, X-ray findings of all participants (100%) had degenerative changes at different levels of cervical vertebrae; however, posttreatment X-ray findings (on the 84th day of study) showed normal X-ray findings in eight participants (5.04%). A significant reduction in the total VAS score (P &lt; 0.001) was observed on day 84 and day 98. The mean NPNPQ score reduced significantly (P &lt; 0.0001), and a highly significant change was observed in the SF-36 Health Survey Score (P &lt; 0.0001). No adverse events were reported during the study period. CONCLUSIONS: PLG and PGT have shown promising outcomes in managing CS and were also safe. However, randomized control trials with adequate sample size, standard care as control, and a longer follow-up may be planned to establish the findings of this preliminary study.

Psychometric validation of the simplified Chinese Copenhagen Neck Functional Disability Scale in patients with chronic nonspecific neck pain.

Reliable and valid measurement tools are crucial for clinical practice in chronic nonspecific neck pain (CNSNP). The Copenhagen Neck Functional Disability Scale (CNFDS) is a widely used scale in neck pain assessment and has its unique advantages, but it is not available for patients with CNSNP in southern China. To develop the simplified Chinese version of CNFDS (CNFDS-SC) cross-culturally and to investigate its measurement properties in patients with CNSNP. Cross-sectional study. Validation of neck pain measurement scale in southern China. One hundred five patients with CNSNP. Not applicable. Internal consistency and test-retest reliability were evaluated using Cronbach's alpha and intraclass correlation coefficient (ICC), respectively. Construct validity and structural validity were validated by hypothesis testing and exploratory factor analysis, respectively. Internal and external responsiveness were validated. Interpretability was revealed by the standard error of measurement (SEM) and smallest detectable change (SDC). Internal consistency (Cronbach's alpha=0.77 for first test and 0.84 for retest) and test-retest reliability (ICC=0.95) were satisfactory. CNFDS-SC scores showed strong correlations with the numeric rating scale (NRS), the Neck Disability Index (NDI), and the Northwick Park Neck Pain Questionnaire (NPQ) scores (r=0.652, 0.763, and 0.719, respectively; p < .001). Factor analysis revealed a one-factor structure of the scale. Regarding responsiveness, the standardized response mean (SRM) and the Guyatt's responsiveness index (GRI) were 1.29 and 2.12, respectively. CNFDS-SC change scores showed good correlations with the anchoring question (r=0.619, p < .001), NDI (r=0.439, p=.001), and NPQ (r=0.438 p=.001) change scores; the area under the receiver-operating characteristic (ROC) curve was 0.89 (p < .001). The SEM and SDC were 0.93 and 2.57, respectively. No floor or ceiling effect and no missing items were observed. The CNFDS-SC was demonstrated with adequate reliability, validity, responsiveness, and interpretability. The CNFDS-SC could be an effective tool for the clinical assessment of patients with CNSNP in southern China.

Effect of compound Unani Drug in the management of cervical spondylosis (Wajaur Raqaba): A case study

Cervical spondylosis is also known as cervical osteoarthritis. It is a disorder characterised by alterations in the bones, discs, and joints of the neck. These changes are induced by the regular wear and tear of ageing, which leads to intervertebral disc degeneration and osteophyte production. The most common complaints are pain in the head, neck, and shoulders, as well as tenderness in these areas. There is also pain radiation and a reduction in cervical range of motion. Wajaur Raqaba (cervical spondylosis) is treated through Ilaj bit Tadbeer (Regional therapy), Ilaj bid Dawa (Pharmacotherapy), and Ilaj bil Yad (Surgery). The purpose of this case study was to assess the efficacy of Unani formulations Habbe Asgand and Habbe Gul-e-akh in the treatment of cervical spondylosis. A 24-year-old female patient with cervical spondylosis presented to the OPD of Ajmal Khan Tibbia College, Aligarh. Treatment was given to the patient for a period of one month. The Northwick Park Neck Pain Questionnaire (NPQ) is used for the assessment of cervical pain. As assessed by NPQ, Unani formulations were proven to be safe and effective in the management of cervical spondylosis.&#x0D; Keywords Cervical spondylosis, Wajaur Raqaba, Unani formulations, Habbe suranjan and Habbe gul-e-akh.

Association Of Decreased Daily Physical Activities, Disturbed Sleep Pattern with Cervical Pain Among Young Adults

There is broad variety in the manner in which neck pain is defined. While examination when providing details for neck pain there are five key points which apparently represented: 1. the origin of issue and information; 2. the situation or testing outline; 3. the neck pain seriousness, also the outcomes; 4. the neck pain extent; 5. the example after some moments. Other evidence showed there is lacking in amount and quality of sleep results in musculoskeletal displacement by patho-physiologically. The pain occurrence and the progression include many environmental and social causes which is widespread. Objective: The purpose of this study was to find the association of decreased daily physical activities, disturbed sleep pattern with cervical pain among young adults. Methods: A cross-sectional survey was conducted on 90 persons presenting with cervical pain. Data was collected from students of University of Lahore. Non-probability Convenient Sampling Technique was used. Northwick Park Neck Pain Questionnaire and The Sleep Revolution Sleep Quality Questionnaire by Arianna Huffington were used to collect data. Results: The total population was 90, which includes 33 males and 57 females with percentage 36.7% and 63.3% respectively. On pain scale to assess the cervical pain there were 43 (47.8%) persons with Mild pain, 37 (41.1%) having Moderate pain and 10 (11.1%) with severe pain. There were 58 (64.4%) persons are physically active even after cervical pain and 32(35.6%) physically not active. There were 3(3.3%) who have severed sleep problems, 16(17.8%) were with some sleep problems, 43(47.8%) having good sleep and 28(31.1%) sleep is in great shape. In this Study there was no association occurs between daily activities, sleep disturbance with cervical pain in overall results. Conclusion: In this study overall, there was no association occurred in persons who were having any sort of cervical pain with daily physical activities and sleep patterns disturbance. As some of the individual activities like daily working, house hold activities, driving is affected in some of the cases with cervical pain.

Efficacy and Safety of Electro-Thumbtack Needle Therapy for Patients With Chronic Neck Pain: Protocol for a Randomized, Sham-Controlled Trial.

BackgroundChronic neck pain is a prevalent condition adversely impacting patients' wellbeing in both life and work experience. Electro-thumbtack needle (ETN) therapy, combining acupuncture with transcutaneous stimulation, might be one of the effective complementary and alternative medicine (CAM) therapies in treating chronic neck pain, although the evidence is scarce. This study aims to estimate the efficacy and safety of ETN therapy for chronic neck pain.Methods and AnalysisThis is a sham-controlled, randomized clinical trial. A total of 180 subjects will be randomly allocated to either the ETN group or the sham ETN group. Treatment will be administrated three times a week for four consecutive weeks, with a 6-month follow-up. The primary outcome measure will be the Numerical Rating Scale for neck pain (NRS-NP) over a period of the 4 weeks. Secondary outcome measures include the Northwick Park Neck Pain Questionnaire (NPQ), Neck Disability Index (NDI), Patient Global Impression of Change (PGIC), patient expectation, and preference assessment. The chi-square test or Fisher's exact test will be used for proportions of participants having clinically meaningful improvement. Analysis of covariance or repeated-measures analysis of variance will be applied to examine changes in the outcome measures from baseline.DiscussionsThis prospective trial will contribute to evaluating the efficacy and safety of ETN in the treatment of chronic neck pain, with an intermediate-term follow-up. This study will provide further evidence for clinical neck pain management.Ethics and DisseminationThis trial has been approved by the Research Ethical Committee of Guang'anmen Hospital (ethical approval number: 2021-039-KY-01). Recruitment began in March 2022 and will continue until December 2023. Dissemination plans include posters, WeChat, websites, and bulletin boards in hospital and communities.Clinical Trial RegistrationThis trial is registered at ClinicalTrials.gov (identifier: NCT04981171).

Psychometric properties of the Brazilian short-version of the Northwick Park Neck Pain Questionnaire

Objective To translate, cross-culturally adapt and assess measurement properties of the translated version of the Northwick Park Neck Pain Questionnaire into Brazilian Portuguese. Design Cross-sectional study. Settings University healthcare facility and online. Participants People with chronic neck pain (n = 178). Interventions Not applicable. Main outcome measures Participants answered the translated version of Northwick Park Neck Pain Questionnaire, the Neck Disability Index, the Numerical Rating Scale for pain, the Tampa Scale for Kinesiophobia and the Pain Catastrophizing Scale. Seven to ten days after that, a subset of 84 participants answered the Northwick Park Neck Pain Questionnaire again. The structural (exploratory and confirmatory factor analyses) and construct validities, internal consistency, reliability and concordance were assessed. Level of significance was set at 5%. Results Participants’ (35.6 ± 13.5 years old) with symptoms duration of 54.4 ± 60.4 months scored 25.5 ± 14.0 on the Brazilian Northwick Park Neck Pain Questionnaire and 11.9 ± 5.8 on the Neck Disability Index. The structural analysis showed that the short version of the Northwick Park Neck Pain Questionnaire has an adequate structure to measure disability due to neck pain. Correlations with other questionnaires were between 0.268 and 0.678, Cronbach's alfa was 0.76, intraclass correlation coefficient was 0.96, standard error of measurement was 2.74 and minimal detectable change was 7.60. Conclusion The short version of the Northwick Park Neck Pain Questionnaire is valid and reliable to be used in patients with chronic neck pain, as it presented adequate measurement properties of structural and construct validity, reliability and concordance.

Placebo response varies between different types of sham acupuncture: A randomized double-blind trial in neck pain patients.

BackgroundIn prospective experimental studies of neck pain patients, it is difficult to determine whether responses to sham acupuncture differ from responses to real acupuncture due to the heterogeneous methodologies in control/sham interventions. Here we aim to compare the specific and nonspecific effects of electroacupuncture with four types of sham acupuncture.MethodsIn this double‐blind, sham‐controlled study, we randomly assigned 175 patients with neck pain to receive 10 sessions of electroacupuncture, shallow puncture, nonacupoint deep puncture, nonacupoint shallow puncture, or nonpenetration acupuncture. We used the Northwick Park Neck Pain Questionnaire (NPQ) as our primary outcome, and Short‐form McGill Pain Questionnaire, visual analog scale (VAS), and Pain Threshold as secondary outcomes to measure the changes from baseline to a 3‐month follow up.ResultsAll groups, except nonacupoint shallow puncture, had significant improvement in all outcome measurements. Electroacupuncture only showed superior improvements than the shallow puncture, nonacupoint shallow puncture, and nonpenetration groups when compared using the NPQ and VAS scale (*p < 0.001). Interestingly, the nonacupoint shallow puncture produced even less placebo response than nonpenetration acupuncture.ConclusionOur study demonstrates the high variability of placebo response among different types of sham controls depending on the depth of needle insertion and the puncture location. An important implication of our results is nonacupoint deep puncture produced similar analgesic effects as electroacupuncture. Our study may shed a new light on the predominant underlying mechanisms among different types of sham acupuncture controls, which can help with interpreting the effect of acupuncture in other studies.Trial registrationChinese clinical trial registry (ChiCTR‐IOR‐15006886).SignificanceThis study compared the observed specific and nonspecific analgesia effect in four different types of sham acupuncture stimulation with neck pain patients, assessed by four outcomes. Although all of the sham controls produced significant reduction in neck pain, electroacupuncture had superior significant improvement. Importantly, placebo responses differed significantly between the sham controls and responses were inconsistent according to different outcome assessments. This study emphasizes the importance of taking into consideration which sham control and method of outcome measurement were used in a pain research study when evaluating its results.

ASSOCIATION BETWEEN FORWARD HEAD POSTURE, PAIN SEVERITY AND DISABILITY IN UNDER-GRADUATE PHYSICAL THERAPY STUDENTS WITH NECK PAIN

Background: Excessive neck flexion may lead to a forward head posture in which Craino-vertebral angle (CV angle) is decreased. Prolonged forward head posture may lead to postural impairment. Pain and disability of neck is increased with forward head posture. Objective: To find out the association of forward head posture with pain and disability in under-graduate physical therapy (PT) students. Methodology: A correlational study was conducted on n=34 male and female undergraduate PT students, with forward head posture. The n=34 participants were divided into group A having crainovertebral angle &lt;50 with neck pain and without neck pain were assigned to group B. The Craniovertebral angle, Northwick Park Neck Pain Questionnaire and Numeric Pain Rating Scale were used to measure head posture, pain and disability. The Pearson moment correlation was used find association among the variables. Results: The mean age of study participants was 21.1±1.87. The results showed that there is no significant association (p&lt;0.05) in both groups, between forward head posture (CV angle) with pain and self-perceived disability due to neck pain. Conclusion: Neck pain and disability showed no association with craniovertebral angle in both groups. Keywords: Disability, neck pain, posture