Northwick Park Neck Pain Questionnaire Research Articles

Changes of Endothelin-1 and Calcitonin Gene-Related Peptide Concentrations in Patients with Cervical Radiculopathy after Wrist-Ankle Acupuncture-Moxibustion and Hot Compression with Chinese Herbal Medicine.

Objective This study aimed at investigating the effects of wrist-ankle acupuncture-moxibustion and hot compression with Chinese herbal medicine on pain symptoms, endothelin-1 (ET-1), and calcitonin gene-related peptide (CGRP) concentrations of patients with cervical radiculopathy (CR). Methods A total of 82 patients with CR were randomly divided into the study group and control group, with 41 cases in each group. The control group was treated with standard treatment. In addition to standard treatment, the study group was additionally treated with wrist-ankle acupuncture-moxibustion and hot compression with Chinese herbal medicine. The ET-1 and CGRP concentrations in the plasma were measured by the radioimmunoassay method. Results The total response rate in the study group and the control group was 97.55% and 82.93%, respectively. The study group showed lower scores of the visual analogue scale (VAS), Northwick Park Neck Pain Questionnaire (NPQ), McGill Pain Questionnaire (MPQ), numbness intensity assessment, and neck disability index (NDI) but higher scores of the Short Form-36 (SF-36) health survey questionnaire than the control group after treatment. Besides, the study group exhibited reduced ET-1 and substance P (SP) concentrations concomitant with increased CGRP and β-endorphin (β-EP) concentrations compared with the control group. Conclusion Wrist-ankle acupuncture-moxibustion and hot compression with Chinese herbal medicine could effectively alleviate the pain of CR patients, affect ET-1 and CGRP concentrations, promote the recovery of cervical function, and improve the quality of life.

Prevalence of Mechanical Neck Pain among University Students: An Observational Study

Mechanical neck pain influences forty five - fifty four % of the all general community eventually during their lives and can come about extreme inability. It is an immense medical issue among undergraduate students because of poor postural habits. Sitting for delayed periods with forward head act, such as reading books and utilizing PCs, work stations and the phone will cause pressure in muscles and compressive power in the cervical spine results in mechanical neck ache. Objectives: To determine the prevalence of mechanical neck pain among university students. Study Design: An observational study. Methodology: In present study, a sample size of 143 was used by using a convenient sampling technique. Subjects were enrolled according to inclusion and exclusion criteria. Data was collected by circulating Oswestry Neck Disability Index (ODI), Northwick Park Neck Pain Questionnaire and Visual Analogue Scale. The research was conducted in public sector universities of Faisalabad. Statistical analysis: Data was analyzed by SPSS, v-24. Results: Study results showed that 36.4% had mild, 37.1% had moderate and 26.6% had severe mechanical neck pain. Conclusion: We concluded that university students were at greater risk of mechanical neck pain. Key Words: Neck pain, Students and Oswestry neck Disability index (ODI)

PREVALENCE OF WORK RELATED NECK PAIN IN GIRL PHYSIOTHERAPY STUDENTS OF AMRITSAR

Neck pain is one of the most common musculoskeletal disorders in physical therapists, especially the females. In the present study, an attempt has been made to search the prevalence of neck pain in girl physiotherapy students of Amritsar. A total of purposively selected 194 under- and post-graduate girl physiotherapy students aged 18-26 years from Guru Nanak Dev University, Amritsar were selected for the present cross-sectional study. Modified Nordic Questionnaire and Northwick Park Neck Pain Questionnaire were applied to gather the information. Standard statistical analyses were also done. In results, the prevalence of neck pain was found as 20.10% in girl physiotherapy students of Amritsar with the maximum prevalence (76.92%) in the BMI category of normal weight, gradual onset (53.84%) of pain in majority cases, the maximum (56.41%) 1-7 days of time of neck trouble during last 12 month, with less medication (29.41%) for their neck pain during last one year, with 1-7 days time (55.88%) when neck trouble had prevented them from doing their normal work during the last one year, and the younger students had higher disability index (279.78; 14.11%) than their older counterparts (254.13; 13.32%). It could be concluded that neck pain should be taken care adequately in the early stages of their profession.
 Keywords: Neck pain, Modified Nordic Questionnaire, Northwick Park Neck Pain Questionnaire, Girl physiotherapy students.

Transcultural adaptation of the neck disability index to mexican spanish and assessment of its psychometric properties.

To transculturally adapt the Neck Disability Index to Mexican Spanish (NDI-Mx) and to evaluate its psychometric properties. Translation and transcultural adaptation of the NDI were conducted according to published guidelines. The test-retest reliability of the NDI-Mx was assessed with intraclass correlation coefficient (ICC3,1), the student t-test, standard error of measurement, minimal detectable change and Bland-Altman plot. Cronbach's α coefficient was used to evaluate internal consistency. Floor and ceiling effects were also evaluated. Convergent validity was assessed by comparison of the NDI-Mx with the Northwick Park Neck Pain Questionnaire (NPQ) through the Spearman correlation coefficient. Finally, a confirmatory factor analysis (CFA) was conducted. The sample was composed of 113 subjects (38 men and 75 women) with a mean age of 30 (SD, 12.19) years. All items of the NDI-Mx showed good test-retest reliability (ICC3,1 = 0.86) and good internal consistency (Cronbach's α = 0.85). Floor and ceiling effects were not observed. There was good convergent validity with a high correlation between NDI-Mx and NPQ (ρ = 0.83). The CFA revealed that a one-factor solution fitted adequately the data (χ2(32) = 41.18, p = .13). The NDI-Mx seems to be a valid and reliable tool that can be used in clinical practice and research on Mexican populations with neck pain.

Influence of Neck Pain on Pectoralis Minor Muscle Length among Young Adults

Background : Students are prone for posture and works related to neck pain due to their desk jobs. It leadsto postural abnormality and muscle imbalance. Neck pain leads to alteration in the length of the pectoralisminor muscle length. Checking pectoralis minor muscle length helps in clinical discussion making inpatients with neck pain. Objective: To find out the prevalance of pectoralis minor muscle tightness amongstudents having neck pain. Methodology: A convenient sample of 100 participants were categorizedinto symptomatic and asymptomatic group. Neck pain was assessed by NORTHWICK PARK neck painquestionnaire. Results: Neck pain has positive correlation with pectoralis minor muscle tightness in bothright(r=0.887) and left(r=0.828) side.The pectoralis minor muscle tightness is more in symptomatic groupthan in asymptomatic group (p=0.00). Result& Conclusion: The study confirms that neck pain has influenceon pectoralis minor muscle length

Effects of scapular stabilization exercises in patients of chronic neck pain with scapular dyskinesis: A quasi-experimental study.

Objectives This study aims to investigate the effectiveness of scapular stabilization exercises in patients with chronic neck pain and scapular dyskinesis. Patients and methods This single-center, prospective study included a total of 36 patients (17 males, 19 females; mean age: 41±12.8 years; range, 25 to 57 years) with chronic neck pain and scapular dyskinesis between April 2018 and September 2018. The patients were randomly assigned to three treatment groups. Group 1 (n=13) consisted of those receiving scapular stabilization exercises by a physiotherapy specialist control in addition to the routine physiotherapy and rehabilitation program; Group 2 (n=12) consisted of those receiving the routine physiotherapy and rehabilitation program in addition to scapular stabilization exercises in-home training program; and Group 3 (n=11) consisted of those receiving the routine physiotherapy and rehabilitation program alone. The assessments were made using the Visual Analog Scale (VAS) and Northwick Park Neck Pain Questionnaire (NPQ). Results Significant differences were found in the pre- and post-treatment VAS scores, and Group 1 and Group 2 created this significant difference (p<0.05). A significant difference was also observed in the pre- and post-treatment NPQ scores among the groups (p<0.05). Group 1 showed the most significant improvement of the NPQ scores (p<0.05). Conclusion Our study results suggest that addition of scapular stabilization exercises to the routine physiotherapy components may be an effective method for improving pain and functional results.

Immediate effect of thoracic distraction thrust versus upper thoracic crossed hand manipulation in mechanical neck pain: A randomized clinical trial

OBJECTIVES: The aim is to compare the immediate effect of thoracic spine distraction thrust and upper thoracic crossed hand manipulation on pain, range of motion, and disability in individuals with mechanical neck pain. METHODS: A randomized clinical trial was conducted on 40 individuals of mean age 27.35 ± 6.78 with mechanical neck pain. Individuals were allocated to one of the two groups. Group A (n = 20) received thoracic spine distraction thrust and Group B (n = 20) received upper thoracic crossed hand manipulation. Both the groups were also given Transcutaneous Electrical Nerve Stimulation (TENS) , hot moist pack, stretching, and exercises. The outcome measures used were the Numerical pain Rating (NPR) scale, cervical ranges, and Northwick Park Neck Pain Questionnaire (NPQ). The outcome measures were assessed pre- and post-intervention. RESULTS: The data were statistically analyzed using an independent t-test for comparing the two groups and dependent t-test for comparison of pre and post of each group. Pre- and post-mean difference values in Group A were 2.00 ± 0.86 and 11.13 ± 5.39, for NPR scores and NPQ scores. Whereas, in Group B, pre- and post-mean difference values were 2.00 ± 0.73 and 10.54 ± 10.05 for NPR scores and NPQ scores. In Group A and Group B, there was improvement seen in cervical ranges. The comparison within groups showed a statistically significant difference (P CONCLUSION: Thoracic spine distraction thrust and upper thoracic crossed hand manipulation, both were seen to be effective in pain, ranges, and disability.

Prevalence of forward head posture and its impact on the activity of daily living among students of Adesh University – A cross-sectional study

Objectives: The aims and objectives of the study were to find the prevalence of forward head posture and to find its impact on activities of daily living in students of Adesh University. Materials and Methods: After the approval from Ethical Committee of Adesh University Survey study was done. A total of 200 subjects were taken according to the inclusion criteria, i.e., craniovertebral angle &lt;53° from Adesh University, Bathinda by convenient sampling. CV angle was measured by knee registry application, and those who fit under inclusion criteria were given a Northwick park neck pain questionnaire to fill. Filled questionnaires were collected from the subjects. Results: The data of 200 subjects was analyzed and it is found that out of 200 subjects, 146 were having forward head posture, whereas 54 were having normal head posture. The 73% prevalence of forward head posture was found in students. The most of the students were having mild or no pain and numbness in the day and during sleeping. Out of students who have reported moderate or severe neck pain, 8.21% shows that they were having pain during the whole day. The students who reposted pain 54.79% show mild pain and 26.02% showed moderate pain while reading and watching TV. Conclusion: It is concluded from the results of this study that there is 73% prevalence of FHP that affects only a little or no activity of daily living.

Rolling needle pricking-cupping therapy and traditional pricking-cupping therapy for cervical spondylosis of neck type: a randomized controlled trial

To compare the clinical efficacy between rolling needle pricking-cupping (RNP-C) and traditional pricking-cupping (TP-C) for cervical spondylosis of neck type. A total of 96 patients with cervical spondylosis of neck type were randomly divided into an RNP-C group, a TP-C group and an electroacupuncture (EA) group, 32 cases in each group. Each group was treated with EA at Jingbailao (EX-HN 15), Fengchi (GB 20), Dazhui (GV 14), Jianjing (GB 21) and ashi points with continuous wave and 2 Hz of frequency; each EA treatment lasted for 20 min, once every 3 to 5 days, totaling 6 treatments. On the basis of EA treatment, the patients in the TP-C group were treated with bloodletting by seven-star needle, followed by fire cupping; the patients in the RNP-C group were treated with bloodletting by rolling needle, followed by fire cupping. The treatment was given once a week for 4 weeks. The follow-up was 1 month. Before treatment, 2 and 4 weeks into treatment and follow-up, the Northwick Park neck-pain questionnaire (NPQ) and visual analogue scale (VAS) scores were evaluated. The acupuncture pain degree was recorded at the first treatment and 2 and 4 weeks into treatment. The efficacy was evaluated after 4 weeks of treatment. Compared before treatment, the scores of NPQ and VAS in each group were all reduced at 2 and 4 weeks into treatment and follow-up (P<0.05). The scores of NPQ in the TP-C group and the RNP-C group were lower than those in the EA group at 2 and 4 weeks into treatment (P<0.05). The scores of VAS in the TP-C group and the RNP-C group were lower than those in the EA group at 2 and 4 weeks into treatment and follow-up (P<0.05). The differences of NPQ and VAS scores between the TP-C group and the RNP-C group at each time point after treatment were not significant (P>0.05). The acupuncture pain degree in the RNP-C group was lower than that in the TP-C group (P<0.05). The total effective rates were 79.3% (23/29) in the TP-C group and 75.0% (24/32) in the RNP-C group, which was superior to 63.3% (19/30) in the EA group (P<0.05), but there was no statistical significance between the TP-C group and the RNP-C group (P>0.05). TP-C and RNP-C could both improve the cervical pain symptoms in patients with cervical spondylosis of neck type, and improve the overall function of the cervical spine, and the curative effect is similar.

Optimized acupuncture treatment (acupuncture and intradermal needling) for cervical spondylosis-related neck pain: a multicenter randomized controlled trial.

Cervical spondylosis (CS)-related neck pain is difficult to treat because of its degenerative nature. The aim of this 9-center, single-blinded, randomized controlled trial was to evaluate the efficacy of optimized acupuncture for CS-related neck pain. Participants who met the inclusion criteria were randomized to optimized, shallow, and sham acupuncture groups (1:1:1). The primary outcome was the change from baseline in the Northwick Park Neck Pain Questionnaire score at week 4. Participants were followed up until week 16. Of the 896 randomized participants, 857 received ≥1 intervention session; 280, 286, and 291 received optimized, shallow, and sham acupuncture, respectively. A total of 835 (93.2%) participants completed the study. At week 4, significant differences (P < 0.001) were observed in the changes in Northwick Park Neck Pain Questionnaire scores between the optimized acupuncture group and both the shallow {7.72 (95% confidence interval [CI], 5.57-9.86)} and sham acupuncture (10.38 [95% CI, 8.25-12.52]) groups. The difference in the scores at week 16 between the optimized acupuncture group and the shallow (8.84 [95% CI, 6.34-11.34]) and sham acupuncture (10.81 [95% CI, 8.32-13.30]) groups were significant. The center effect indicated wide variability in the treatment effects (Cohen's d = 0.01-2.19). Most SF-36 scores were higher in the optimized acupuncture group than those in the other groups. These results suggest that 4-week optimized acupuncture treatment alleviates CS-related neck pain and improves the quality of life, with the effects persisting for minimum 3 months. Therefore, acupuncture can have positive effects on CS-related neck pain, although the effect size may vary widely.

The update on scales and questionnaires used to assess cervical spine disorders

Musculoskeletal disorders affect 20%–33% of all the global population, and its prevalence is continually increasing. According to the World Health Organisation, persistent neck pain (NP) is currently one of the leading causes of disability. Therefore, the assessment of the effectiveness of treatment methods and severity of the disease is a necessity. However, due to the multiplicity of the clinical assessment tools used and different inconsistent scoring methods between researchers, some inaccuracies may arise. This review article is an up-to-date overview that provides an insight into the scales and questionnaires used to assess cervical spine disorders. We discuss generic outcome measures, i.e. NMQ (Nordic Musculoskeletal Questionnaire) and VAS (Visual Analog Scale) and the tools specific for cervical pains: NDI (Neck Disability Index), NOOS (Neck Outcome Score), NPAD (Neck Pain and Disability Scale), and NPQ (Northwick Park Neck Pain Questionnaire). Each of these measures is presented together with the information about its origin, scoring method, and interpretation. This descriptive review is designed as an introduction to the questionnaires and scales used in the assessment of neck ailments and can serve as a practical guide for beginner clinicians and researchers.

Evaluation of the Effect of Jambira Pinda Sweda in Cervical Spondylosis w.r.t. Clinical Symptomatology

Introduction: Cervical spondylosis is a chronic degenerative condition of the cervical spine that affects the vertebral bodies, intervertebral discs of the neck, and the contents of the spinal canal. Spondylosis progresses with age and often develops at multiple interspaces. Though many conventional treatments are available but in view of their side effects and dependency, it is important to search for safe and effective Ayurvedic treatment. Objective: To evaluate the effect of Jambira Pinda Sweda in cervical spondylosis w.r.t. clinical symptomatology. Materials and methods: A single-arm, open, prospective interventional clinical study was conducted at two peripheral institutes of Central Council for Research in Ayurvedic Sciences. Total 60 patients of either sex aged between 30 years and 65 years, with clinical and radiological evidence of cervical spondylosis, were selected for the study. The treatment procedure Jambira Pinda Sweda was done daily for the period of 14 days. The patients were assessed at baseline, 7th day, 14th day, and 21st day (after 1 week without intervention) on the basis of relief in sign and symptoms of cervical spondylosis by reduction in the visual analog scale (VAS) score, Northwick Park Neck Pain Questionnaire, and SF-36 Health Survey Score for Quality of life. Results: Mean value of VAS on baseline was 6.90, on 7th day it was 3.37, and decreased up to 2.57 on 14th day and 2.08 on 21st day showing statistically significant improvement (p &lt; 0.001). The mean value of Northwick Park Neck Pain Questionnaire on baseline was 45.79, on 7th day it was 23.57, which further decreased to 17.32 on 14th day showing statistically significant decrease (p &lt; 0.001). The significant improvement was revealed in all the parameters of the SF-36 health survey (p &lt; 0.001). Conclusion: Jambira Pinda Sweda have been shown to be an effective local Ayurvedic treatment for cervical spondylosis. During the study, no adverse effect was noticed; hence, it proved to be a safe treatment.

Effect of acupuncture and family exercise on the pain and quality of life in patients with cervical spondylotic radiculopathy: a pilo study

Objective To observe the effect of acupuncture and family exercise on the pain and quality of life in the patients withcervical spondylotic radiculopathy. Methods A total of 104 patients with cervical spondylotic radiculopathy were randomly divided into 4 groups: the control group was treated with cervical traction therapy, the exercise group were with traction therapy and family exercise, the Acupuncture group were with traction therapy and acupuncture, and the combined group were with traction therapy, family exercise and acupuncture. The short-form of McGill Pain Questionnaire (SF-MPQ), Northwick Park Neck Pain Questionnaire (NPQ) and WHO quality of life (WHOQOL-BREF) were compared between two groups. Results After treatment, the SF-MPQ were (5.8 ± 1.0, 7.1 ± 1.1, 7.9 ± 2.1 vs. 9.3 ± 1.1, F=44.897) and NPQ (12.9 ± 2.0, 15.5 ± 1.6, 15.9 ± 3.4 vs. 17.8 ± 1.9, F=69.730) in Comb. G, Acu. G, Exe. G were significantly lower than those in the Ctrl G. (P<0.01). The scores of physiology, psychology, society and environment of WHOQOL in the Comb. G, Acu. G and Exe. G after treatment were significantly higher than that in the Ctrl G. (F=154.216, 190.314, 65.227, 344.897, all Ps<0.001). Conclusions Four groups’ interventions are effective for cervical spondylotic radiculopathy. The combined interventions have more positive impact on pain management and quality of life in patients. Key words: Cervical spondylosis; Radiculopathy; Point selection, meridian; Exercise movement techniques; Traction; Acupuncture therapy; Quality of life; Therapies, investigational

Dose-effect relationship in treatment of chronic neck pain with the direct moxibustion of small moxa cone

To evaluate the effectiveness in treatment of chronic neck pain with the direct moxibustion of small moxa cone and explore the dose-effect relationship in treatment of chronic neck pain with different small moxa cones. A total of 120 patients with chronic neck pain were randomized into a 3-moxa-cone group, a 5-moxa-cone group, a 7-moxa-cone group and a sham-moxibustion group, 30 cases in each one. Fengchi (GB 20), Tianzhu (BL 10), Jingbailao (EX-HN 15), Jianzhongshu (SI 15) and Jianjing (GB 21) were selected in each of the groups. The direct moxibustion with 3, 5 and 7 moxa cones as well as the sham-moxibustion therapy were provided successively in each of the above groups. In the sham-moxibustion group, the lower 1/3 section of moxa cone (about 1.5 mm in length) was soaked in wanhua oil before used in treatment. In each group, the treatment was given twice a week, for 10 treatments totally. Separately, before treatment, after treatment and in 1-month follow-up, the scores of the Northwick Park neck pain questionnaire (NPQ), the scores of McGill pain questionnaire (MPQ) and the local pressure pain threshold (PPT) were observed in each group. After treatment and in 1-month follow-up, the therapeutic effects were evaluated in each group. After treatment and in 1-month follow-up, NPQ scores and MPQ scores in the 3-moxa-cone group, the 5-moxa-cone group and the 7-moxa-cone group were reduced as compared with those before treatment separately (all P<0.01), PPT values were increased as compared with those before treatment (all P<0.01). But the differences were not statistically significant in the sham-moxibustion group as compared with those before treatment (all P>0.05). After treatment and in 1-month follow-up, NPQ scores and MPQ scores in the 3-moxa-cone group, the 5-moxa-cone group and the 7-moxa-cone group were lower as compared with the sham-moxibustion group separately (all P<0.05), PPT values were higher as compared with the sham-moxibustion group (all P<0.05). After treatment, the NPQ score and MPQ score in the 7-moxa-cone group were lower than the 3-moxa-cone group and PPT values was higher than the 3-moxa-cone group (all P<0.05). After treatment and in 1-month follow-up, the therapeutic effects in the 3-moxa-cone group, the 5-moxa-cone group and the 7-moxa-cone group were better than the sham-moxibustion group separately (all P<0.05). But, the therapeutic effects were not significantly different in comparison among the moxibusiton groups (P>0.05). The direct moxibustion therapy with different small-moxa-cones effectively relieves chronic neck pain. There is a trend of improvement of the therapeutic effects with increase of the numbers of moxa cones.

Cervicogenic headache treated by acupuncture based on jin theory: study protocol for a randomized controlled trial

BackgroundNumerous randomized trials involving acupuncture treatment for cervicogenic headache (CEH) have been conducted in recent years, but the evidence for its effectiveness is not clear. Hence, we designed a randomized trial to evaluate the efficacy and advantages of acupuncture for treating CEH.DesignThis is a parallel-design, two-arm, patient-assessor blinded, randomized, sham-controlled clinical trial. A total of 166 patients with CEH aged from 18 to 70 will be recruited and assigned randomly into a jin acupuncture group and a pseudo acupuncture group at a 1:1 ratio; they will receive 12 sessions of real acupuncture and sham acupuncture for 4 weeks, respectively, during the study. The primary outcomes are pain degree (PD) and pain rate (PR) calculated by the PainVision analyzer, as well as parameters detected by surface electromyography (SEMG). The secondary outcomes will be measured with the short-form McGill Pain Questionnaire (SF-MPQ), range of motion (ROM) of the neck, the Northwick Park Neck Pain Questionnaire (NPQ), the 36-item short-form Health Survey (SF-36), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS). Clinical assessments will be evaluated at baseline and in the fourth week as well as in the eighth and sixteenth weeks. Adverse events will be noted and recorded for the safety evaluation.DiscussionThis study will provide high-quality evidence of the value of acupuncture based on jin theory for treating CEH.Trial registrationChinese Clinical Trial Registry, ChiCTR1800015316. Registered on 22 March 2018. Updated version AMCTR-IOR-18000157. Registered on 1 April 2018.

Acupuncture for chronic neck pain with sensitive points: study protocol for a multicentre randomised controlled trial

IntroductionChronic neck pain is a challenging condition to treat in clinical practice and has a considerable impact on quality of life and disability. According to the theory of traditional Chinese...

Spanish Version of the Whiplash Disability Questionnaire in Adults With Acute Whiplash-Associated Disorders

ObjectiveThe purpose of this study was to develop and validate a Spanish version of the Whiplash Disability Questionnaire (WDQ) for the Spanish population with acute whiplash-associated disorder (WAD). MethodsThis was a cross-sectional questionnaire validation study. Adults with acute WAD (grade I to III) were enrolled within 3 weeks of their injury. A blinded forward and back translation of the WDQ was made from English to Spanish, and the resulting back-translation version was compared with the original. Patients with WAD completed the Spanish version of the 13-item WDQ. The developed questionnaire was assessed using psychometric statistical analysis including correlation with the numerical rating score for pain, Northwick Park Neck Pain Questionnaire, Neck Disability Index, and 36-item Short Form Health Survey. ResultsFifty-six patients completed the questionnaire, the mean age was 33.9 years (standard deviation [SD] = 10.5), and 76.8% were women. Participants were enrolled 13.9 days (SD 4.9) after the injury, with 14.3% presenting with WAD grade I and 85.7% with WAD grade II. The mean WDQ score was 62 (SD = 31). Two factors were detected, and the factor structure remained stable after translation. Positive correlations were identified between the total WDQ score and the numerical rating score, Neck Pain Questionnaire, and Neck Disability Index results, with a strong negative correlation with the 36-item Short Form Health Survey. ConclusionThe Spanish version of WDQ is psychometrically reliable and a valid instrument to measure the disability status in patients with acute WAD within the clinic.

Efficacy of tuina in patients with chronic neck pain: study protocol for a randomized controlled trial

BackgroundChronic neck pain (CNP) is a common and disabling musculoskeletal disorder in developing and developed countries. Previous studies have shown that tuina and traditional Chinese massage are effective treatments for patients with CNP. However, there is little evidence to support the use of one intervention over the other. The aim of this study is to compare the effects of tuina and traditional Chinese massage in the treatment of pain and disability in patients with CNP.Methods/designThis is a multicenter, assessor- and analyst-blinded, randomized controlled trial with two parallel arms: a tuina group and a traditional Chinese massage group. A total of 356 eligible CNP patients will be randomly assigned to the groups in a 1:1 ratio. The intervention in the tuina group includes both structural and relaxation massage, while the traditional Chinese massage group will receive relaxation massage only. The interventions for both groups will last for 15 min and will be carried out three times a week for a period of 4 weeks. The primary outcome will be changes in the Northwick Park Neck Pain Questionnaire. Secondary outcomes will be measured by a visual analogue scale (VAS), the Neck Disability Index (NDI), and the 36-item Short-Form Health Survey (SF-36). The data will be analyzed at the baseline, at the end of the intervention, and during the 3 months of follow-up by repeated measures analysis of variance. The significance level is 5%. The safety of tuina and traditional Chinese massage will be evaluated after each treatment session. The results of this trial will help clarify the value of tuina and traditional Chinese massage as treatments for CNP and will highlight any differences in the efficacy of the treatments.DiscussionThe purpose of this trial is to determine whether tuina is more effective than traditional Chinese massage in adults with CNP. This trial will, therefore, contribute to providing a solid foundation for clinical treatment of CNP, as well as future research in massage therapy.Trial registrationChinese Clinical Trial Registry, ChiCTR-INR-17013763. Registered 8 December 2017.

Regional Homogeneity and Multivariate Pattern Analysis of Cervical Spondylosis Neck Pain and the Modulation Effect of Treatment.

Objects: We investigated brain functional alteration in patients with chronic cervical spondylosis neck pain (CSNP) compared to healthy controls (HCs) and the effect of intervention.Methods: 104 CSNP patients and 96 matched HCs were recruited. Patients received 4 weeks of treatment. Resting-state fMRI and Northwick Park Neck Pain Questionnaire (NPQ) were collected before and after treatment. Resting state regional homogeneity (rs-ReHo) and multivariate pattern analysis (MVPA) were applied to (1) investigate rs-ReHo differences between CSNP patients and controls and the effect of longitudinal treatment and (2) classify CSNP patients from HCs and predict clinical outcomes before treatment using MVPA.Results: We found that (1) CSNP patients showed decreased rs-ReHo in the left sensorimotor cortex and right temporo-parietal junction (rTPJ), and rs-ReHo at the rTPJ significantly increased after treatment; (2) rs-ReHo at rTPJ was associated with NPQ at baseline, and pre- and post-treatment rs-ReHo changes at rTPJ were associated with NPQ changes in CSNP patients; and (3) MVPA could discriminate CSNP patients from HCs with 72% accuracy and predict clinical outcomes with a mean absolute error of 19.6%.Conclusion: CSNP patients are associated with dysfunction of the rTPJ and sensorimotor area.Significance: rTPJ plays on important role in the pathophysiology and development of CSNP.

Comparative effectiveness and economic evaluation of Chuna manual therapy for chronic neck pain: protocol for a multicenter randomized controlled trial

BackgroundNeck pain is a highly prevalent medical condition that incurs substantial social burden. Although manual therapy is widely used for treatment of neck pain, the body of evidence supporting its effectiveness and safety is not conclusive. The aim of this study is to examine the effect, safety, and cost-effectiveness of Chuna manual therapy, a traditional Korean manual therapy for treatment of various musculoskeletal complaints.Methods/DesignThis study is the protocol for a two-armed parallel, assessor-blinded, multicenter, randomized controlled trial. A total 108 patients with chronic neck pain (time to onset ≥ 3 months, numeric rating scale [NRS] of neck pain ≥ 5) will be recruited at five Korean medicine hospital sites. Participants will be allotted to one of two groups (n = 54, respectively): the Chuna manual therapy group, and the usual care (conventional physical therapy and medication treatment) group. Ten sessions of Chuna manual therapy or usual care will be administered twice a week for five weeks. Since the study design does not permit patient or physician blinding, the outcome assessor and statistician will be blinded. The primary outcome will be the visual analogue scale (VAS) of neck pain at 5 weeks after randomization. Secondary outcomes include the VAS of radiating arm pain, NRS of neck pain and radiating arm pain, Vernon-Mior neck disability index (NDI), Northwick Park neck pain questionnaire (NPQ), EuroQol-5 Dimension (EQ-5D), EQ-VAS, patient global impression of change (PGIC), economic evaluation, adverse effects, and drug consumption. Follow-up outcome assessments will be conducted at 3, 6, 9, and 12 months after randomization.DiscussionThis study will evaluate the comparative effectiveness of Chuna manual therapy and usual care on chronic neck pain. Adverse events, and costs and effectiveness (utility) data will be evaluated to assess safety and exploratory cost-effectiveness (economic evaluation). This study aims to provide evidence on the effectiveness, safety, and cost-effectiveness of Chuna manual therapy.Trial registrationClinical Research Information Service (CRIS), KCT0002732. Registered on 13 March 2018. ClinicalTrials.gov, NCT03294785. Registered on 27 September 2017.