Treatment Of Neck Pain Research Articles

The effect of McKenzie protocol vs. deep neck flexor and scapulothoracic exercises in subjects with chronic neck pain - a randomized controlled study.

This study investigated the impact of McKenzie exercises against deep neck flexor (DNF) combined with scapulothoracic exercises on improving pain severity, cervical mobility, and functional disability. Fifty-five subjects suffering from chronic neck pain participated in this randomized controlled study. They were randomly assigned to three groups; the DNF group, which was treated by traditional physical therapy (i.e., physical therapy agents, stretching, and isometric exercises), combined with DNF, and scapulothoracic exercises; the McKenzie group, treated by traditional physical therapy, combined with McKenzie exercises; and finally, a control group, treated by traditional physical therapy. Before and after 6 weeks of treatment, they were assessed for neck pain severity, cervical range of motion (ROM), and functional disability using a visual analog scale (VAS), a gravity-reference goniometer, and the Copenhagen neck functional disability scale (CNFDS), respectively. Compared to baseline, all groups showed a significant decrease in neck pain severity and disability (p <0.05), and there was a significant increase in neck flexion/extension, lateral right flexion/left flexion, and right/left rotation ROMs (p<0.05). The improvement of the McKenzie group was significantly higher than the DNF group, and control group. Moreover, the improvement of the DNF group was significantly higher than the control group (p<0.05). The McKenzie exercises were better than DNF combined with scapulothoracic exercises to treat neck pain, functional disability, and mobility.

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).

Dry Needling in Physical Therapy Treatment of Chronic Neck Pain: Systematic Review

Chronic Neck Pain (CNP) is one of the main causes of disability worldwide, and it is necessary to promote new strategies of therapeutic approach in the treatment of chronic pain. Dry needling (DN) is defined as an invasive physiotherapy technique used in the treatment of neuromusculoskeletal disorders. The purpose of this review was to assess the effectiveness of invasive techniques in treatment of CNP. The search focused on randomized clinical trials, and according to the selection criteria, eight studies were obtained. In conclusion, DN can be an effective treatment option for CNP, positive outcomes were achieved in the short-term and in the follow-up performed between three and six months, and this technique may offer better outcomes than a placebo intervention based on the application of simulated DN.

Periosteal Needling to the Cervical Articular Pillars as an Adjunct Intervention for Treatment of Chronic Neck Pain and Headache: A Case Report

(1) Background: Periosteal dry needling (PDN) involves clinicians using a solid filiform needle to stimulate bone for analgesic purposes. This case report presents the use of PDN to the cervical articular pillars (CAPs) in an 85-year-old female with chronic neck pain and headache. (2) Case description: PDN was applied to the right C2–C3 articular pillars, following trigger point dry needling (TrPDN) and manual therapy, in order to provide a direct sensory stimulus to the corresponding sclerotomes. PDN added over two treatments led to improved cervical range of motion and eliminated the patient’s neck pain and headache at 1 week follow-up. (3) Outcomes: At discharge, clinically relevant improvements were demonstrated on the numeric pain rating scale (NPRS), which improved from an 8/10 on intake to a 0/10 at rest and with all movements. In addition, the patient exceeded the risk adjusted predicted four-point score improvement and the minimal clinically important improvement (MCII) value of four points on the Focus on Therapeutic Outcomes (FOTO) Neck Functional Status (Neck FS). At one month post-discharge, the patient remained symptom-free. (4) Discussion: In the context of an evidence-informed approach for neck pain and headache, PDN led to marked improvements in pain and function. Patient outcomes exceeded predictive analytic expectations for functional gains and efficient utilization of visits and time in days. Combined with other interventions, PDN to the CAPs could be a viable technique to treat chronic neck pain with headache.

OPAL: a randomised, placebo-controlled trial of opioid analgesia for the reduction of pain severity in people with acute spinal pain—a statistical analysis plan

BackgroundLow back and neck pain are a leading cause of disease burden globally. Opioids are recommended in guidelines for acute low back and neck pain; however, there is a lack of compelling efficacy data to support this.MethodsThe OPAL trial is a prospectively registered, triple-blinded, randomised, placebo-controlled trial. Patients with acute (≤12 weeks duration) back and/or neck pain receive guideline care plus either an opioid (oxycodone + naloxone, up to 20 mg per day) or a placebo for up to 6 weeks or earlier, if pain is resolved. The primary outcome is pain measured using the Pain Severity Score of the Brief Pain Inventory with the primary time point being 6 weeks. Secondary outcomes include physical function, time to recovery, quality of life, adverse events and risk of opioid misuse. Outcomes are collected at weeks 2, 4, 6, 12, 26 and 52. Analysis will be done on an intention-to-treat principle. p values of < 0.05 will be considered significant and 95% confidence intervals will be reported. Repeated-measures linear mixed models will be used to assess the effect of the treatment group on the primary outcome and continuous secondary outcomes. Adverse events will be compared between groups using Fisher’s exact test. Cost-effectiveness analyses will be conducted if a treatment effect on pain is seen at week 6. Subgroup analyses will be performed to assess whether pain duration and pain location are treatment effect modifiers.DiscussionThe OPAL trial will provide important evidence about whether a short course of opioids is effective in the treatment of acute non-specific low back and/or neck pain. This pre-specified statistical analysis plan details the methodology for the analysis of the OPAL trial results.Trial registrationACTRN12615000775516. The trial has completed recruitment. Follow-up on the last patient will be completed in March 2022.

Differential diagnosis and treatment of neck pain

Neck pain is widespread in the population and reaches 60%. Women in the age group under 60 are more likely to be affected than men. Acute pain is typical for young people, chronic – for patients of the older age group. Neck pain can be nonspecific, neural or mixed, depending on the involvement of various anatomical structures in the pathological process.Nonspecific (nociceptive, musculoskeletal) pain accounts for about 80–90% of all cases. The clinical picture may also include limited range of motion in the cervical spine (CS), changes in muscle tone in the region. With damage to the cervical spinal roots, neural symptoms join, which is observed in 11.9–43% of cases.The key to making the correct diagnosis is a deep study of complaints, anamnesis, and a thorough physical examination. Paraclinical research methods play a secondary role in the diagnosis, they are prescribed only if their results can affect the formulation of the diagnosis and further treatment. The need for differential diagnosis between nonspecific and neuropathic pain arises in the presence of complaints and clinical manifestations characteristic of both options. Standard schemes of drug therapy for nonspecific and neuropathic pain have certain differences, while they do not depend on the localization of the process and the involvement of certain structures in the process. In both cases, the main therapeutic tasks are to provide effective pain relief and influence on the inflammatory process. With these tasks, NSAIDs are most fully coping. The original diclofenac has a pronounced analgesic and anti-inflammatory effect with a high safety profile, which, together with a variety of dosage forms, makes it attractive for the treatment of various types of neck pain. An additional local effect on pathologically altered structures by the topical diclofenac forms significantly increases the effectiveness of the treatment. In the above clinical cases, two variants of neck pain are considered, which have similar symptoms, while being different forms of pathology.

EFFECTIVENESS OF CONVENTIONAL THERAPY ON GOLDSMITH WORKERS WITH NECK PAIN– AN EXPERIMENTAL STUDY

Goldsmith workers are used to work for long time with cross legged posture, they may lead to develop different kinds of musculoskeletal disorder among them. The study aimed to nd the effectiveness of conventional therapy on Gol AIM: - Objective: dsmith workers with neck pain. To provide benets and improve the working pattern, ergonomics, strength, posture and overall condition of Goldsmith workers. An Study Design: - Experimental In 4 weeks of intervention; 30participants with features of neck pai Methods:- n were studied. They will be collected by Study convenience sampling. They were received conventional exercises program. The outcome was measured using the Numerical Pain rating scale (NPRS) &amp; the Neck Disability index (NDI). Pre and post data were collected and analyzed using SPSS 22.0. Paired t - test was used to nd out the signicance of the treatment. A signicant improvement in pain &amp; disabil Result: - ity (p&lt;0.05) after the treatment was found. Greater statistically signicant improvement was seen in all the participants. The study concl Conclusion:- ude that conventional exercises program was more effective in treating neck pain on Goldsmith Workers.

Effect of Global Posture Re-Education Versus Static Stretching on Pain, Range of Motion And Quality of Life in Post-Menopausal Women with Chronic Neck Pain

Objective: To compare the effects of global posture re-education and static stretching on pain, range of motion and disability in post-menopausal women with chronic neck pain.&#x0D; Study Design: A quasi-experimental study.&#x0D; Place and Duration of Study: Sheikh Zayed hospital Rahim Yar Khan, from Jun to Dec 2020.&#x0D; Methodology: A total of 36 female patients between 45-65 years of age were included in the study. Patients who had received physiotherapy or manual therapy treatment for neck pain in the previous six months or had any tumour infection were excluded. There were two groups, the global posture re-education group (n=18) performed muscle chain stretching, while the static stretching group (n=18) performed conventional static muscle stretching. Visual analogue scale, neck disability index and goniometer were used for outcome measurement.&#x0D; Results: The results showed significant improvement in visual analogue scale score, neck disability index, flexion and extension range at four weeks and three months follow up (p&lt;0.05). There was no significant improvement in NDI score at three months follow up (p-value &gt;0.05).&#x0D; Conclusion: There was a significant difference in pain, function and disability in both groups, but the global posture reeducation group showed a maximum decrease in pain and disability and gain in ROM as compared to the static stretching group.

A Serious Game for Performing Task-Oriented Cervical Exercises Among Older Adult Patients With Chronic Neck Pain: Development, Suitability, and Crossover Pilot Study.

BackgroundThere is sparse research on the effectiveness of therapeutic exercise for the treatment of neck pain in older adult populations. Moreover, there is a lack of research on the use of serious games or virtual reality for the treatment of neck pain in this population.ObjectiveThe primary aim of this study was to develop and assess the suitability of a serious game for performing task-oriented cervical exercises in patients with neck pain.MethodsA serious game was designed based on the key features identified by previous studies that designed serious video games for physical and cognitive rehabilitation or exercise. The game in this study was designed to provide an interactive scenario, with the main functionality of the software solution to control a virtual airplane to reach targets using head motions. At the end of the exercise, the application stores the targets reached and missed and the airplane’s trajectory. A crossover pilot study was carried out for preliminary evaluation of the suitability of the technology in the older adult population. Men and women over 65 years of age with chronic neck pain were included. Subjects were randomly assigned to two study arms; each arm consisted of a sequence of two 4-week treatments with an intermediate washout period of 4 weeks. The total study duration was 16 weeks due to a final follow-up measure 4 weeks after the end of all treatments. Treatment A consisted of the use of the serious game developed in this study, and treatment B consisted of conventional exercises. Subjects allocated to the A-B study arm received treatment A first, followed by treatment B, and vice versa in the B-A arm. The following variables were assessed: Suitability Evaluation Questionnaire (SEQ) scores, Visual Analog Scale scores, and the number of targets reached in the serious game.ResultsA total of 18 subjects were assessed for eligibility. A total of 13 subjects, aged between 71 and 92 years (mean 81.85, SD 6.82), were finally included and completed the study protocol. The global mean SEQ score was 50.38 (SD 5.35) out of 65 points, showing good suitability of the serious game. Most patients considered the experience very enjoyable and “real” in terms of the virtual environment and found the information provided to be clear. Also, they believed that the game could be very helpful for their rehabilitation. None of the patients felt any neck pain or discomfort when playing the game, and only 2 patients out of 13 (15%) reported some degree of dizziness, eye discomfort, or disorientation, which did not limit their capacity to finish the session.ConclusionsThe serious game developed in this study showed good suitability for use in adults over 70 years of age with chronic neck pain. The game was a safe method for performing task-oriented cervical exercises, and patients reported very high levels of satisfaction and acceptance after the use of this technology.

Effects of Sleep Quality and Mental and Physical Fatigue on Mechanical Neck Pain

Objective: Mechanical neck pain is a very common problem in society and can lead to disability. In modern societies, increasing expectations from individuals in work, family and social life have brought along sleep disorders, mental and physical fatigue. The aim of our study was to examine the effects of sleep disorder, mental and physical fatigue on mechanical neck pain.Method: Two hundred fifty-two individuals with mechanical neck pain having a mean age of 28.01±9.97 years were included in our study. Neck Disability Index, Chalder Fatigue Scale, and Pitssburg Sleep Quality Index were applied to all individuals.Results: According to the regression analysis results, only the mental fatigue sub-dimension of the Chalder Fatigue Scale was associated with increased Neck Disability Index score (β=0.169, p=0.036). Pitssburgh Sleep Quality Index and the physical sub-dimension of Chalder Fatigue Scale were found not to have a significant effect on Neck Disability Index score (p&amp;gt;0.05).Conclusion: Mental fatigue was found among the independent determinants of neck disability. Therefore, a more holistic approach including mental fatigue should be adopted in the treatment of mechanical neck pain.

An opioid‐free anaesthesia (OFA) technique for dorsal laminectomy in a dog subsequent to severe bradycardia and hypothermia after previous subcutaneous methadone administration

AbstractA 6‐year‐old, male, crossbreed dog presented for investigation and treatment of neck and thoracic limb pain. Frequent and repeated subcutaneous methadone administration resulted in severe side effects, including bradycardia, hypothermia and profound sedation. Based on the dog's previously evasive behaviour, suspected cervical myelopathy and technical impracticality, the decision was made not to antagonise opioid effects. Supportive treatment was given until general anaesthesia for diagnostic imaging, and surgery was deemed appropriate. In veterinary medicine, opioids are considered the gold‐standard analgesics; therefore, perioperative analgesia can be challenging when previous opioid use in a patient caused side effects. This case report presents an opioid‐free anaesthetic technique for magnetic resonance imaging and dorsal laminectomy in a dog. As a part of a balanced and multimodal approach, ketamine, dexmedetomidine, paracetamol, gabapentin, lidocaine and bupivacaine were included in the anaesthetic protocol; with meloxicam discontinued before surgery due to repeated episodes of vomiting and regurgitation.

Evaluation of the therapeutic efficacy of original and generic meloxicam in the treatment of acute neck pain

Introduction. In the structure of the global burden of diseases, back pain ranks first in the world in the list of causes of disability. Neck pain is one of the most common diseases of the musculoskeletal system. An integral part of the strategy for the treatment of acute neck pain is the use of original nonsteroidal anti-inflammatory drugs (NSAIDs) with high proven effectiveness.Objective. To conduct a comparative analysis of the therapeutic efficacy of the original drug meloxicam (Movalis) and its generic (Amelotex) in the treatment of patients with acute nonspecific musculoskeletal pain of cervical localization.Materials and methods. The article provides an assessment of the therapeutic effectiveness of the original drug meloxicam (Movalis) and its generic (Amelotex) in the treatment of patients with acute neck pain. Comparative analysis of the results of treatment of 108 patients hospitalized in the Branch of the MC JSC “Admiralteyskie Verfi” aged 18 to 60 years (58 men and 50 women) with a diagnosis of acute dorsalgia of cervical localization (M54.2 according to ICD-10). The average age of patients is 42.5 ± 11.1 years.Results. As a result of the clinical and neurological study and statistical processing of the data obtained, it was found that the use of Movalis in the treatment of patients with acute neck pain was more effective compared to the use of generic (Amelotex). In the Movalis group, the level of pain intensity and the index of disability after treatment was significantly lower than in the Amelotex group at an equivalent dose of 15 mg per day (p &lt; 0.01). The analgesic effect in the group of patients receiving Movalis was longer. There was a significant decrease in sleep disorders associated with pain syndrome in the group (Movalis) compared with patients of the second group (Amelotex). Conclusions. The absence of therapeutic bioequivalence between Movalis and Amelotex revealed in our study determines the relevance of the choice of drugs for the complex therapy of patients of this profile. A multimodal approach to the strategy of treating neck pain, individually patient-oriented, including the use of effective and safe medicines, physical exercises, manual therapy, is optimal.&gt;&lt; 0.01). The analgesic effect in the group of patients receiving Movalis was longer. There was a significant decrease in sleep disorders associated with pain syndrome in the group (Movalis) compared with patients of the second group (Amelotex).Conclusions. The absence of therapeutic bioequivalence between Movalis and Amelotex revealed in our study determines the relevance of the choice of drugs for the complex therapy of patients of this profile. A multimodal approach to the strategy of treating neck pain, individually patient-oriented, including the use of effective and safe medicines, physical exercises, manual therapy, is optimal.

Short time effects of a low-frequency, high intensity magnetic field in the treatment of chronic neck and low back pain.

IntroductionNeck and back pain afflicts millions of people. Magnetotherapy has shown to have anti-inflammatory effects that could act on pain generation, but the literature lacks provide a precise therapeutic protocol.MethodsA high-intensity electromagnetic field with a dedicated applicator was administered to 38 patients with low-back pain and 30 patients with neck pain. The device provides 60 mT and a frequency of 50 Hz for 30 minutes, the session was repeated 4 times.ResultsThe mean VAS of the low-back pain group decreased from 6.56 to 4.54, with a significant reduction of 30.8%. The mean VAS of the neck pain group decreased from 6.51 to 1.96, with a significant reduction of 69.9%.DiscussionThe treatment used showed good results in both groups of the patient, without side effects. The therapeutic protocol adopted is safe, provide rapid relief from the pain and is not time demanding. This treatment could represent an effective non-pharmacologic physical therapy option in the treatment of low-back pain and cervical pain.

Investigation of muscle imbalance among asymptomatic and symptomatic neck pain male office workers

IntroductionOffice workers tend to have a forward head and shoulder posture during prolonged use of a computer, which can develop into neck pain owing to the imbalance of neck and shoulder muscles. The aim of this study was to evaluate neck and scapular muscle imbalance including the muscle length and strength among male office workers.MethodsOverall, 72 male office workers aged 20–45 years were recruited for this study. There were 34 participants in the neck pain group and 38 participants in the asymptomatic group. The study was conducted through a self-report questionnaire including demographic data and work characteristics, and a test on neck and shoulder muscle length and strength performed by means of passive movement and a hand-held dynamometer, respectively.ResultsOffice workers with neck pain demonstrated a significantly longer duration of computer use than workers without neck pain (6.50 ± 1.78 hours) (&lt;i&gt;p&lt;/i&gt; = 0.016) and less strength in the neck flexor (0.154 ± 0.051 kg/body weight [BW]) (&lt;i&gt;p&lt;/i&gt; = 0.017), in the neck extensor (0.183 ± 0.044 kg/BW) (&lt;i&gt;p&lt;/i&gt; = 0.029), and on both sides of the serratus anterior muscles (0.233 ± 0.079 and 0.234 ± 0.063 kg/BW) (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). However, there was no significant difference in muscle length between the groups.ConclusionsThe study indicated that male office workers with neck pain had a greater imbalance in the neck and shoulder muscles than asymptomatic office workers. Specific treatment for neck pain should be considered to promote muscle balance among male office workers.

Bibliometric Analysis of Research Trends on Acupuncture for Neck Pain Treatment Over the Past 20 Years - Response to Zhang and Zhang [Response To Letter

Bibliometric Analysis of Research Trends on Acupuncture for Neck Pain Treatment Over the Past 20 Years - Response to Zhang and Zhang [Response To Letter

Comparison of an exercise program with and without manual therapy for patients with chronic neck pain and upper cervical rotation restriction. Randomized controlled trial.

BackgroundCervical exercise has been shown to be an effective treatment for neck pain, but there is still a need for more clinical trials evaluating the effectiveness of adding manual therapy to the exercise approach. There is a lack of evidence on the effect of these techniques in patients with neck pain and upper cervical rotation restriction.PurposeTo compare the effectiveness of adding manual therapy to a cervical exercise protocol for the treatment of patients with chronic neck pain and upper cervical rotation restriction.MethodsSingle-blind randomized clinical trial. Fifty-eight subjects: 29 for the Manual Therapy+Exercise (MT+Exercise) Group and 29 for the Exercise group. Neck disability index, pain intensity (0–10), pressure pain threshold (kPa), flexion-rotation test (°), and cervical range of motion (°) were measured at the beginning and at the end of the intervention, and at 3-and 6-month follow-ups. The MT+Exercise Group received one 20-min session of manual therapy and exercise once a week for 4 weeks and home exercise. The Exercise Group received one 20-min session of exercise once a week for 4 weeks and home exercise.ResultsThe MT+Exercise Group showed significant better values post-intervention in all variables: neck disability index: 0% patient with moderate, severe, or complete disability compared to 31% in the Exercise Group (p = 0.000) at 6-months; flexion-rotation test (p = 0.000) and pain intensity (p = 0.000) from the first follow-up to the end of the study; cervical flexion (p = 0.002), extension (p = 0.002), right lateral-flexion (p = 0.000), left lateral-flexion (p = 0.001), right rotation (p = 0.000) and left rotation (p = 0.005) at 6-months of the study, except for flexion, with significative changes from 3-months of follow up; pressure pain threshold from the first follow-up to the end of the study (p values range: 0.003–0.000).ConclusionFour 20-min sessions of manual therapy and exercise, along with a home-exercise program, was found to be more effective than an exercise protocol and a home-exercise program in improving the neck disability index, flexion-rotation test, pain intensity, and pressure pain threshold, in the short, medium, and medium-long term in patients with chronic neck pain and upper rotation restriction. Cervical range of motion improved with the addition of manual therapy in the medium and medium-long term. The high dropout rate may have compromised the external validity of the study.

Effectiveness of Specific Neck Exercise for Nonspecific Neck Pain; Usefulness of Strategies for Patient Selection and Tailored Exercise-A Systematic Review With Meta-Analysis.

Specific neck exercises (SNE) targeting deep cervical flexors and extensors are commonly used for the treatment of nonspecific neck pain (NSNP). However, whether SNE are more effective than alternative exercise interventions (AEI) remains unclear. Furthermore, it has been postulated that SNE may be most effective when they are tailored and targeted to patients with evidence of motor control dysfunction, yet this notion also remains unproven. The objectives of this study were to compare the effectiveness of SNE with that of AEI for reducing pain and disability in people with NSNP and to assess whether the effectiveness of SNE is increased when the exercises are tailored and provided to patients with evidence of motor control dysfunction. For this systematic review with meta-analysis, Medline, Web of Science, Scopus, and Physiotherapy Evidence Database were searched. Eligibility criteria included randomized controlled trials evaluating the effectiveness of SNE against that of AEI in people with NSNP. Meta-analysis included subgroup analyses to determine the effect of exercise tailoring and participant selection criteria on the effectiveness of SNE. Twelve studies were included. Meta-analysis revealed greater effectiveness of SNE in the short to medium term for reducing pain (pooled standardized mean difference [SMD] = -0.41; 95% CI = -0.76 to -0.06; P = .02) and disability (pooled SMD = -0.41; 95% CI = -0.78 to -0.04; P = .03) but no differences in the long term for pain (pooled SMD = -1.30; 95% CI = -3.35 to 0.75; P = .21) and disability (pooled SMD = -1.81; 95% CI = -4.29 to 0.67; P = .15), although evidence was limited for the latter. The effectiveness of SNE was not superior in studies that included only participants with motor control dysfunction or when exercises were tailored to each participant. Overall, the studies were of low quality. Grading of Recommendations Assessment, Development and Evaluation revealed low certainty, serious risk of bias, and inconsistency of findings for short- to medium-term effects and very low certainty, serious risk of bias, and very serious inconsistency for long-term effects. The preferential use of SNE may be recommended to achieve better short- to medium-term outcomes, although the low quality of evidence affects the certainty of these findings. Currently used strategies for selecting patients and tailoring SNE are not supported by the evidence and therefore cannot be recommended for clinical practice. SNE are more effective than AEI for reducing pain and disability in patients with NSNP in the short to medium term, but overall evidence is of low quality, affecting the certainty of the findings. Tests of muscle dysfunction (mostly the craniocervical flexion test) currently used in studies to select patients and tailor SNE do not result in greater effectiveness of these exercises. Evidence suggests SNE are more effective than other forms of exercise, although evidence is overall of low quality. Use of the craniocervical flexion test in isolation to select participants and/or tailor SNE cannot be recommended.

Retraction Note: Tropical coastal climate change based on image defogging algorithm and swimming rehabilitation training

This paper first designs and implements an image defogging algorithm based on FPGA. The hardware design mainly includes SDRAM control module, SD card control module, data transmission control module, and convolution neural network calculation module. The SDRAM control module controls the working state of SDRAM; the SD card control module controls the working state of SD card; the data transmission control module controls the data transmission of reading and writing SDRAM; and the convolution neural network module is responsible for the image defogging algorithm. Based on this point, this paper uses the medium complex ocean atmosphere combination model to estimate the SST diversity and climate characteristics of the tropical coastal Pacific and Atlantic Ocean in recent years, and studies and analyzes the influencing factors of the prediction. The atmospheric part of the coupled model is the global atmospheric circulation model CCM3, and the oceanic part is a simplified gravity model of Zebiak Cane type. In addition, an air filter is added to the coupled model to test the impact of natural noise during broadcasting. Finally, the article investigated the positive effect of swimming rehabilitation training on chronic neck pain symptoms of office workers; Objectives were to study the effect of various swimming rehabilitation trainings on neck pain of office workers and investigate the effect of different swimming rehabilitation training cycles on chronic neck pain symptoms of office workers. Objective was to provide a theoretical basis for the development of exercise rehabilitation plan to improve the chronic pain symptoms of office workers. The results showed that breaststroke training and freestyle training were effective in treating neck pain of office workers. In this paper, the application of adaptive image defogging algorithm and the correction of coastal climate change in the rehabilitation training research has promoted the healthy development and progress of swimming rehabilitation training.

Treatment of chronic migraine and neck pain with cognitive-behavioral therapy. Case report

The article presents a case of a patient with chronic migraine, neck pain, drug-induced headache and generalized anxiety disorder. We analyzed the relationship between migraines and neck pain. The article discusses the interdisciplinary treatment of chronic migraine, which included educational conversation, detoxification therapy, rational relief of migraine attacks, preventive pharmacotherapy and cognitive-behavioral therapy. The latter allowed to change the patient's perception of the disease, reduce anxiety and catastrophization of pain, cope with fears, stop taking benzodiazepines, reduce the intake of pain relievers, and increase daily activity and productivity at work. Clinical efficacy (reduction in the frequency of headaches per month by 50% or more) was achieved after 3 months of treatment. Long-term (12 months) follow-up of the patient showed long-term clinical effect of the interdisciplinary treatment.

Median Nerve Neural Mobilization Adds No Additional Benefit When Combined with Cervical Lateral Glide in the Treatment of Neck Pain: A Randomized Clinical Trial.

Background: This study aimed to compare the effectiveness of cervical lateral glide (CLG) added to median nerve neural mobilization (MNNM) in patients with neck pain (NP). Methods: A single-blinded randomized controlled clinical trial was carried out in a Pain Management Unit from a Hospital. A total sample of 72 patients with NP was recruited from a hospital. Patients were randomized to receive isolated CLG (n = 36) or CLG + MNNM (n = 36). Bilateral elbow extension range of motion (ROM) on upper limb neurodynamic test 1 (ULNT1), bilateral pressure pain thresholds (PPT) on the median nerve at elbow joint, C6 zygapophyseal joint and tibialis anterior, Visual analogue scale (VAS), body chart distribution of pain, active cervical ROM (CROM), Neck Disability Index (NDI), and Tampa Scale of Kinesiophobia (TSK-11) were measured at baseline as well as immediately, 15 days, and 1 month after treatment. Results: There were no statistically significant interactions (p > 0.05) between treatment and time for median nerve mechanosensitivity outcomes, pain intensity, symptom distribution, and PPT of the widespread pain assessment, as well as cervical function, and kinesiophobia. Conclusions: MNNM gave no additional benefit to CLG in patients with NP regarding pain intensity, symptom distribution, mechanosensitivity, functionality, and kinesiophobia. Only two treatment sessions and the short follow-up are important issues, therefore, justifying further studies to answer the research question with better methodology.