Volume 7, Issue 2 (Summer 2017 2017)                   PTJ 2017, 7(2): 113-121 | Back to browse issues page

XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Ghodrati M, Mosallanezhad Z, Shati M, Rastgar Koutenaei F, Nourbakhsh M R, Noroozi M. The Effect of Combination Therapy; Manual Therapy and Exercise, in Patients With Non-Specific Chronic Neck Pain: A Randomized Clinical Trial. PTJ. 2017; 7 (2) :113-121
URL: http://ptj.uswr.ac.ir/article-1-314-en.html
1- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- PhD Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
3- Department of Ageing, Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
4- Department of Physical Therapy, University of North Georgia, Dahlonega, Georgia, United States.
5- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Abstract:   (1071 Views)

Purpose: Neck pain is one of the most common health problems that its prevalence ranges from 34% to 50%. Chronic Neck Pain (CNP) is also a frequent complaint in the general population. The pathogenesis of nonspecific CNP is not clear. This study aimed to assess the effects of soft tissue release, muscle energy techniques and exercise on neck Range of Motion (ROM), Neck Disability Index (NDI), and pain in patients with nonspecific CNP.
Methods: This is a randomized, single-blind, clinical study conducted on two groups of patients in Iran, during 2016-2017. Group A received intervention treatment and group B, as control, received no treatment for 21 days. Each group consisted of 12 participants who were selected considering inclusion and exclusion criteria. Each patient in group A received manual treatment protocols (soft tissue release and muscle energy techniques) plus exercise therapy, in six sessions, one session per day, two days a week over a period of 21 days. Clinical assessments were performed at the first and last session (before and after the treatment). Before starting the study, the reliabilities of measurement methods were evaluated and the results were acceptable. Clinical assessments included neck ROM, NDI and pain based on Visual Analogue Scale (VAS). Repeated measures ANOVA test was performed for data analysis using SPSS (version 20).
Results: Totally, 16 women and 8 men were participated in this study. To test the hypothesis and analysis of the study variables at regular intervals from the beginning to the end of treatment, repeated measures ANOVA was used. In the intervention group, the indexes showed significant improvements (P<0.001). This means that our intervention treatment was effective.
Conclusion: The study results support the effectiveness of the combination therapy (soft tissue release, muscle energy techniques plus exercise therapy) with some improvements in the neck ROM, NDI and pain (Based on VAS scores) for the management of patients with non-specific CNP.

Full-Text [PDF 1044 kb]   (235 Downloads) |   |   Full-Text (HTML)  (6 Views)  
Type of Study: Research | Subject: Special
Received: 2017/01/19 | Accepted: 2017/04/26 | Published: 2017/07/1

References
1. Côté P, Cassidy JD, Carroll L. The treatment of neck and low back pain. Medical Care. 2001; 39(9):956–67. doi: 10.1097/00005650-200109000-00006 [DOI:10.1097/00005650-200109000-00006]
2. Bovim G, Schrader H, Sand T. Neck pain in the general population. Spine. 1994; 19(12):1307–9. doi: 10.1097/00007632-199406000-00001 [DOI:10.1097/00007632-199406000-00001]
3. Mäkela M, Heliövaara M, Sievers K, Impivaara O, Knekt P, Aromaa A. Prevalence, determinants, and consequences of chronic neck pain in Finland. American Journal of Epidemiology. 1991; 134(11):1356–67. doi: 10.1093/oxfordjournals.aje.a116038 [DOI:10.1093/oxfordjournals.aje.a116038]
4. Barry M, Jenner JR. ABC of Rheumatology: Pain in neck, shoulder, and arm. BMJ. 1995; 310(6973):183–6. doi: 10.1136/bmj.310.6973.183 [DOI:10.1136/bmj.310.6973.183]
5. Leclerc A, Niedhammer I, Landre M-F, Ozguler A, Etore P, Pietri Taleb F. One-year predictive factors for various aspects of neck disorders. Spine. 1999; 24(14):1455. doi: 10.1097/00007632-199907150-00011 [DOI:10.1097/00007632-199907150-00011]
6. Ehsani F, Mosallanezhad Z. Epidemiological study on neck pain in office workers in Semnan, risk factors and consequences. Physical Treatments. 2012; 1(1):17-21.
7. Taimela S, Takala E-P, Asklöf T, Seppälä K, Parviainen S. Active treatment of chronic neck pain. Spine. 2000; 25(8):1021–7. doi: 10.1097/00007632-200004150-00018 [DOI:10.1097/00007632-200004150-00018]
8. Hagberg M, Wegman DH. Prevalence rates and odds ratios of shoulder-neck diseases in different occupational groups. Occupational and Environmental Medicine. 1987; 44(9):602–10. doi: 10.1136/oem.44.9.602 [DOI:10.1136/oem.44.9.602]
9. Westgaard RH, Jensen C, Hansen K. Individual and work-related risk factors associated with symptoms of musculoskeletal complaints. International Archives of Occupational and Environmental Health. 1993; 64(6):405–13. doi: 10.1007/bf00517946 [DOI:10.1007/BF00517946]
10. Daffner SD, Hilibrand AS, Hanscom BS, Brislin BT, Vaccaro AR, Albert TJ. Impact of neck and arm pain on overall health status. Spine. 2003; 28(17):2030–5. doi: 10.1097/01.brs.0000083325.27357.39 [DOI:10.1097/01.BRS.0000083325.27357.39]
11. Takala EP, Viikari Juntura E, Moneta GB, Saarenmaa K, Kaivanto K. Seasonal variation in neck and shoulder symptoms. Scandinavian Journal of Work, Environment & Health. 1992; 18(4):257–61. doi: 10.5271/sjweh.1580 [DOI:10.5271/sjweh.1580]
12. Tsakitzidis G, Remmen R, Dankaerts W, Van Royen P. Non-specific neck pain and evidence-based practice. European Scientific Journal. 2013; 9(3).
13. Fernández-de-las-Pe-as C, Simons DG, Cuadrado ML, Pareja JA. The role of myofascial trigger points in musculoskeletal pain syndromes of the head and neck. Current Pain and Headache Reports. 2007; 11(5):365–72. doi: 10.1007/s11916-007-0219-z [DOI:10.1007/s11916-007-0219-z]
14. Catanzariti JF, Debuse T, Duquesnoy B. Chronic neck pain and masticatory dysfunction. Joint Bone Spine. 2005; 72(6):515–9. doi: 10.1016/j.jbspin.2004.10.007 [DOI:10.1016/j.jbspin.2004.10.007]
15. Fejer R, Kyvik KO, Hartvigsen J. The prevalence of neck pain in the world population: a systematic critical review of the literature. European Spine Journal. 2005; 15(6):834–48. doi: 10.1007/s00586-004-0864-4 [DOI:10.1007/s00586-004-0864-4]
16. Hoftun GB, Romundstad PR, Zwart JA, Rygg M. Chronic idiopathic pain in adolescence – high prevalence and disability: The young HUNT study 2008. Pain. 2011; 152(10):2259–66. doi: 10.1016/j.pain.2011.05.007 [DOI:10.1016/j.pain.2011.05.007]
17. Jull GA, Falla D, Vicenzino B, Hodges PW. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Manual Therapy. 2009; 14(6):696–701. doi: 10.1016/j.math.2009.05.004 [DOI:10.1016/j.math.2009.05.004]
18. Kim JH, Lee HS, Park SW. Effects of the active release technique on pain and range of motion of patients with chronic neck pain. Journal of Physical Therapy Science. 2015; 27(8):2461–4. doi: 10.1589/jpts.27.2461 [DOI:10.1589/jpts.27.2461]
19. Vernon H, Humphreys BK. Chronic mechanical neck pain in adults treated by manual therapy: A systematic review of change scores in randomized controlled trials of a single session. Journal of Manual & Manipulative Therapy. 2008; 16(2):42E–52E. doi: 10.1179/jmt.2008.16.2.42e [DOI:10.1179/jmt.2008.16.2.42E]
20. Gross AR1, Goldsmith C, Hoving JL, Haines T, Peloso P, Aker P, Santaguida P, Myers C; Cervical Overview Group. Conservative management of mechanical neck disorders: a systematic review. The Journal of Rheumatology. 34(5):1083-102. PMID: 17295434 [PMID]
21. Philadelphia Panel Members, Clinical Specialty Experts, Albright J, Allman R, Bonfiglio RP, Conill A, et al. Philadelphia panel evidence-based clinical practice guidelines on selected rehabilitation interventions for neck pain. Physical Therapy. 2001; 81:1701–17. doi: 10.1093/ptj/81.10.1701 [DOI:10.1093/ptj/81.10.1701]
22. Gross A, Kay T, Kennedy C, Gasner D, Hurley L, Yardley K, et al. Clinical practice guideline on the use of manipulation or mobilization in the treatment of adults with mechanical neck disorders. Manual Therapy. 2002; 7(4):193–205. doi: 10.1054/math.2002.0477 [DOI:10.1054/math.2002.0477]
23. Aker PD, Gross AR, Goldsmith CH, Peloso P. Conservative management of mechanical neck pain: systematic overview and meta-analysis. BMJ. 1996; 313(7068):1291–6. doi: 10.1136/bmj.313.7068.1291 [DOI:10.1136/bmj.313.7068.1291]
24. Hurwitz EL, Aker PD, Adams AH, Meeker WC, Shekelle PG. Manipulation and mobilization of the cervical spine. Spine. 1996; 21(15):1746–59. doi: 10.1097/00007632-199608010-00007 [DOI:10.1097/00007632-199608010-00007]
25. Sarigiovannis P, Hollins B. Effectiveness of manual therapy in the treatment of non-specific neck pain: A review. Physical Therapy Reviews. 2005; 10(1):35–50. doi: 10.1179/108331905x43436 [DOI:10.1179/108331905X43436]
26. Gross A., Kay T, Hondras M, Goldsmith C, Haines T, Peloso P, et al. Manual therapy for mechanical neck disorders: A systematic review. Manual Therapy. 2002; 7(3):131–49. doi: 10.1054/math.2002.0465 [DOI:10.1054/math.2002.0465]
27. Dusunceli Y, Ozturk C, Atamaz F, Hepguler S, Durmaz B. Efficacy of neck stabilization exercises for neck pain: A randomized controlled study. Journal of Rehabilitation Medicine. 2009; 41(8):626–31. doi: 10.2340/16501977-0392 [DOI:10.2340/16501977-0392]
28. Chiu TTW, Lam TH, Hedley AJ. A randomized controlled trial on the efficacy of exercise for patients with chronic neck pain. Spine. 2005; 30(1):E1–E7. doi: 10.1097/01.brs.0000149082.68262.b1 [DOI:10.1097/01.brs.0000149082.68262.b1]
29. Andersen LL, KjÆr M, SØgaard K, Hansen L, Kryger AI, SjØgaard G. Effect of two contrasting types of physical exercise on chronic neck muscle pain. Arthritis & Rheumatism. 2007; 59(1):84–91. doi: 10.1002/art.23256 [DOI:10.1002/art.23256]
30. Sweeney T. Neck school: Cervicothoracic stabilization training. Occupational Medicine (Philadelphia, Pa.). 1992; 7(1):43-54. [PMID]
31. Namvar H, Olyaei G, Attarbashi Moghadam B, Hosseinifar M. Effect of myofascial release technique on pain, disability, maximum isometric contraction of the extensor muscles, and pressure pain threshold in patients with chronic nonspecific neck pain: Double blinded randomized clinical trial. Health Sciences. 2016; 5(7S):500-6.
32. Yadav H, Goyal M. Efficacy of muscle energy technique and deep neck flexors training in mechanical neck pain: A randomized clinical trial. International Journal of Therapies and Rehabilitation Research. 2015; 4(1):52. doi: 10.5455/ijtrr.00000048 [DOI:10.5455/ijtrr.00000048]
33. Nagrale AV, Glynn P, Joshi A, Ramteke G. The efficacy of an integrated neuromuscular inhibition technique on upper trapezius trigger points in subjects with non-specific neck pain: a randomized controlled trial. Journal of Manual & Manipulative Therapy. 2010; 18(1):37–43. doi: 10.1179/106698110x12595770849605 [DOI:10.1179/106698110X12595770849605]
34. Freburger JK, Carey TS, Holmes GM, Wallace AS, Castel LD, Darter JD, Jackman AM. Exercise prescription for chronic back or neck pain: Who prescribes it? Who gets it? What is prescribed?. Arthritis Care & Research. 2009; 61(2):192-200. doi: 10.1002/art.24234. [DOI:10.1002/art.24234]
35. Hurwitz EL, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, et al. Treatment of neck pain: Noninvasive interventions. Spine. 2008; 33(Supplement):S123–52. doi: 10.1097/brs.0b013e3181644b1d [DOI:10.1097/BRS.0b013e3181644b1d]
36. Sarig Bahat H. Evidence for exercise therapy in mechanical neck disorders. Manual Therapy. 2003; 8(1):10–20. doi: 10.1054/math.2002.0480 [DOI:10.1054/math.2002.0480]
37. Haefeli M, Elfering A. Pain assessment. European Spine Journal. 2005; 15(S1):S17–S24. doi: 10.1007/s00586-005-1044-x [DOI:10.1007/s00586-005-1044-x]
38. Youdas JW, Carey JR, Garrett TR. Reliability of measurements of cervical spine range of motion—Comparison of three methods. Physical Therapy. 1991; 71(2):98–104. doi: 10.1093/ptj/71.2.98 [DOI:10.1093/ptj/71.2.98]
39. Tsakitzidis G, Remmen R, Peremans L, Van Royen P, Duchesnes C, Paulus D, et al. Non-specific neck pain: Diagnosis and treatment. Good Clinical Practice (GCP). KCE Reports C. 2009; 119.
40. Mousavi SJ, Parnianpour M, Montazeri A, Mehdian H, Karimi A, Abedi M, et al. Translation and validation study of the Iranian versions of the neck disability index and the neck pain and disability scale. Spine. 2007; 32(26):E825–31. doi: 10.1097/brs.0b013e31815ce6dd [DOI:10.1097/BRS.0b013e31815ce6dd]
41. Chaitow L. Muscle energy techniques. Amsterdam: Elsevier Health Sciences; 2013.
42. Manheim CJ. The myofascial release manual. Thorofare, NJ: Slack Incorporated; 2008. [PMCID]
43. Phadke A, Bedekar N, Shyam A, Sancheti P. Effect of muscle energy technique and static stretching on pain and functional disability in patients with mechanical neck pain: A randomized controlled trial. Hong Kong Physiotherapy Journal. 2016; 35:5–11. doi: 10.1016/j.hkpj.2015.12.002 [DOI:10.1016/j.hkpj.2015.12.002]
44. Spina AA. External coxa saltans (snapping hip) treated with active release techniques®: A case report. The Journal of the Canadian Chiropractic Association. 2007; 51(1):23-9. PMCID: PMC1924651 [PMID] [PMCID]
45. Feeney T. Active Release Techniques (ART) for neck pain or stiffness [Internet]. 2015 [Cited 2015 March 3]. Available from: http://whitleybaychiropractic.co.uk/neck-pain-and-stiff-neck-active-release-art/
46. Stanborough M. Direct release myofascial technique: An illustrated guide for practitioners. London: Churchill Livingstone; 2004.
47. Ylinen J. Physical exercises and functional rehabilitation for the management of chronic neck pain. Europa Medicophysica. 2007; 43(1):119-32. PMID: 17369784 [PMID]
48. Informed Health Online. What are the treatment options for non-specific neck pain [Internet]. 2015 [Cited 2015 December 2]. Available from: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0084211/
49. Levoska S, Keinänen Kiukaanniemi S. Active or passive physiotherapy for occupational cervicobrachial disorders? A comparison of two treatment methods with a 1-year follow-up. Archives of Physical Medicine and Rehabilitation. 1993; 74(4):425-30. PMID: 8466426 [PMID]
50. Kay T, Santaguida P, Hoving J, Bronfort G, Goldsmith C. Exercises for mechanical neck disorders. The Cochrane Database of Systematic Reviews. 2003; doi: 10.1002/14651858.cd004250 [DOI:10.1002/14651858.CD004250]
51. Miller J, Gross A, D'Sylva J, Burnie SJ, Goldsmith CH, Graham N, et al. Manual therapy and exercise for neck pain: A systematic review. Manual Therapy. 2010; 15(4):334–54. doi: 10.1016/j.math.2010.02.007 [DOI:10.1016/j.math.2010.02.007]
52. Vernon H, Humphreys K, Hagino C. Chronic mechanical neck pain in adults treated by manual therapy: A systematic review of change scores in randomized clinical trials. Journal of Manipulative and Physiological Therapeutics. 2007; 30(3):215–27. doi: 10.1016/j.jmpt.2007.01.014 [DOI:10.1016/j.jmpt.2007.01.014]
53. Vincent K, Maigne JY, Fischhoff C, Lanlo O, Dagenais S. Systematic review of manual therapies for nonspecific neck pain. Joint Bone Spine. 2013; 80(5):508–15. doi: 10.1016/j.jbspin.2012.10.006 [DOI:10.1016/j.jbspin.2012.10.006]
54. Bronfort G, Evans R, Anderson AV, Svendsen KH, Bracha Y, Grimm RH. Spinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: a randomized trial. Annals of internal medicine. 2012; 156(1_Part_1):1-10. doi: 10.7326/0003-4819-156-1-201201030-00002. [DOI:10.7326/0003-4819-156-1-201201030-00002]
55. Ylinen J, Wirén K, Häkkinen A. Stretching exercises vs manual therapy in treatment of chronic neck pain: A randomized, controlled cross-over trial . Journal of Rehabilitation Medicine. 2007; 39(2):126–32. doi: 10.2340/16501977-0015 [DOI:10.2340/16501977-0015]

Add your comments about this article : Your username or Email:
CAPTCHA code

Send email to the article author


© 2018 All Rights Reserved | Physical Treatments - Specific Physical Therapy Journal

Designed & Developed by : Yektaweb