Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
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A Comparison of The Effects of Manual Therapy Plus Stabilization Exercise with Manual Therapy Alone in Patients with Chronic Mechanical Neck Pain

만성 역학적 목 통증을 가진 환자에게 도수치료만 적용할 때와 도수치료와 안정화운동을 함께 적용할 때 목 통증과 신체기능에 미치는 효과 비교

  • Received : 2021.09.03
  • Accepted : 2021.11.01
  • Published : 2022.02.28
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Abstract

PURPOSE: This study aimed to compare the effects of manual therapy with stabilization exercises to manual therapy alone, on neck pain and body functions in patients with chronic mechanical neck pain. METHODS: Twenty patients with chronic mechanical neck pain were recruited and randomly allocated into two groups. A control group(n = 10) was given the manual therapy alone and an experimental group(n = 10) was given the manual therapy with stabilization exercises. The intervention was carried out 3 days per week for 4 weeks. The cervical resting pain, the most painful motion pain, craniocervical flexor endurance, forward head posture and neck disability index were used to assess participants at baseline and after 4 weeks. RESULTS: A comparison of the parameters before and after the intervention showed that both groups experienced significant improvements in the resting pain, the most painful motion pain, craniocervical flexor endurance, and forward head posture except for the forward head posture in the control group. A comparison of the parameters between the groups did not show a significant difference. CONCLUSION: The results of this study suggest that the combined intervention of manual therapy with stabilization exercise does not seem to be more effective than manual therapy alone for improving neck pain, craniocervical flexor endurance, forward head posture, and the neck disability index in patients with chronic mechanical neck pain.

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References

  1. Hoy DG, Protani M, De R, et al. The epidemiology of neck pain. Best Pract Res Clin Rheumatol. 2010; 24(6):783-92. https://doi.org/10.1016/j.berh.2011.01.019
  2. Jull G, Sterling M, Falla D, et al. Whiplash, Headache and Neck Pain: Research-evidenced Directions for Physical Therapies. China: Churchill Livingstone. 2008.
  3. Carroll LJ, Hogg-Johnson S, van der Velde G, et al. Course and prognostic factors for neck pain in the general population: Results of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. J Manipulative Physiol Ther. 2009;32(2 Suppl):013. https://doi.org/10.1016/j.jmpt.2008.11.001
  4. Bovim G, Schrader H, Sand T. Neck pain in the general population. Spine. 1994;19(12):1307-9. https://doi.org/10.1097/00007632-199406000-00001
  5. Maitland GD, Hengeveld E, Banks K, et al. Maitland's Vertebral Manipulation. 6th ed. Edinburgh: Elsevier Butterworth Heinemann, 2001:61-242.
  6. Aprill C, Bogduk N. The prevalence of cervical zygapophyseal joint pain. A first approximation. Spine. 1992;17(7):744-7. https://doi.org/10.1097/00007632-199207000-00003
  7. Cooper G, Bailey B, Bogduk N. Cervical zygapophysial joint pain maps. Pain Med. 2007;8(4):344-53. https://doi.org/10.1111/j.1526-4637.2006.00201.x
  8. Hurwitz EL, Aker PD, Adams AH, et al. Manipulation and mobilization of the cervical spine. A systematic review of the literature. Spine. 1996;21(15):1746-59. https://doi.org/10.1097/00007632-199608010-00007
  9. Danneels L, Beernaert A, De Corte K, et al. A didactical approach for musculoskeletal physiotherapy: The planetary model. J Musculskel Pain. 2011;19(4):218-24. https://doi.org/10.3109/10582452.2011.609637
  10. Panjabi MM. The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. J Spinal Disord. 1992;5(4):390-6. https://doi.org/10.1097/00002517-199212000-00002
  11. Danna-Dos-Santos A, Degani AM, Latash ML. Anticipatory control of head posture. Clin Neurophysiol. 2007;118(8): 1802-14. https://doi.org/10.1016/j.clinph.2007.05.060
  12. Winters JM, Peles JD. Neck muscle activity and 3-D head kinematics during quasi-static and dynamic tracking movements. In: Winters JM, Woo SLY, editors. Multiple Muscle Systems: Biomechanics and Movement Organisation. New York: Springer-Verlag, 1990:461-80.
  13. Falla DL, Jull GA, Hodges PW. Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine. 2004;29(19):2108-14. https://doi.org/10.1097/01.brs.0000141170.89317.0e
  14. Porterfield JA, DeRosa C. Mechanical Neck Pain: Perspectives in Functional Anatomy. Philadelphia, PA: W.B. Saunders Company; 1995.
  15. Gross AR, Goldsmith C, Hoving JL, et al. Conservative management of mechanical neck disorders: A systematic review. J Rheumatol. 2007;34(5):1083-102.
  16. 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. J Manipulative Physiol Ther. 2007;30(3):215-27. https://doi.org/10.1016/j.jmpt.2007.01.014
  17. Albright J, Allman R, Bonfiglio RP, et al. Philadelphia panel evidence-based clinical practice guidelines on selected rehabilitation interventions for neck pain. Phys Ther. 2001;81(10):1701-17.
  18. McDonnell MK, Sahrmann SA, Van Dillen L. A specific exercise program and modification of postural alignment for treatment of cervicogenic headache: A case report. J Orthop Sports Phys Ther. 2005;35(1):3-15. https://doi.org/10.2519/jospt.2005.35.1.3
  19. Sahrmann, S. Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spine. Elsevier Health Science, 2006;61-100.
  20. Falla D, O'Leary S, Fagan A, et al. Recruitment of the deep cervical flexor muscles during a postural-correction exercise performed in sitting. Man Ther. 2007;12(2): 139-43. https://doi.org/10.1016/j.math.2006.06.003
  21. Miller J, Gross A, D'Sylva J, et al. Manual therapy and exercise for neck pain: A systematic review. Man Ther. 2010;15(4):334-54. https://doi.org/10.1016/j.math.2010.02.007
  22. Gross AR, Hoving JL, Haines TA, et al. A Cochrane review of manipulation and mobilization for mechanical neck disorders. Spine. 2004;29(14):1541-8. https://doi.org/10.1097/01.BRS.0000131218.35875.ED
  23. Fredin K, Loras H. Manual therapy, exercise therapy or combined treatment in the management of adult neck pain-A systematic review and meta-analysis. Musculoskelet. Sci. Pract. 2017;31:62-71. https://doi.org/10.1016/j.msksp.2017.07.005
  24. Schroeder J, Kaplan L, Fischer DJ, et al. The outcomes of manipulation or mobilization therapy compared with physical therapy or exercise for neck pain: a systematic review. Evid Based Spine Care J 2013; 4: 30-41. https://doi.org/10.1055/s-0033-1341605
  25. Cleland JA, Childs JD, Whitman JM. Psychometric properties of the neck disability index and numeric pain rating scale in patients with mechanical neck pain. Arch Phys Med Rehabil. 2008;89(1):69-74. https://doi.org/10.1016/j.apmr.2007.08.126
  26. Dewitte V, Beernaert A, Vanthillo B, et al. Articular dysfunction patterns in patients with mechanical neck pain: A clinical algorithm to guide specific mobilization and manipulation techniques. Man Ther. 2014;19(1):2-9. https://doi.org/10.1016/j.math.2013.09.007
  27. Hing WA, Reid DA, Monaghan M. Manipulation of the cervical spine. Manual Therapy. 2003;8(1):2-9. https://doi.org/10.1054/math.2002.0487
  28. Wagner DR, Tatsugawa K, Parker D, et al. Reliability and utility of a visual analog scale for the assessment of acute mountain sickness. High Alt Med Biol. 2007;8(1):27-31. https://doi.org/10.1089/ham.2006.0814
  29. Harris KD, Heer DM, Roy TC, et al. Reliability of a measurement of neck flexor muscle endurance. Phys Ther. 2005;85(12):1349-55. https://doi.org/10.1093/ptj/85.12.1349
  30. Domenech MA, Sizer PS, Dedrick GS, et al. The deep neck flexor endurance test: Normative data scores in healthy adults. Pm R. 2011;3(2):105-10. https://doi.org/10.1016/j.pmrj.2010.10.023
  31. Brunton J, Brunton E, Aoife NM. Reliability of measuring natural head posture using the craniovertebral angle. Irish Ergonomics Review 2003:37-41.
  32. Lee EW, Shin WS, Jung KS et al, Reliability and Validity of the Neck Disability Index in Neck Pain Patients. Phys Ther Korea. 2007;14(3):97-106.
  33. Lee NY, Song HS, K SY. Effects of Two Different Joint Mobilization Positions on Neck Pain, Function and Treatment Satisfaction in Patient with Acute Mechanical Neck Pain. J Korean Soc Phys Med. 2015;10(4):69-80. https://doi.org/10.13066/kspm.2015.10.4.69
  34. Krauss JR, Evjenth O, Creighton D. Translatoric spinal manipulation for physical therapists. Rochester, Lakeview Media LLC, 2006:41-58.
  35. Katavich L. Differential effects of spinal manipulative therapy on acute and chronic muscle spasm: A proposal for mechanisms and efficacy. Man Ther. 1998;3(3):132-9. https://doi.org/10.1016/S1356-689X(98)80003-9
  36. Wyke B, Pain SoLB, Manipulation. Articular neurology and manipulative therapy. Canadian Memorial Chiropractic College, 1982.
  37. Vicenzino B, Collins D, Benson H, et al. An investigation of the interrelationship between manipulative therapyinduced hypoalgesia and sympathoexcitation. J Manipulative Physiol Ther. 1998;21(7):448-53.
  38. Fanselow Ms. The midbrain periaqueductal gray as a coordinator of action in response to fear and anxiety. In: Depaulis A, Bandler R, eds. The Midbrain Periaqueductal Gray Matter. New York, Plenum Press, 1991:151-73.
  39. Koltyn KF, Brellenthin AG, Cook DB, et al. Mechanisms of exercise-induced hypoalgesia. J Pain. 2014;15(12): 1294-304. https://doi.org/10.1016/j.jpain.2014.09.006
  40. Jull GA. Deep cervical flexor muscle dysfunction in whiplash. Journal of Musculoskeletal Pain. 2000;8(1-2): 143-54. https://doi.org/10.1300/j094v08n01_12
  41. Edmondston SJ, Sharp M, Symes A, et al. Changes in mechanical load and extensor muscle activity in the cervicothoracic spine induced by sitting posture modification. Ergonomics. 2011;54(2):179-86. https://doi.org/10.1080/00140139.2010.544765
  42. Gong W. The effects of cervical joint manipulation, based on passive motion analysis, on cervical lordosis, forward head posture, and cervical rom in university students with abnormal posture of the cervical spine. J Phys Ther Sci. 2015;27(5):1609-11. https://doi.org/10.1589/jpts.27.1609
  43. Sterling M, Jull G, Wright A. Cervical mobilisation: Concurrent effects on pain, sympathetic nervous system activity and motor activity. Man Ther. 2001;6(2):72-81. https://doi.org/10.1054/math.2000.0378
  44. Jesus-Moraleida FR, Ferreira PH, Pereira LS, et al. Ultrasonographic analysis of the neck flexor muscles in patients with chronic neck pain and changes after cervical spine mobilization. J Manipulative Physiol Ther. 2011;34(8):514-24. https://doi.org/10.1016/j.jmpt.2011.08.006
  45. Rogers R. The effects of spinal manipulation on cervical kinesthesia in patients with chronic neck pain: a pilot study. Journal of Manipulative and Physiological Therapeutics 1997;20: 80-5.
  46. Schmid A, Brunner F, Wright A, et al. Paradigm shift in manual therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation. Man Ther. 2008;13(5):387-96. https://doi.org/10.1016/j.math.2007.12.007
  47. Sakshi N, Suman M, Geetanjali S. Effect of muscle energy technique and deep neck flexors exercise on pain, disability and forward head posture in patients with chronic neck pain. Indian Journal of Physiotherapy and Occupational Therapy-An International Journal. 2014;8(4):43-8. https://doi.org/10.5958/0973-5674.2014.00009.4
  48. Harsulkar SG, Khatri SM, Rao K, et al. Effectiveness of gong's mobilization in cervical spondylosis: A prospective comparative study. International Journal of Community Medicine and Public Health. 2015;2(1): 38-44. https://doi.org/10.5455/2394-6040.ijcmph20150209
  49. Hurwitz EL, Morgenstern H, Harber P, et al. A randomized trial of chiropractic manipulation and mobilization for patients with neck pain: clinical outcomes from the UCLA neck-pain study. Am J Public Health. 2002;92(10): 1634-41. https://doi.org/10.2105/AJPH.92.10.1634
  50. Chiu TT, Lam TH, Hedley AJ. A randomized controlled trial on the efficacy of exercise for patients with chronic neck pain. Spine. 2005;30(1):E1-7. https://doi.org/10.1097/01.brs.0000149082.68262.b1