Lucia Domingues1, Fernando Manuel Pimentel-Santos1,2, Eduardo Brazete Cruz3, Ana Cristina Sousa4, Ana Santos4, Ana Cordovil4, Anabela Correia5, Laura Sa Torres5, Antonio Silva5, Pedro Soares Branco5, Jaime Cunha Branco1,2. 1. Rheumatic Diseases, Chronic Diseases Research Center (CEDOC), Nova Medical School - Faculdade de Ciencias Medicas, Universidade Nova de Lisboa, Lisboa, Portugal. 2. Rheumatology Department CHLO, Hospital Egas Moniz, Lisboa, Portugal. 3. Department of Physiotherapy, Escola Superior de Saúde - Instituto Politecnico de Setúbal, Setúbal, Portugal. 4. Ambulatory Care Unit, Centro de Medicina de Reabilitação de Alcoitão, Alcabideche, Portugal. 5. Department of Physical Medicine and Rehabilitation, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
Abstract
OBJECTIVE: The aim of this study was to compare the effectiveness of a combined intervention of manual therapy and exercise (MET) versus usual care (UC), on disability, pain intensity and global perceived recovery, in patients with non-specific chronic neck pain (CNP). DESIGN: Randomized controlled trial. SETTING: Outpatient care units. SUBJECTS: Sixty-four non-specific CNP patients were randomly allocated to MET (n = 32) or UC (n = 32) groups. INTERVENTIONS: Participants in the MET group received 12 sessions of mobilization and exercise, whereas the UC group received 15 sessions of usual care in physiotherapy. MAIN MEASURES: The primary outcome was disability (Neck Disability Index). The secondary outcomes were pain intensity (Numeric Pain Rating Scale) and global perceived recovery (Patient Global Impression Change). Patients were assessed at baseline, three weeks, six weeks (end of treatment) and at a three-month follow-up. RESULTS: Fifty-eight participants completed the study. No significant between-group difference was observed on disability and pain intensity at baseline. A significant between-group difference was observed on disability at three-week, six-week and three-month follow-up (median (P25-P75): 6 (3.25-9.81) vs. 15.5 (11.28-20.75); P < 0.001), favouring the MET group. Regarding pain intensity, a significant between-group difference was observed at six-week and three-month follow-up (median (P25-P75): 2 (1-2.51) vs. 5 (3.33-6); P < 0.001), with superiority of effect in MET group. Concerning the global perceived recovery, a significant between-group difference was observed only at the three-month follow-up (P = 0.001), favouring the MET group. CONCLUSION: This study's findings suggest that a combination of manual therapy and exercise is more effective than usual care on disability, pain intensity and global perceived recovery.
OBJECTIVE: The aim of this study was to compare the effectiveness of a combined intervention of manual therapy and exercise (MET) versus usual care (UC), on disability, pain intensity and global perceived recovery, in patients with non-specific chronic neck pain (CNP). DESIGN: Randomized controlled trial. SETTING: Outpatient care units. SUBJECTS: Sixty-four non-specific CNP patients were randomly allocated to MET (n = 32) or UC (n = 32) groups. INTERVENTIONS: Participants in the MET group received 12 sessions of mobilization and exercise, whereas the UC group received 15 sessions of usual care in physiotherapy. MAIN MEASURES: The primary outcome was disability (Neck Disability Index). The secondary outcomes were pain intensity (Numeric Pain Rating Scale) and global perceived recovery (Patient Global Impression Change). Patients were assessed at baseline, three weeks, six weeks (end of treatment) and at a three-month follow-up. RESULTS: Fifty-eight participants completed the study. No significant between-group difference was observed on disability and pain intensity at baseline. A significant between-group difference was observed on disability at three-week, six-week and three-month follow-up (median (P25-P75): 6 (3.25-9.81) vs. 15.5 (11.28-20.75); P < 0.001), favouring the MET group. Regarding pain intensity, a significant between-group difference was observed at six-week and three-month follow-up (median (P25-P75): 2 (1-2.51) vs. 5 (3.33-6); P < 0.001), with superiority of effect in MET group. Concerning the global perceived recovery, a significant between-group difference was observed only at the three-month follow-up (P = 0.001), favouring the MET group. CONCLUSION: This study's findings suggest that a combination of manual therapy and exercise is more effective than usual care on disability, pain intensity and global perceived recovery.
Authors: Jacek Cholewicki; John M Popovich; N Peter Reeves; Lisa A DeStefano; Jacob J Rowan; Timothy J Francisco; Lawrence L Prokop; Mathew A Zatkin; Angela S Lee; Alla Sikorskii; Pramod K Pathak; Jongeun Choi; Clark J Radcliffe; Ahmed Ramadan Journal: PM R Date: 2021-10-31 Impact factor: 2.218