Scapular exercise combined with cognitive functional therapy is more effective at reducing chronic neck pain and kinesiophobia than scapular exercise alone: a randomized controlled trial.

OBJECTIVE

The aim of this study was to compare the effectiveness of scapular exercises alone and combined with cognitive functional therapy in treating patients with chronic neck pain and scapular downward rotation impairment.

DESIGN

Single-blind randomized controlled trial.

SETTING

Outpatient.

SUBJECTS

A total of 72 patients (20-45 years old) with chronic neck pain were studied.

INTERVENTION

Allocation was undertaken into three groups: scapular exercise ( = 24), scapular exercise with cognitive functional therapy ( = 24) and control ( = 24) groups. Each programme lasted three times a week for six weeks.

MAIN OUTCOMES

The primary outcome measure was pain intensity measured by the visual analogue scale scores. The secondary outcome measures included kinesiophobia and muscles activity.

RESULTS

Statistically significant differences in pain intensity were found when multidisciplinary physiotherapy group including a cognitive functional approach was compared with the scapular exercise alone group at six weeks (effect size (95% CI) = -2.56 (-3.32 to -1.80);  = 0.019). Regarding kinesiophobia, a significant between-group difference was observed at six-week (effect size (95% CI) = -2.20 (-2.92 to -1.49);  = 0.005), with the superiority of effect in multidisciplinary physiotherapy group. A significant between-group differences was observed in muscle activity. Also, there were significant between-group differences favouring experimental groups versus control.

CONCLUSION

A group-based multidisciplinary rehabilitation programme including scapular exercise plus cognitive functional therapy was superior to group-based scapular exercise alone for improving pain intensity, kinesiophobia and muscle activation in participants with chronic neck pain.