Groisman Sandro, da Silva Luciano de Souza, Sanches Tamara Rocha Ribeiro, Rocha Clarice Sperotto Dos Santos, Malysz Tais, Jotz Geraldo Pereira
Doctoral Program in Health Sciences; Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre/RS, Brazil.
FEEVALE University, Novo Hamburgo/RS, Brazil.
J Chiropr Med. 2023 Dec;22(4):265-274. doi: 10.1016/j.jcm.2023.10.003. Epub 2023 Nov 18.
The purpose of this study was to evaluate the long-term effects of adding osteopathic manipulative treatment (OMT) to neck exercises compared to exercises alone for individuals with non-specific chronic neck pain (NCNP).
A randomized controlled trial was conducted by assigning 90 individuals with NCNP into the following 2 groups: (1) exercises group (EG, n = 45) or (2) OMT plus exercises group (OMT/EG, n = 45). All participants received 4 weeks of treatment. The clinical outcomes were recorded at baseline and at 3 and 6 months after the treatment. The primary outcomes were pain and function-Numerical Pain Rating Scale (NPRS), Pressure Pain Threshold, and the Neck Disability Index (NDI). The secondary outcomes included range of motion for cervical spine rotation, Fear-Avoidance Beliefs Questionnaire, and Pain Self-Efficacy Questionnaire.
In comparison to baseline data, both groups had a reduction of NPRS ( < .05) and NDI ( < .05) after the treatment. However, no statistically significant differences in pain intensity or disability were found when OMT/EG was compared to EG alone at 3 months ( = 0.1 and = 0.2, respectively) and at 6 months ( = 0.4 and = 0.9, respectively for pain and disability) and no difference was found between OMT/EG and the EG in the secondary outcomes during the same follow-up period ( > .05).
Outcomes of pain and functionality for patients in both groups were improved at 6 months. Our findings show that the combination of OMT and neck exercises for 4 weeks did not improve functionality and reduction of pain in patients with NCNP.
本研究旨在评估与单纯颈部锻炼相比,为非特异性慢性颈部疼痛(NCNP)患者增加整骨手法治疗(OMT)的长期效果。
进行了一项随机对照试验,将90名NCNP患者分为以下两组:(1)锻炼组(EG,n = 45)或(2)OMT加锻炼组(OMT/EG,n = 45)。所有参与者均接受4周的治疗。在基线以及治疗后3个月和6个月记录临床结果。主要结果指标为疼痛和功能——数字疼痛评分量表(NPRS)、压力疼痛阈值和颈部功能障碍指数(NDI)。次要结果指标包括颈椎旋转活动范围、恐惧回避信念问卷和疼痛自我效能问卷。
与基线数据相比,两组在治疗后NPRS(P <.05)和NDI(P <.05)均有所降低。然而,在3个月时(疼痛和残疾的P值分别为0.1和0.2)以及6个月时(疼痛和残疾的P值分别为0.4和0.9),将OMT/EG与单纯EG组相比,在疼痛强度或残疾方面未发现统计学上的显著差异,并且在同一随访期内,OMT/EG与EG组在次要结果指标方面也未发现差异(P >.05)。
两组患者在6个月时疼痛和功能结局均有所改善。我们的研究结果表明,OMT与颈部锻炼相结合4周,并未改善NCNP患者的功能和减轻疼痛。