Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia.
Department of Physiotherapy, Integral University, Lucknow, UP, India.
Medicine (Baltimore). 2023 Dec 29;102(52):e36710. doi: 10.1097/MD.0000000000036710.
BACKGROUND: Sedentary lifestyle, age-related degenerative changes or traumatic injuries leads to cervical spine structural mal-alignment, which results in neck pain and other symptoms. Various therapeutic exercises and manual techniques have been proven to be beneficial in terms of managing these symptoms. This study aimed to determine the combined effects of cervical mobilization and post-isometric relaxation (PIR) technique on managing neck pain, cervical side flexion range of motion, and functional limitation in participants with mechanical neck pain linked with myofascial trigger points. METHODS: This study followed a 2-arm, parallel-group, pretest-posttest randomized comparative design. Thirty participants with mechanical neck pain associated with myofascial trigger points aged 30.87 ± 4.45 years were randomly allocated to Groups 1 and 2. Group 1 received conventional intervention, PIR, and cervical mobilization techniques while Group 2 received conventional intervention and PIR technique only. Neck pain, muscle tenderness, cervical range of motion, and functional limitations were assessed using a visual analog scale, pressure pain threshold (PPT), goniometer, and neck disability index (NDI) questionnaire, respectively at baseline on day 1 and post-intervention on day 7, 14, and 21. Wilcoxon signed-rank test and the Mann-Whitney U test evaluated within-group and between-group analyses, respectively. Statistical significance was established at a 95% confidence interval, indicated by P < .05. RESULTS: Significant differences (95% confidence interval [CI], P < .05) were observed within each group for all the outcomes scores when compared to the baselines across multiple time points. Significant variations were observed between the groups when comparing visual analog scale and NDI scores at weeks 1, 2, and 3 post-interventions. In contrast, insignificant differences (95% CI, P > .05) were observed for side flexion range of motion and PPT compared at weeks 1, 2, and 3 post-interventions except for PPT at week 3 post-intervention (95% CI, P < .05). Additionally, Cohen d test revealed the superiority of group 1 over group 2 in reducing pain and functional limitations and improving cervical side flexion range of motion and PPT. CONCLUSION: The combination of cervical mobilization and Post-isometric relaxation techniques was discovered to effectively alleviate neck pain and enhance functional abilities when contrasted with the application of post-isometric relaxation alone in patients with mechanical neck pain linked with myofascial trigger points.
背景:久坐的生活方式、与年龄相关的退行性变化或创伤性损伤会导致颈椎结构排列不正,从而导致颈部疼痛和其他症状。各种治疗性运动和手法技术已被证明对管理这些症状有益。本研究旨在确定颈椎松动术和等长后放松(PIR)技术联合应用于管理机械性颈痛伴肌筋膜触发点患者的颈部疼痛、颈椎侧屈活动度和功能受限的效果。
方法:本研究采用 2 臂、平行组、前后测试随机对照设计。30 名年龄 30.87±4.45 岁的机械性颈痛伴肌筋膜触发点患者随机分为第 1 组和第 2 组。第 1 组接受常规干预、PIR 和颈椎松动术,第 2 组仅接受常规干预和 PIR 技术。在基线(第 1 天)和干预后第 7、14、21 天,使用视觉模拟量表、压力疼痛阈值(PPT)、量角器和颈部残疾指数(NDI)问卷分别评估颈部疼痛、肌肉压痛、颈椎活动度和功能受限。Wilcoxon 符号秩检验和 Mann-Whitney U 检验分别用于评估组内和组间分析。置信区间为 95%,P 值<.05 表示具有统计学意义。
结果:与基线相比,各时间点各组的所有结局评分均有显著差异(95%置信区间,P<.05)。与对照组相比,干预后第 1、2、3 周时,视觉模拟量表和 NDI 评分有显著差异。然而,除了干预后第 3 周的 PPT(95%置信区间,P<.05)外,侧屈活动度和 PPT 在干预后第 1、2、3 周时无显著差异(95%置信区间,P>.05)。此外,Cohen d 检验显示,与仅应用 PIR 相比,颈椎松动术联合 PIR 技术在减轻疼痛和改善颈椎侧屈活动度和 PPT 方面更具优势。
结论:与仅应用 PIR 相比,颈椎松动术联合 PIR 技术可有效缓解机械性颈痛伴肌筋膜触发点患者的颈部疼痛,提高功能能力。