Department of Physiotherapy, Institute of Physical Medicine and Rehabilitation, Dow University of Health and Sciences, Karachi, Pakistan.
Department of Physiotherapy, Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan.
BMC Musculoskelet Disord. 2024 Sep 4;25(1):707. doi: 10.1186/s12891-024-07749-8.
Nonspecific neck pain (NSNP) is a well-established global burden affecting. It is also a common problem in Pakistan. The burden of neck pain is also increasing day by day due to poor work ergonomics, and increased use of computers and mobiles after the pandemic. An individual's poor posture is often associated with forward head posture (FHP). Limited evidence is available about the effects of neck stabilization (NSE) and dynamic exercises (NDE) for nonspecific neck pain particularly in patients with FHP. This aimed to compare the effects of NSE versus NDE among patients having NSNP with FHP in reducing pain, disability, forward head posture and improving neck range of motion.
It is a single-blinded randomized clinical trial with 60 patients aged 18-40 years, with moderate intensity NSNP for > 3 weeks and < 6 months along with FHP with a moderate disability on neck disability index (NDI) randomly assigned to the treatment groups. Group 1 was doing NSE and group 2 was doing NDE. Transcutaneous Electical Nerve Stimulation, cold packs, and stretching exercises were given to both groups. A total of 9 sessions (3 sessions/ week) were given to participants. NDI questionnaire, Visual analogue scale (VAS), goniometry, and plumb line measurement tool were used as baseline and assessment at the end of 3rd week. The data was analyzed on SPSS version 21. Descriptive analysis was performed. Independent t-test was used for between group comparison and paired t-test used for within group comparison. A p-value less than 0.05 was considered statistically significant.
After treatment within-group analysis of both NSE and NDE showed significant (p < 0.001) improvement in pain on VAS, all ROMs of the neck including flexion, extension, left and right lateral flexion and left rotation, plumb line and NDI score with very large effect size. However, between-group analysis showed non-significant differences (p > 0.05) for post-treatment mean VAS, neck ROM, NDI and plumb line measurement.
Between NSE and NDE, no one is more beneficial than another. Both are equally effective in alleviating pain, increasing ROM, decreasing functional disability, and improving forward head posture in patients with NSNP.
Registered trial at ClinicalTrials.gov Identifier: NCT05298631, 28/03/2022, prospectively registered.
非特异性颈部疼痛（NSNP）是一种全球公认的负担，影响着许多人。它也是巴基斯坦的一个常见问题。由于工作 ergonomics 不佳以及大流行后计算机和移动设备的使用增加，颈部疼痛的负担也在与日俱增。个体的不良姿势通常与前伸头姿势（FHP）有关。关于颈部稳定性（NSE）和动态运动（NDE）对非特异性颈部疼痛的影响，特别是对有 FHP 的患者，证据有限。本研究旨在比较 NSE 与 NDE 在减轻疼痛、残疾、前伸头姿势和改善颈部活动范围方面对患有 FHP 的 NSNP 患者的效果。
这是一项单盲随机临床试验，纳入了 60 名年龄在 18-40 岁之间、有中等强度的 NSNP 病史超过 3 周且不超过 6 个月、伴有中度颈部残疾的 NDI 患者，以及 FHP。这些患者被随机分配到治疗组。第 1 组进行 NSE，第 2 组进行 NDE。两组患者均接受经皮神经电刺激、冷敷包和伸展运动。参与者共接受 9 次（每周 3 次）治疗。在基线和第 3 周结束时使用颈部残疾指数（NDI）问卷、视觉模拟量表（VAS）、量角器和铅垂线测量工具进行评估。数据使用 SPSS 21 版本进行分析。采用描述性分析。采用独立 t 检验进行组间比较，采用配对 t 检验进行组内比较。p 值小于 0.05 被认为具有统计学意义。
在治疗后，NSE 和 NDE 的组内分析均显示 VAS 疼痛评分、所有颈部活动度（包括前屈、后伸、左/右侧屈和左旋）、铅垂线和 NDI 评分均有显著改善（p<0.001），具有非常大的效应量。然而，组间分析显示治疗后 VAS、颈部活动度、NDI 和铅垂线测量的平均值无显著差异（p>0.05）。
在 NSE 和 NDE 之间，没有一种方法比另一种更有效。两种方法在缓解疼痛、增加活动度、降低功能障碍和改善 NSNP 患者的前伸头姿势方面同样有效。
在 ClinicalTrials.gov 注册的临床试验标识符：NCT05298631，2022 年 3 月 28 日，前瞻性注册。
