Bameri Atena, Yassin Marzieh, Salehi Reza, Mansour Sohani Soheil
Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2024 Sep 17;38:107. doi: 10.47176/mjiri.38.107. eCollection 2024.
This study was designed to compare the effectiveness of manual therapy alone and a combination of it and TECAR (Transfer Energy Capacitive and Resistive) therapies on the conditions of pain, disability, and neck range of motion (ROM) in patients with non-specific chronic neck pain (NCNP).
In this Randomized controlled study, 30 women with non-specific chronic neck pain were randomly divided into two groups: Manual therapy along with TECAR therapy (intervention group) and single manual therapy (control group). The participants were homogenized in terms of age, height, and weight. Both groups received manual therapy for two weeks and a total of 8 sessions. Furthermore, self-stretching the scalene muscles, upper trapezius, and suboccipital muscles was taught to the participants. After the treatment ended, patients were followed up for two weeks. The primary outcomes in this study were pain and disability. The pain was measured with the VAS index, and disability was measured with two questionnaires, namely the neck disability index (NDI) and neck pain disability scale (NPDS). The secondary outcomes in this study were neck flexion and extension AROM measured with a goniometer. Pain was evaluated in four stages, including before the treatment onset, at the end of session 4, at the end of treatment and after a two-week follow-up, and other conditions were measured in three stages including before the treatment onset, at the end of treatment and after a two-week follow-up. The Repeated Measure ANOVA (2*3), the Wilcoxon test, and the Paired Student's t-test were used. The significance level was set at ˂ 0.05.
The comparison of the two groups indicated that at the end of the treatment period and after the follow-up, the average pain level in the intervention group was lower than that of the control group. The effect size also revealed that the combination of manual and TECAR therapies acts effectively in pain reduction. Furthermore, the combinatorial treatment compared to the single manual therapy was preferable to improving the disability, while after the two-week follow-up period, no statistically significant difference was observed between the two groups. The comparison of neck flexion and extension AROM did not reveal any difference between the two groups. The intragroup comparison also revealed that both the control and intervention groups experienced a significant decrease in pain intensity and disability level and a significant increase in neck flexion and extension AROM after the end of treatment and after a two-week follow-up compared to before the treatment (> 0.05).
Based on the results of this study, TECAR seems to be able to increase the effectiveness of manual treatments as a thermal modality.
本研究旨在比较单纯手法治疗以及手法治疗与TECAR(电容电阻转移能量)疗法相结合对非特异性慢性颈部疼痛(NCNP)患者的疼痛、功能障碍和颈部活动范围(ROM)状况的疗效。
在这项随机对照研究中,30名患有非特异性慢性颈部疼痛的女性被随机分为两组:手法治疗联合TECAR疗法(干预组)和单纯手法治疗(对照组)。参与者在年龄、身高和体重方面进行了同质化处理。两组均接受为期两周、共8次的手法治疗。此外,还向参与者教授了斜角肌、上斜方肌和枕下肌的自我拉伸方法。治疗结束后,对患者进行了两周的随访。本研究的主要结局指标是疼痛和功能障碍。疼痛采用视觉模拟评分(VAS)指数进行测量,功能障碍采用两份问卷进行测量,即颈部功能障碍指数(NDI)和颈部疼痛功能障碍量表(NPDS)。本研究的次要结局指标是使用角度计测量的颈部前屈和后伸主动活动范围(AROM)。疼痛在四个阶段进行评估,包括治疗开始前、第4次治疗结束时、治疗结束时和两周随访后,其他情况在三个阶段进行测量,包括治疗开始前、治疗结束时和两周随访后。采用重复测量方差分析(2×3)、Wilcoxon检验和配对学生t检验。显著性水平设定为˂0.05。
两组比较表明,在治疗期结束时和随访后,干预组的平均疼痛水平低于对照组。效应量还显示,手法治疗与TECAR疗法相结合在减轻疼痛方面有显著效果。此外,与单纯手法治疗相比,联合治疗在改善功能障碍方面更具优势,而在两周随访期后,两组之间未观察到统计学上的显著差异。颈部前屈和后伸AROM的比较未显示两组之间有任何差异。组内比较还显示,与治疗前相比,对照组和干预组在治疗结束时和两周随访后疼痛强度和功能障碍水平均显著降低,颈部前屈和后伸AROM均显著增加(˃0.05)。
基于本研究结果,TECAR似乎能够作为一种热疗方式提高手法治疗的效果。