Tatsios Petros I, Grammatopoulou Eirini, Dimitriadis Zacharias, Koumantakis George A
Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece.
Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece.
Healthcare (Basel). 2025 Jul 21;13(14):1765. doi: 10.3390/healthcare13141765.
A randomized controlled trial (RCT) was designed to test the emerging role of respiratory mechanics as part of physiotherapy in patients with non-specific chronic neck pain (NSCNP). Ninety patients with NSCNP and symptom duration >3 months were randomly allocated to three intervention groups of equal size, receiving either cervical spine (according to the Mulligan Concept) and diaphragm manual therapy plus breathing reeducation exercises (experimental group-EG1), cervical spine manual therapy plus sham diaphragmatic manual techniques (EG2), or conventional physiotherapy (control group-CG). The treatment period lasted one month (10 sessions) for all groups. The effect on the cervical spine range of motion (CS-ROM) and on the craniovertebral angle (CVA) was examined. Outcomes were collected before treatment (0/12), after treatment (1/12), and three months after the end of treatment (4/12). The main analysis comprised a two-way mixed ANOVA with a repeated measures factor (time) and a between-groups factor (group). Post hoc tests assessed the source of significant interactions detected. The significance level was set at = 0.05. No significant between-group baseline differences were identified. Increases in CS-ROM and in CVA were registered mainly post-treatment, with improvements maintained at follow-up for CS-ROM. EG1 significantly improved over CG in all movement directions except for flexion and over EG2 for extension only, at 1/12 and 4/12. All groups improved by the same amount for CVA. EG1, which included diaphragm manual therapy and breathing re-education exercises, registered the largest overall improvement over CG (except for flexion and CVA), and for extension over EG2. The interaction between respiratory mechanics and neck mobility may provide new therapeutic and assessment insights of patients with NSCNP.
一项随机对照试验（RCT）旨在测试呼吸力学作为物理治疗一部分在非特异性慢性颈痛（NSCNP）患者中的新作用。90例NSCNP且症状持续时间>3个月的患者被随机分为三个等规模的干预组，分别接受颈椎（根据穆利根概念）和膈肌手法治疗加呼吸再教育练习（实验组-EG1）、颈椎手法治疗加假膈肌手法技术（EG2）或传统物理治疗（对照组-CG）。所有组的治疗期均为1个月（10次治疗）。检查了对颈椎活动范围（CS-ROM）和颅椎角（CVA）的影响。在治疗前（0/12）、治疗后（1/12）和治疗结束后三个月（4/12）收集结果。主要分析包括一个具有重复测量因素（时间）和组间因素（组）的双向混合方差分析。事后检验评估检测到的显著交互作用的来源。显著性水平设定为 = 0.05。未发现组间基线存在显著差异。CS-ROM和CVA的增加主要在治疗后出现，CS-ROM的改善在随访时得以维持。在1/12和4/12时，EG1除屈曲方向外，在所有运动方向上均显著优于CG，仅在伸展方向上优于EG2。所有组的CVA改善程度相同。包括膈肌手法治疗和呼吸再教育练习的EG1在总体上比CG有最大改善（除屈曲和CVA外），在伸展方向上比EG2有更大改善。呼吸力学与颈部活动度之间的相互作用可能为NSCNP患者提供新的治疗和评估思路。
