A Comparison of the Effects of Stabilization Exercises Plus Manual Therapy to Stabilization Exercises Alone in Patients With Nonspecific Mechanic Neck Pain: A Randomized Clinical Trial
Authors: Seyda Toprak Celenay, PT, PhD
Study Design
Randomized clinical trial.
Background
Little is known about the efficacy of providing manual therapy in addition to cervical and scapulothoracic stabilization exercises in people with mechanical neck pain (MNP).
Objectives
To compare the effects of stabilization exercises plus manual therapy to stabilization exercises alone on disability, pain, range of motion (ROM), and quality of life in patients with MNP.
Methods
One hundred and two patients with MNP (18-65 years) were recruited and randomly allocated into two groups: stabilization exercise without (StEx-only, n:51) and with manual therapy (StEx+MT, n:51). The program was carried out 3 days/week for 4 weeks. Neck Disability Index (NDI), visual analog pain scale (VAS), digital algometry of pressure pain threshold (PPT), goniometric measurements, and SF-36, were assessed at baseline and after 4 weeks.
Results
Improvements for the NDI, night pain, rotation ROM and SF36 were greater in the StEx+MT group compared with StEx-only. Between-group differences (with 95% confidence intervals) were: 2.2 points (0.1, 4.3) for the NDI; 1.1 cm (0.0, 2.3) for the VAS at night; -4.3 (-8.1, -0.5) and -5.0 (-8.2, -1.7) for right and left rotation ROM; -2.9 points (-5.4, -0.4) and -3.1 points (-6.2, 0.0) for the SF-36 physical and mental components, respectively. Changes in resting and activity pain, PPT, cervical extension or lateral flexion ROM did not differ significantly between the groups. PPT increased only within the StEx+MT group (P<.05).
Conclusion
The study indicates that stabilization exercise with manual therapy may be superior to stabilization exercise alone for improving disability, pain intensity at night, cervical rotation motion, and quality of life in people with MNP.
Level of Evidence
Therapy, level 1b. J Orthop Sports Phys Ther, Epub 11 Jan 2016. doi:10.2519/jospt.2016.5979