A Randomized Clinical Trial of Exercise and Spinal Manipulation for Patients With Chronic Neck Pain

Brønfort, Gert; Evans, Roni; Nelson, Brian; Aker, Peter; Goldsmith, Charles H.; Vernon, Howard

doi:10.1097/00007632-200104010-00020

Cited by 362 publications

(232 citation statements)

References 22 publications

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“…In a recent randomized clinical trial (Bronfort et al, 2001) substantial improvement in the neck disability index was observed in the groups, but no significant differences between groups reported (p > 0.05). In contrast to these findings, our study demonstrated that experimental group had significantly improved in neck disability score (p < 001) than isometric group after three weeks of treatment.…”

Section: Resultsmentioning

confidence: 81%

“…Couch, Hot packs, Standard Inclinometer, Visual Analogue Scale (VAS) and Neck disability index (NDI) were the instruments used during the study ((Youdas & Garret, 1992;Cynthia, 1998;Bronfort, et al, 2001;Werner, 2001) The study protocol was reviewed and approved by the Institutional Research Committee of Department of Therapies and Health Sciences, Faridabad. After the process of screening, examination and informed consent, the patient rated their pain intensity on Visual Analogue Scale, functional outcomes on Neck Disability Index and followed by an inclinometer examination of cervical Range of Motion.…”

Section: Methodsmentioning

confidence: 99%

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A Comparative Study between Postisometric Relaxation and Isometric Exercises in Non-specific Neck Pain

Gupta¹,

Jaiswal²,

Chhabra³

2012

Journal of Exercise Science and Physiotherapy

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Postisometric relaxation is commonly used to treat patients with neck pain. No randomized controlled trial examining the outcomes of this treatment in symptomatic populations has been reported in the literature. The objective of the study was to evaluate the efficacy of postisometric relaxation in patients with non-specific neck pain. A Convenient sample of thirty seven subjects diagnosed with non-specific neck pain was randomly allocated to one of the two treatment groups on the basis of the inclusion criteria. The experimental group (n=19) received postisometric relaxation and control group (n=18) received isometric exercises. Visual analogue scales (VAS), range of motion (ROM) and neck disability index (NDI) scores were recorded on 1 st , 8 th , 15 th and 22 nd day. Both groups received the selected treatment for three weeks. Non-paramametric tests demonstrated a statistically significant difference with experimental group showing greater improvement in ROM, VAS and NDI than the control group and significant difference within group also. Conclusion: Postisometric relaxation may be more effective in decreasing pain and disability and increasing cervical range of motion in patients with non-specific neck pain. In order to generalize the results, the studies should be done on wider population including different subjects with different age group.

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Section: Resultsmentioning

confidence: 81%

Section: Methodsmentioning

confidence: 99%

A Comparative Study between Postisometric Relaxation and Isometric Exercises in Non-specific Neck Pain

Gupta¹,

Jaiswal²,

Chhabra³

2012

Journal of Exercise Science and Physiotherapy

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“…Gong et al 4) reported that cervical mobilization performed for 40 students with abnormal posture of the cervical spine significantly improved FHP. Bronfort et al 10) also reported that spinal manual therapy combined with exercise, used to treat 191 chronic neck pain patients, resulted in significantly increased ROM. In another study, in which traction combined with cervical manipulation was used to treat patients with reduced cervical lordosis and severe FHP, it was reported that cervical lordosis increased while FHP decreased 11) .…”

Section: Discussionmentioning

confidence: 99%

“…All patients had FHP with 15 mm or larger anterior weight bearing (AWB) 10) in lateral views in plain radiography. Patients were seen at D Hospital in Korea between April and June 2012.…”

Section: Methodsmentioning

confidence: 99%

The Effects of Cervical Mobilization Combined with Thoracic Mobilization on Forward Head Posture of Neck Pain Patients

Lee

Lee²,

Kim

et al. 2013

J Phys Ther Sci

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Abstract.[Purpose] The purpose of the present study was to examine the effects of cervical mobilization combined with thoracic mobilization on neck pain patients' recovery from forward head posture (FHP). [Subjects] Thirty neck pain patients with FHP were randomly assigned to an experimental group (n=15) and a control group (n=15).[Methods] The experimental group received cervical mobilization combined with thoracic mobilization and the control group received only cervical mobilization. Cranial vertical angle (CVA) and cranial rotation angle (CRA) were measured before and after the experiment.[Results] The experimental group had significantly greater improvements in CVA and CRA than the control group.[Conclusion] Therefore, we recommend cervical mobilization combined with upper thoracic mobilization for the improvement of FHP in neck pain patients.

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“…5,6 Recent randomized clinical trials (RCTs) of patients with neck pain have also reported minor adverse reactions in which HVLA SM and other manual therapies were used as the primary interventions. 7,8 The frequencies reported in these RCTs ranged from 9% to 28% for the most common reaction, increased neck pain.…”

Section: Introductionmentioning

confidence: 99%

A feasibility study assessing manual therapies to different regions of the spine for patients with subacute or chronic neck pain

Strunk

Hondras

2008

Journal of Chiropractic Medicine

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Objective: The purpose of this project was to develop and test protocols for a randomized clinical trial of a combined therapeutic approach (thoracic spine and sacroiliac joint highvelocity, low-amplitude spinal manipulation [HVLA SM] + cervical spine postisometric relaxation) and cervical spine HVLA SM for patients with subacute or chronic neck pain. Methods: Patients were recruited in the Quad Cities in Iowa and Illinois. After a baseline assessment visit, eligible patients were randomly assigned to cervical spine HVLA SM or to the combined therapeutic approach for 4 treatment visits over 2 weeks. Outcome assessments included the Neck Disability Index, visual analog scale, and posttreatment response questionnaire. Patient outcomes were not aggregated or compared by treatment group. Results: It took approximately 8 months of planning, which included the development of forms and protocols, pretesting the forms, and training staff and clinicians in the standardized protocols. Twelve participants were screened, and 6 patients were enrolled and randomly allocated to care over a 6-week period. All patients completed 5 visits. Five of 6 patients had an improvement on the Neck Disability Index. On the visual analog scale, 2 patients improved at 2 weeks, whereas the other 4 got worse. Five patients completed the posttreatment response questionnaire; 2 of the 5 indicated they experienced discomfort or an unpleasant reaction from the study treatments. Conclusions: Designing a successful feasibility randomized clinical trial requires considerable planning, development and pretesting of the forms and protocols, and training clinicians and staff for standardized protocols. Patients were willing to be randomized, follow treatment protocols, complete baseline and outcome assessments, and return 83% of the follow-up questionnaires.

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A Randomized Clinical Trial of Exercise and Spinal Manipulation for Patients With Chronic Neck Pain

Cited by 362 publications

References 22 publications

A Comparative Study between Postisometric Relaxation and Isometric Exercises in Non-specific Neck Pain

A Comparative Study between Postisometric Relaxation and Isometric Exercises in Non-specific Neck Pain

The Effects of Cervical Mobilization Combined with Thoracic Mobilization on Forward Head Posture of Neck Pain Patients

A feasibility study assessing manual therapies to different regions of the spine for patients with subacute or chronic neck pain

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