Effectiveness of manual therapy or pulsed shortwave diathermy in addition to advice and exercise for neck disorders: A pragmatic randomized controlled trial in physical therapy clinics

Dziedzic, Krzysztof; Hill, Jonathan; Lewis, Martyn; Sim, Julius; Daniels, Jane; Hay, Elaine M

doi:10.1002/art.21087

Cited by 99 publications

(68 citation statements)

References 31 publications

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“…Las medidas de resultado más comúnmente utilizadas en los artículos seleccionados fueron: dolor medido con Escala Visual Análoga (EVA) (40)(41)(42)(44)(45)(46)(47)49,51,53,55,(61)(62)(63)(64), Lattinen Test Score (LTS) (53,59,62) (42,56,57) y solo 2 realizaron un seguimiento a largo plazo (1 año) (41,48).…”

Section: Medidas De Resultadounclassified

“…De acuerdo a la evaluación efectuada por los autores de esta revisión, 12 artículos fueron evaluados de alta calidad metodológica (≥ 6 puntos): Akyol et al Cabe consignar que si bien es cierto que los 26 artículos seleccionados se reportaban como estudios clínicos "aleatorizados", en solo 10 de ellos (40,(42)(43)(44)48,52,56,61,62,65) se explicitaba en el texto la forma como se había realizado la aleatorización y en solo 5 artículos (40,44,48,52,56) (48,56) tienen inscrito su protocolo en alguno de los sistemas de registro existentes en la actualidad, como manera de poder cotejar los datos de la planificación metodológica de los estudios previos a su realización.…”

Section: Discussionunclassified

“…Por el contrario, 12 fueron los ECAs que presentaron resultados desfavorables (58,43,45,40,61,42,52,54,56,57,60,63). Vale decir que al realizar la comparación entre los grupos de estudio, no hubo diferencia clínica y estadís-ticamente significativa en favor del que se aplicaba OC, esto independiente que dentro de cada grupo los pacientes hayan mostrado mejoría de sus mediciones basales al finalizar el tratamiento y/o el seguimiento, es conveniente mencionar que en solo 5 de estos artículos, la OC se estudió como objetivo primario del ECA (40,52,54,56,58) (56,57,58,60), ninguno realizó cálculo de dosis, todos los estudios tenían intervenciones, comparaciones, número de sesiones, tiempo de aplicación y duración del tratamiento diferentes, el promedio de sesiones fue de 11,1 (DS 3,9), valor que es significativamente menor (p < 0,05) que el grupo de estudios con resultados favorables.…”

Section: Discussionunclassified

“…Catorce estudios (41,42,46,(52)(53)(54)56,57,59,60,(62)(63)(64)(65), con un n = 1.710 pacientes, investigaron la efectividad de un programa de tratamiento que incluía OC versus otro programa de tratamiento, en pacientes con OA de rodilla, dolor cervical, SD lumbar, capsulitis adhesiva y tendinitis cálcica de hombro.…”

Section: Programa De Tratamiento Que Incluya Oc Versus Otro Programa unclassified

“…Dziedzic et al (56), con un n = 350 pacientes, comparó la efectividad de un programa de tratamiento con ejercicios más asesoramiento (grupo nº 1) versus ejercicios, asesoramiento más terapia manual (grupo n° 2) y ejercicios, asesoramiento más OCP (grupo n° 3). Para la OCP no hubo cálculo de dosis, se realizaron sesiones de 15 minutos, la duración total del tratamiento fue de 6 semanas, las medidas de resultado estudiadas fueron: dolor (NPq) y evaluación global.…”

Section: Programa De Tratamiento Que Incluya Oc Versus Otro Programa unclassified

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Onda corta para el dolor musculoesquelético: revisión sistemática

M.²,

H.³

2013

Rev. Soc. Esp. Dolor

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Recibido: 18-12-12. Aceptado: 25-03-12. H. Gutiérrez E. et al. Onda corta para el dolor musculoesquelético. Revisión sistemática. Rev Soc Esp Dolor 2013; 20(5): 230-262. ABSTRACTShortwave is a type of electromagnetic radiation whose frequency band commonly used is 27.12 MHz with a wavelength of 11.6 m, is a one of the most commonly used by physiotherapists for pain management of musculoskeletal origin, will be a synthesis of evidence through a systematic review of randomized controlled clinical trials.Objetive: To determine whether there is scientific evidence to support the analgesic effectiveness of shortwave therapy in musculoskeletal pathologies source.Search strategy: We included in the search for randomized clinical trials (RCTs) and controlled clinical trials (CCTs), the databases used were MEDLINE, CINAHL, Central, PEDro, and LILACS.Results: 26 studies that met our eligibility criteria. Conclusions:There is moderate evidence that the short and long term PSW to high and low doses reduce pain and improve function; and the CSW to add an exercise program an education does not reduce pain or analgesic consumption reduced in patients with knee OA; there is moderate evidence that shortterm CSW adding to NSAID and exercise program produces a decrease in pain in patients with chronic low back pain.Key words: Short-wave. Electromagnetic radiation. Musculoskeletal pain. Randomized clinical trial. Systematic review. RESUMENLa onda corta es un tipo de radiación electromagnética, cuya banda de frecuencia más comúnmente usada es 27,12 MHz con una longitud de onda de 11,06 m, es una de las modalidades más usadas por los fisioterapeutas para el manejo del dolor de origen musculoesquelético. Se realizará una síntesis de la evidencia a través de una revisión sistemática de ensayos clínicos aleatorizados y controlados.Objetivo: Determinar si existe evidencia científica que avale la efectividad analgésica de la onda corta en patologías de origen musculoesquelético.Estrategia de búsqueda: Se incluyeron en la búsqueda ensayos clínicos aleatorizados (ECAs) y ensayos clínicos controlados (ECCs), las bases de datos usadas fueron: MEDLINE, CINAHL, Central, PEDro y LILACS.Resultados: Se seleccionaron 26 artículos que cumplían con nuestros criterios de elegibilidad.Conclusión: Existe moderada evidencia de que a corto y largo plazo la OCP a dosis altas y bajas reducen el dolor y mejoran la función; y el adicionar OCC a un programa de ejercicios y educación no disminuye el dolor ni reduce el consumo de analgésicos en pacientes con OA de rodilla; existe moderada evidencia a corto plazo de que adicionar OCC a un programa terapéutico con AINEs y ejercicios produce una disminución del dolor en pacientes con SDL crónico.Palabras clave: Onda corta. Radiación electromagnética. Dolor musculoesquelético. Ensayo clínico aleatorizado. Revisión sistemática. INTRODUCCIÓNLa onda corta (OC) es un tipo de radiación electromagnética (RE) usada por los fisioterapeutas (FT), cuyo rango REVISIONES MBA

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Section: Medidas De Resultadounclassified

Section: Discussionunclassified

Section: Programa De Tratamiento Que Incluya Oc Versus Otro Programa unclassified

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Onda corta para el dolor musculoesquelético: revisión sistemática

M.²,

H.³

2013

Rev. Soc. Esp. Dolor

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Chuna Manual Therapy vs Usual Care for Patients With Nonspecific Chronic Neck Pain

et al. 2021

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IMPORTANCEThe incidence rate of neck pain is increasing worldwide, and the disease is associated with a high social burden. Manual therapy has been widely applied in the treatment of neck pain, but a high-quality, pragmatic randomized clinical trial for this treatment has not been conducted to date. OBJECTIVE This study aimed to compare the effectiveness of Chuna manual therapy with that of usual care for patients with chronic neck pain. DESIGN, SETTING, AND PARTICIPANTSA multicenter, assessor-blinded, pragmatic, randomized clinical trial was conducted between October 18, 2017, and June 28, 2019. This intention-to-treat analysis included 108 patients with chronic neck pain persisting for at least 3 months; patients were recruited from 5 hospitals in Korea. INTERVENTIONSTen sessions (2 sessions per week for 5 weeks) of Chuna manual therapy or usual care (electrotherapy and oral medication) were conducted. MAIN OUTCOMES AND MEASURES The main outcome was the difference in visual analog scale (VAS) score for chronic neck pain between baseline and 5 weeks after randomization. RESULTS This randomized clinical trial recruited 108 patients (mean [SD] age, 38.4 [9.3] years; 73 women [67.6%]). Fifty-four patients were allocated to the Chuna therapy group, and 54 received usual care. At 5 weeks after randomization, manual therapy showed statistically superior results compared with usual care in terms of pain (difference in chronic neck pain VAS, 16.8 mm; 95% CI, 10.1-23.5 mm), function (difference in Neck Disability Index, 8.6%; 95% CI, 4.2%-13.1%), and quality of life (difference in the European Quality of Life-5 Dimension 5 Levels (EQ-5D-5L) scores, −0.07 points; 95% CI, −0.11 to −0.02 points). Regarding the 1-year cumulative values measured using area under the curve analyses, superior outcomes were attained in the manual therapy group in terms of the numerical rating scale for chronic neck pain (1.3 points; 95% CI, 0.5-2.0 points), Neck Disability Index (6.7%; 95% CI, 2.5%-10.9%), Neck Pain Questionnaire (7.4%; 95% CI, 2.3%-12.6%), and EQ-5D-5L scores (−0.03 points; −0.07 to 0.00 points). CONCLUSIONS AND RELEVANCEIn this randomized clinical trial, for patients with chronic neck pain, Chuna manual therapy was more effective than usual care in terms of pain and functional recovery at 5 weeks and 1 year after randomization. These results support the need to consider recommending manual therapies as primary care treatments for chronic neck pain. (continued) Key Points Question Is Chuna manual therapy more effective than usual care (electrotherapy and medication) in week 5 after randomization for chronic neck pain? Findings This randomized clinical trial of 108 patients found that compared with usual care, Chuna manual therapy was more effective in terms of pain and functional improvements at week 5 and year 1 after randomization and in terms of cumulative 1-year results given the accelerated recovery of nonspecific chronic neck pain. Meaning These results support the need to consider the use of Chuna manual therapies, such ...

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Patient education for neck pain with or without radiculopathy

Haines

Gross

Goldsmith

et al. 2008

Cochrane Database of Systematic Reviews

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A 43-year-old right-handed man presents with left shoulder pain and left arm pain and numbness. His symptoms began 6 weeks previously while weightlifting, performing repetitive shoulder abductions with a 10-pound dumbbell in each hand. He noticed a sudden cramp in his neck and left shoulder and immediately stopped his workout. While driving home from the gym, he noticed a temporary jolting pain into his left arm to the hand and fingers. He awoke the following morning with sharply increased pain. His primary care physician initially prescribed ibuprofen, cyclobenzaprine, and hydrocodone, and later gabapentin. Ibuprofen was helpful, and each of the remaining medications ameliorated a portion of his pain but caused either somnolence or vertigo.Within the first week, the patient developed numbness in left hand and thumb whereas the overall severity of his pain decreased. Cervical magnetic resonance imaging (MRI) was ordered, and physical therapy prescribed including 12 sessions of traction, mobilization, and stretching, resulting in temporary improvement only. He attempted a few home exercises but was limited by increased pain while performing sit-ups and weakness of his left arm while performing push-ups and pull-ups. He denied problems with walking or balance and had no changes in his bladder or bowel function except for some constipation associated with use of hydrocodone.The patient works for the phone company, installing and repairing phone lines. The job involves phone line work from a bucket as well as ground work for building installations. Aside from his tools, there is no heavy lifting. During installations, he is required to maintain awkward neck and arm positions that significantly aggravate his arm pain and numbness more than neck pain. He has missed 4 of the last 6 weeks of work and has exhausted his paid sick leave and is concerned about losing his job.He is cooperative and pleasant during the examination. He has a positive Spurling maneuver to the left, a diminished left brachioradialis tendon reflex, subtle weakness of the left biceps, and reduced pin-prick sensation in the left lateral hand and thumb. The remainder of the neurologic examination is normal. His MRI taken 2 weeks previously demonstrates a left paracentral disc herniation at C5-C6 ( Figs. 1 and 2). While the physician discusses these findings with the patient, the patient states that he is "willing to have surgery or do whatever it takes to get better quickly." cial and personal distress. Also, progressing to surgical treatment is premature without first attempting less invasive alternatives. Therefore, I recommend a left C5-6 transforaminal epidural corticosteroid injection.

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Effectiveness of manual therapy or pulsed shortwave diathermy in addition to advice and exercise for neck disorders: A pragmatic randomized controlled trial in physical therapy clinics

Abstract: The addition of pulsed shortwave or manual therapy to advice and exercise did not provide any additional benefits in the physical therapy treatment of neck disorders.

Cited by 99 publications

References 31 publications

Onda corta para el dolor musculoesquelético: revisión sistemática

Onda corta para el dolor musculoesquelético: revisión sistemática

Chuna Manual Therapy vs Usual Care for Patients With Nonspecific Chronic Neck Pain

Patient education for neck pain with or without radiculopathy

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