Osteopathic manipulative treatment combined with exercise improves pain and disability in individuals with non-specific chronic neck pain: A pragmatic randomized controlled trial.

Autor: Groisman, Sandro, Malysz, Tais, de Souza da Silva, Luciano, Rocha Ribeiro Sanches, Tamara, Camargo Bragante, Karoline, Locatelli, Franciele, Pontel Vigolo, Cleder, Vaccari, Simone, Homercher Rosa Francisco, Cristina, Monteiro Steigleder, Simone, Jotz, Geraldo Pereira
Zdroj: Journal of Bodywork & Movement Therapies; Apr2020, Vol. 24 Issue 2, p189-195, 7p
Abstrakt: To determine effectiveness of osteopathic manipulative treatment combined with stretching and strengthening exercises in the cervical region on pain and disability in individuals with non-specific chronic neck pain. 90 adults with non-specific chronic neck pain were randomized to either exercises group (EG, n = 45) or osteopathic manipulative treatment associated with exercises group (OMT/EG, n = 45). The primary outcomes were obtained by the use of Numeric Pain-Rating Scale (NPRS), Pressure Pain Threshold (PPT) and Neck Disability Index (NDI). Secondary outcomes included range of motion (ROM) for cervical spine rotation, Fear-Avoidance Beliefs Questionnaire Work/Physical Activity (FABQ-W/PA) and Pain-self efficacy at two different moments: baseline and 4 weeks after the first treatment. Techniques and dosages of OMT were selected pragmatically by a registered osteopath. Generalized Estimating Equations model (GEE), complemented by the Least Significant Difference (LSD) and the intention-to-treat analysis, was used to assess the clinical outcomes. Analysis with GEE indicated that OMT/EG reduced pain and disability more than the EG alone after 4 weeks of treatment with statistically significant difference (p < 0,05), as well as cervical active rotation was significantly improved (p = 0.03). There were no between-group differences observed in Pressure Pain Threshold (PPT) measure, Fear-Avoidance Beliefs Questionnaire and Pain-self efficacy. The association between OMT and exercises reduces pain and improves functional disability more than only exercise for individuals with non-specific chronic neck pain. • The combination of osteopathic manipulative treatment and exercise is effective for patients with chronic neck pain. • The results support this treatment combination for pain reduction and improved function. • Exercise and OMT has also been shown to be helpful in the management of neck pain. [ABSTRACT FROM AUTHOR]
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