Effectiveness of standard cervical physiotherapy plus diaphragm manual therapy on pain in patients with chronic neck pain: A randomized controlled trial
| Autor: | S. Bonnini, Angela Grassi, A. Zucchini, D. Oliva, C. Mazzanti, M. Bozzolan, F. Caterino, G. Simoni, A. Gallo, M. Da Roit |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Complementary and Manual Therapy
medicine.medical_specialty Diaphragm Physical Therapy Sports Therapy and Rehabilitation Diaphragm Manual therapy Permutation test Chronic Neck Pain Physiotherapy NO law.invention PE1_14 03 medical and health sciences 0302 clinical medicine Quality of life Randomized controlled trial law Manual therapy Humans Medicine Permutation test Physiotherapy Physical Therapy Modalities 030222 orthopedics Neck pain Neck Pain Intention-to-treat analysis business.industry Rehabilitation 030229 sport sciences Musculoskeletal Manipulations LS2_12 Diaphragm (structural system) Treatment Outcome Chronic Neck Pain Complementary and alternative medicine Private practice Quality of Life Physical therapy Chronic Pain medicine.symptom business Range of motion |
| Zdroj: | Journal of Bodywork and Movement Therapies. 26:481-491 |
| ISSN: | 1360-8592 |
| DOI: | 10.1016/j.jbmt.2020.12.032 |
| Popis: | Background Literature concerning the effect of diaphragm treatment to reduce neck pain symptoms is scarce. Aim of this trial was to investigate the effects of diaphragm manual therapy associated with standard physiotherapy treatment on pain in patients with Chronic Neck Pain (CNP). Methods In a private practice clinic, subjects with CNP were randomly assigned to receive three 30-min treatment sessions of standard cervical physiotherapy and Diaphragm Manual Therapy (DMT) or Sham Diaphragm Technique (SDT). Participants and assessors were blinded to the assignment. Primary outcome was pain, secondary outcomes were cervical active range of motion, pain pressure threshold, disability and quality of life measured at baseline, before and after each session, at 3 and 6-months. Adverse events were monitored. A non-parametric multivariate approach (combined permutation test) was applied to assess the effect of the treatment on all the outcomes. An intention to treat analysis was performed. Results Forty patients were randomly allocated to DMT and SDT groups. Combined permutation test showed a significant higher improvement in DMT group compared to SDT group (p-value = 0.0002). The between-group comparisons on single outcomes showed a statistically significant improvement only for pain pressure threshold on upper trapezius (adjusted p-value = 0.029). No adverse events related to the intervention were registered. Conclusions In patients with CNP, addition of diaphragm manual techniques to standard cervical treatment seems to give a better global outcome, but this improvement is of unclear clinical relevance; the primary outcome seems not to have a role. Further studies are needed to confirm and clarify these results. Trial registration Release Date: July 18, 2017 Registered in ClinicalTrial.gov database ID: NCT03223285A. |
| Databáze: | OpenAIRE |
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