International Scholarly Research Notices / 2013 / Article / Tab 3

Review Article

Evidence of Physiotherapy Interventions for Patients with Chronic Neck Pain: A Systematic Review of Randomised Controlled Trials

Table 3

Manual therapy—patients with chronic nonspecific neck pain.

Author ParticipantsInterventionsMain outcome measuresStudy results on effect* of intervention between groups

Bronfort et al. [56]Patients with mechanical neck pain lasting > 12 wks, age 20–65 ( )(1) Spinal manipulation and low-technology rehabilitative neck exercise ( )
(2) High-technology MedX rehabilitative neck exercise ( )
(3) Spinal manipulation ( )
All: attended 20 one-hour visits during the 11 wk study
Pain rating scale (0–10), NDI, SF-36, global improvement of satisfaction with care, medication useNo statistically significant differences between groups in patient rated outcomes at 11 wk and at 12 mth followup

Lau et al. [57]Patients with a diagnosis of chronic mechanical neck pain (>3 mths), age 18–55 ( )(1) Thoracic manipulations TM, anterior-posterior approach in supine lying ( )
(2) Control ( )
All: 8 sessions infrared radiation (2/wk) for 15 min over painful site. Educational pamphlet involving active neck mobilisation, isometric neck muscle stabilisation, stretching, postural correction exercise
NPRS, NPQ, SF-36, cervical ROM, craniovertebral angleStatistically significant differences in favour of TM post-treatment on pain intensity ( ) and NPQ ( ). Improvements were maintained at 3 and 6 mths followup

Martel et al. [58]Patients with pain of mechanical origin located in the anatomical region of the neck, with or without radiation to the head, trunk, or limbs > 12 wks; between 18 and 60 yrs ( )All: spinal manipulation 10–15 treatments in 5-6 wk (symptomatic phase) after that 3 different interventions (preventive phase).
(1) Spinal manipulation cervical and thoracic until Th4, once per month, 4 times ( )
(2) Spinal manipulation cervical and thoracic until Th4, once per mth, 4 times AND 20–30 min home exercises 3× per wk: including range of motion exercises, 4 stretching/mobilisation, and 4 strengthening exercises. Three series of each exercise. Ten mths ( )
(3) Attention control group: no treatment ( )
VAS, cervical ROM, NPDI, Bournemouth questionnaire, SF-12 questionnaire, fear-avoidance behaviour questionnaireNo statistically significant differences were found between groups

Sherman et al. [59]Patients with chronic neck pain (>3 mths), age 20–64 ( )(1) Therapeutic neck massage ( ), commonly used Swedish and clinical massage techniques, allowed typical self-care recommendations, up to 10 treatments over a 10 wk period
(2) Self-care book ( ), they were mailed a copy of a self-care book with information and recommendation
NDI, NRSStatistically significant effect on massage after four wks measured by NDI, −2.1 (−4.00–0.03) ( ), but not in long-term followup at 10 and 26 wks

Sillevis et al. [60]Patients between 18 and 65 from outpatients physiotherapy clinic with non-specific pain in the cervical and cervicothoracic region down to T4, provoked with neck movements, present for at least 3 mths ( )(1) One time thrust manipulation at T3-T4 ( )
(2) Placebo manipulation at T3-T4 ( )
VAS, pupil diameterNo statistically significant differences between groups immediately after the treatment

Yaǧci et al. [61]Patients with chronic cervical myofascial pain syndrome (>6 mths), age 21–44 ( )(1) Spray-stretch technique ( ), ethyl chloride sprayed on muscle with trigger point in muscle stretched position, 6 sessions.
(2) Connective tissue massage ( ), 15 sessions
All: followed active exercises to be carried out three times a day
VAS, pain threshold, ROM, strength, enduranceNo statistically significant differences between groups were found on pain posttreatment

order to show an effect of an intervention and hereby support the intervention, it requires showing statistical significant difference between groups.
VAS: visual analogue scale; NRS: numerical rating scale; VNPS: verbal numeric pain scale; NPQ: Northwick Park neck pain questionnaire; NDI: neck disability index; NPDI: neck pain and disability index; NPDS: neck pain and disability scale; NPDVAS: neck pain and disability visual analogue scale; PSFS: patient-specific functional scale; NPI: Northwick Park neck pain index; SF-36: short-form 36; PPT: pressure pain threshold; ROM: range of movement; RPE: rating of perceived exertion; EMG: electromyographic, HRQoL: health-related quality of life.

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