Online Exercise Programs for Chronic Nonspecific Neck Pain: A Randomized Controlled Trial Reveals Comparable Effects of Global, Local, and Combined Approaches.

IF 3.5 4区 医学 Q1 ORTHOPEDICS Physical Therapy Pub Date : 2024-06-04 DOI:10.1093/ptj/pzae040
Jente Bontinck, Mira Meeus, Lennard Voogt, Marjolein Chys, Iris Coppieters, Barbara Cagnie, Kayleigh De Meulemeester
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Abstract

Objective: Specific neck exercises are recommended in the rehabilitation of chronic nonspecific neck pain (CNNP). They are unfortunately often accompanied by acute pain flare-ups. Global exercises might be a beneficial addition, as they activate endogenous analgesia without overloading painful structures. However, it is still unclear which type of exercise is most effective. This randomized controlled trial was done to evaluate the effect of an online blended program of global and specific neck exercises, compared to programs including only 1 of both types of exercise.

Methods: Forty-eight patients with CNNP were randomized into 3 groups. Online questionnaires were collected at baseline, at midtreatment, immediately after treatment, and at the 3-month follow-up. Quantitative sensory testing and actigraphy were assessed at baseline and after treatment. Linear mixed-model analyses were performed to evaluate treatment effects within and between groups. Neck pain-related disability after treatment was considered the primary outcome.

Results: No time × treatment interaction effects were found. All groups improved in neck pain-related disability, pain intensity, self-reported symptoms of central sensitization, local pain sensitivity, physical activity, and pain medication use. No effects were found on quality of life, sleep quality, depression, anxiety, stress, widespread pain sensitivity, health economics, or actigraphy measurements. A higher global perceived effect was reported after performing the blended program, compared to the other groups.

Conclusion: A blended exercise program was not superior to the stand-alone programs in reducing disability. Nevertheless, the global perceived effect of this type of exercise was higher. Future research necessitates larger sample sizes to adequately explore the optimal type of exercise for patients with CNNP.

Impact: Exercise therapy should be an important part of the rehabilitation of patients with CNNP, regardless of the type of exercise.

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治疗慢性非特异性颈痛的在线锻炼计划:一项随机对照试验揭示了整体、局部和综合方法的可比效果。
目的:在慢性非特异性颈部疼痛的康复治疗中,建议进行特定的颈部锻炼。遗憾的是,这些运动往往伴随着急性疼痛的复发。整体运动可能是一种有益的补充,因为它能激活内源性镇痛,而不会使疼痛结构负担过重。然而,目前还不清楚哪种运动最有效。本随机对照试验旨在评估在线综合颈部锻炼和特定颈部锻炼项目与仅包含两种锻炼中的一种的项目相比的效果:48名慢性非特异性颈部疼痛患者被随机分为3组。分别在基线期、治疗中期、治疗后即刻和 3 个月随访时收集在线问卷。在基线和治疗后进行了定量感觉测试和运动电图评估。通过线性混合模型分析来评估组内和组间的治疗效果。治疗后颈部疼痛相关残疾被视为主要结果:结果:没有发现时间×治疗的交互效应。所有组别在颈部疼痛相关残疾、疼痛强度、自我报告的中枢敏感症状、局部疼痛敏感性、体力活动和止痛药物使用方面均有所改善。在生活质量、睡眠质量、抑郁、焦虑、压力、广泛性疼痛敏感性、健康经济学或动电图测量方面没有发现任何影响。与其他组相比,实施混合计划后的总体感知效果更高:结论:在减少残疾方面,混合运动项目并不优于独立项目。结论:在减少残疾方面,混合运动项目并不优于独立运动项目,但这种运动项目的整体感知效果更高。未来的研究需要更大的样本量,以充分探讨慢性非特异性颈痛患者的最佳运动类型:影响:无论采用哪种运动方式,运动疗法都应成为慢性非特异性颈痛患者康复治疗的重要组成部分。
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来源期刊
Physical Therapy
Physical Therapy Multiple-
CiteScore
7.10
自引率
0.00%
发文量
187
审稿时长
4-8 weeks
期刊介绍: Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.
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