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Background Individuals with nonspecific chronic neck pain (NP) walk with a stiffer spine. However, there is a lack of understanding on kinematic similarities on the limbs during gait between individuals with and without NP. Research question Are there differences in gait parameters and the kinematic similarity index (SI) between individuals with and without NP? Methods Eighteen individuals with NP and 17 controls participated in this study. A three-dimensional motion capture system and two force plates were utilized to measure kinematic changes of the upper and lower limbs during gait. The gait parameters included cadence, speed, stride length, and step width. The SI calculations were compared based on the response vectors from the NP group and the prototype response vectors from the control participants. The SI values at 5% intervals of the entire gait cycle were compared between groups. Results Although the gait parameters were not significantly different between groups, the SI values of the control group were significantly higher than the NP group during gait (0.98 ± 0.02 vs. 0.95 ± 0.03), especially at the midstance (10–30 %) and swing (80–90 %) phases. Also, the standard deviation of the SI decreased in the control group when compared to the NP group (0.02 ± 0.01 vs. 0.04 ± 0.02). Significance The SI was a useful measure to differentiate similarities between groups in the gait cycle at specific phases. These results indicated that the NP group demonstrated a greater variation of walking patterns during the midstance and swing phases and displayed altered compensatory gait. Clinicians need to consider the similarities of the kinematic changes for the NP group to aid in detection of limb motion differences and the resulting gait dysfunction.

Chronic neck pain is a prevalent health condition and a leading cause of disability worldwide. Prompt therapeutic measures are required to overcome this condition.To evaluate the efficacy of incorporation of scapular stabilization and upper limb proprioceptive exercises to cervical stabilization exercises in patients with chronic neck pain (CNP).A single-blinded randomized controlled design.A sample of convenience was deployed to recruit twenty-eight patients having CNP (18-45 years) and was randomized into two groups: group A (cervical stabilization exercises group) and group B (scapular stabilization and upper limb proprioceptive exercises group + cervical stabilization exercises). Pain intensity, disability, sleep quality, quality of life, scapular muscles strength and proprioception were assessed at 4 weeks follow up to determine the efficacy of the intervention.A mixed model ANOVA was used. A statistically significant (p 0.05) group by time interaction for pain intensity (p = 0.000), scapular muscles strength of all muscles (p = 0.000) was observed. Significant group interaction for absolute error (p = 0.00), for pain (p = 0.001), disability (p = 0.04) and scapular muscle's strength (p = 0.000) was also demonstrated.The results indicated that scapular stabilization and upper limb proprioceptive exercises when combined with cervical stabilization exercises are more beneficial in alleviating pain and disability and improving scapular muscle strength and proprioception in patients with CNP.

Objectives To study the addition of feedback-guided neck strength home exercise to physical therapy as an enhanced rehabilitation programme in the treatment of patients with chronic neck pain. Design A prospective randomised controlled trial. Setting Rehabilitation department of an academic hospital. Subjects Patients with chronic neck pain. Interventions The patients in both groups received supervised physical therapy sessions 3 times a week for 12 weeks. Patients in Group A ( N = 38) used the neck strengthening exerciser device for 20 min daily at home for 6 weeks and patients in Group B ( N = 20) performed 20 min of daily regular neck exercise at home for 6 weeks. Outcome measures Neck disability index, pain visual analogue scale, active range of motion of the neck, Patient Global Assessment and patient evaluation of treatment effect. All subjects were assessed at baseline as well as at 6- and 12-week follow-ups. Results At the 6-week follow-up, Group A exhibited significantly greater improvements ( P Conclusion Adding neck strengthening exerciser home training to physical therapy was demonstrated to be more effective than physical therapy alone for patients with chronic neck pain.

Purpose: Chronic neck pain is the most prevalent work-related musculoskeletal injury among surgeons. Urologists may be at higher risk of neck injury due to extended time spent operating in deep ana...

Patients with neck pain demonstrate a variety of sensorimotor impairments, such as decreased cervical joint position sense (CJPS) acuity, which might also be associated with an impaired internal body representation. The present study evaluated the effect of real-time visual feedback of the individual’s own neck on CJPS compared to observing a book. Twenty-three patients with neck pain participated in the experiment and received the interventions in randomized order on separate days in a within-subject pretest–posttest design. Before and immediately after each intervention, CJPS was measured by a therapist blinded to the intervention. The results demonstrate a significantly different development of CJPS (p = .04), with increased CJPS acuity after observing one’s own neck and decreased acuity after observing a book. Real-time visual feedback of the neck improved CJPS acuity in patients with neck pain without active movements of the neck, indicating the importance of central nervous system processing for CJPS acuity.

PURPOSE Neck pain is a musculoskeletal problem increasing with age. The disorders that occurs in the neck region may also affect the upper extremity due to its close anatomical relationships. The aim of this study was to determine whether neck pain affects shoulder position sense and upper extremity function in the older adults. METHODS This cross-sectional study was carried out in nursing homes. The older adults over 65 years of age with chronic neck pain for the last 6 months were included. Pain intensity was evaluated with a Visual Analog Scale. Acumar dual digital inclinometer was used for the evaluation of shoulder position sense. 9-Hole Peg Test was used for the measure of upper extremity function. RESULTS It was found dominant side shoulder position sense and the function of both upper extremities were different between the three groups (p

Neck pain tends to persist for periods of 1 to 4 years of follow-up in adolescents, and a high percentage of them report disability. However, studies assessing the factors associated with persistent neck pain and disability in this age group are scarce. This study aimed to explore the association between psychosocial factors, sleep, and symptoms of central sensitization at baseline and the persistence of neck pain and disability at 6-month follow-up. A total of 710 adolescents with chronic neck pain were assessed at baseline with an online questionnaire that collected information on sociodemographic data, presence of musculoskeletal pain, pain intensity, physical activity, functional disability, depression, anxiety, stress, quality of sleep, catastrophizing, kinesiophobia, self-efficacy, and symptoms of central sensitization. At 6-month follow-up, adolescents were reassessed for disability and pain intensity and categorized as recovered or reporting persistent neck pain. Of the 710 participants with neck pain at baseline, 334 were classified as having persistent neck pain and 375 adolescents as being recovered at 6-month follow-up. Multivariable analysis showed that female gender (OR 1.47; p = 0.04) and symptoms of central sensitization (OR 1.02; p = 0.001) at baseline were positively associated with the persistence of neck pain at 6-month follow-up. Similarly, higher levels of disability (β = 0.41; p

SUMMARY OBJECTIVE: The aim of this study was to evaluate the intra- and inter-rater reliability of pressure pain threshold measurement on myofascial trigger points in the trapezius muscle in women with chronic neck pain. METHODS: This reliability study involved 30 volunteers with neck pain for more than 90 days. The assessment procedures were performed by blinded researchers. Two examiners, who were previously trained in the use of algometry, independently performed two assessments of the pressure pain threshold at two time intervals, one week apart. RESULTS: The study sample consisted of 30 young adult women. Excellent intra- and inter-rater reliability were found for the pressure pain threshold on myofascial trigger points, with intraclass correlation coefficient values ranging between 0.752 and 0.874, standard error of measurement ranging between 0.18 and 0.22 kg/cm2, and minimum detectable change ranging between 0.45 and 0.62 kg/cm2. CONCLUSION: The present study showed that the assessment of pressure pain threshold through algometry presents satisfactory intraclass correlation coefficient values, considering different time and examiners, contributing to the spread of the use of this tool as a quantitative method of pain evaluation in myofascial trigger points.

Background The pathogenesis of neck pain in the brain, which is the fourth most common cause of disability, remains unclear. Furthermore, little is known about the characteristics of dynamic local functional brain activity in cervical pain. Objective The present study aimed to investigate the changes of local brain activity caused by chronic neck pain and the factors leading to neck pain. Methods Using the amplitude of low-frequency fluctuations (ALFF) method combined with sliding window approach, we compared local brain activity that was measured by the functional magnetic resonance imaging (fMRI) of 107 patients with chronic neck pain (CNP) with that of 57 healthy control participants. Five pathogenic factors were selected for correlation analysis. Results The group comparison results of dynamic amplitude of low-frequency fluctuation (dALFF) variability showed that patients with CNP exhibited decreased dALFF variability in the left inferior temporal gyrus, the middle temporal gyrus, the angular gyrus, the inferior parietal marginal angular gyrus, and the middle occipital gyrus. The abnormal dALFF variability of the left inferior temporal gyrus was negatively correlated with the average daily working hours of patients with neck pain. Conclusions The findings indicated that the brain regions of patients with CNP responsible for audition, vision, memory, and emotion were subjected to temporal variability of abnormal regional brain activity. Moreover, the dALFF variability in the left inferior temporal gyrus might be a risk factor for neck pain. This study revealed the brain dysfunction of patients with CNP from the perspective of dynamic local brain activity, and highlighted the important role of dALFF variability in understanding the neural mechanism of CNP.

The purpose of this study was to evaluate the responsiveness of Copenhagen Neck Functional Disability Scale (CNFDS), Neck Disability Index (NDI), Neck Bournemouth Questionnaire (NBQ), Neck Pain and Disability Scale (NPDS) in geriatric patients with non-specific chronic neck pain. A total of 52 geriatric patients with non-specific chronic neck pain were included in the present study. All participants were included in a physical therapy and rehabilitation program for five sessions per week that lasted 3 weeks. All participants were evaluated before and after the treatment. Pain and disability were assessed with the Visual Analog Scale-pain (VAS-pain), VAS-disability, muscle spasm, CNFDS, NDI, NBQ, NPDS scales. Additionally, patient satisfaction scores were questioned both before and after the treatment. Following the 3-week physical therapy and rehabilitation program, significant improvements were detected in the VAS-pain, VAS-disability, muscle spasm, CNFDS, NDI, NBQ, and NPDS scores (p

BACKGROUND Chronic neck pain is one of the common and painful musculoskeletal conditions. Determining the prevalence of nerve impairment in chronic neck pain patients is faced with various challenges such as individual perception and coping patterns of pain and likelihood to seek and receive treatment. We wanted to determine the prevalence of nerve impairment in patients of chronic neck pain and estimate the occupation, age, and gender wise involvement of nerve impairment in chronic neck pain patients. METHODS Population in and around Karad diagnosed with chronic neck pain by an orthopaedician fulfilling the inclusion criteria with prior consent were taken for the study. In the first half of the study, participants were assessed based on a questionnaire and a clinical assessment using Upper Limb Tension Tests following which the participants were assessed using nerve conduction velocity studies. RESULTS Participants having chronic neck pain and showing nerve dysfunctions were 32.14 %. Based on F min, frequency of nerve dysfunction within age groups showed the highest percentage that was 10.72 % in the age group of 39 - 42 years. Higher involvement was observed in males than females which was 23.21 %. Occupation wise nerve involvement for nerve dysfunction showed physically demanding occupations which had higher percentage of 14.28 %. CONCLUSIONS This study shows large population of chronic neck pain with no symptoms of nerve involvement but having nerve dysfunction and were not receiving any treatment for their condition thereby allowing it to progress into a radiculopathy. KEY WORDS Chronic Neck Pain, NCV Study, Cervical Radiculopathy, F Min Latency

Neck pain caused by functional impairment of the cervical spine is manageable with the appropriate intervention. This study aimed to prove that the addition of Abdominal Control Feedback to the conventional protocol, that included only Scapular Stabilization Exercises, would assist with pain minimization, increased available range of movement at the cervical spine, elevation in the endurance time of the deep flexor and extensor group of cervical muscles, better proprioception and an overall decrease in the disability caused due to the pain. A total of 40 participants with chronic mechanical neck pain in the age group of 18-40 years and a pain scale rating of less than 7 on the Visual Analog Scale were chosen and randomized into 2 groups. Group 1 (n=20) received Scapular stabilization exercises without Abdominal control feedback for 6 weeks whereas Group 2 (n=20) received Scapular stabilization exercises along with Abdominal control feedback for 6 weeks. Pain, range of motion, endurance, proprioception and disability were assessed before and after the interventions. There were significant intra group differences in pain, range, endurance, proprioception and disability in both the groups 1 and 2. There were significant inter group differences in pain and endurance siding with group 2. No significant inter group differences were observed in range of motion, proprioception and disability. This verified that the addition of Abdominal control feedback to Scapular stabilization exercises aided in reducing neck pain and increasing endurance time in individuals with chronic mechanical neck pain. Key words: Neck pain, Abdominal control feedback, Scapular stabilization.

The purpose of this study was to investigate the effects of 8 weeks of lumbar stabilization exercise on Forward head posture and neck function(NDI:neck disability index). Sixteen patients with chronic neck pain participated in this study and were randomly assigned to the exercise group(n=8) and the control group(n=8). The exercise program consists of various types of lumbar stabilization exercise. The exercise group performed the lumbar stabilization exercise modified from the previous studies with three times a week for 8 weeks. In results, there was a significant difference in craniovertebral angle(p

Neck pain is a very common problem that creates a socio-economic burden. One of the most common causes of neck pain is disc herniation and often causes the pain to become chronic. Factors such as poor posture, long working hours, and psychological stress exacerbate the symptoms related to the cervical region. Surgical nurses are also at high risk for neck pain. Also, due to the Covid-19 pandemic, many patients, especially healthcare professionals, cannot access physiotherapy and rehabilitation services both due to their busy work and to reduce the risk of contamination. Therefore, this study aimed to examine the effectiveness of remote spinal stabilization exercises in a patient with chronic neck pain. Pain, disability, kinesophobia, grip strength, and quality of life of a 26-year-old female patient who was an operating room nurse were evaluated. Architectural features of the muscles were evaluated by ultrasonography. 3 days a week, 5 weeks of distance exercise training was given. As a result, it was observed that pain, kinesiophobia, and disability levels decreased, quality of life and grip strength increased in this case. M. Longus Colli thickness was found to be increased. Also, the patient stated that her symptoms were reduced and she was less tired at work. This study is the first to provide remote exercise training for a surgical nurse with chronic neck pain. It is thought that the results of this study will shed light on more comprehensive studies on surgical nurses.

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.

Purpose Neck extensor endurance (NEE) and position sense are vital for maintaining cervical spine function and defects in these processes may be associated with impaired postural control in chronic neck pain (CNP) subjects. The study’s objectives are 1) to compare the cervical extensor endurance capability and postural control of CNP subjects with those of asymptomatic controls; 2) to investigate the association between NEE and postural control. Materials and Methods Sixty-four participants (38 asymptomatic, 38 with CNP) participated in this cross-sectional study. NEE was assessed using a clinical extensor endurance test. Under open and closed eyes conditions, postural control measures were tested with the Good Balance system. The postural control parameters were AP-velocity (mm/s), ML-velocity (mm/s) and Velocity moment (mm2). NEE capacity and postural control parameters were compared and correlated between asymptomatic and CNP subjects. Results and Discussion CNP subjects showed lower NEE capacity (p

Objectives This study aims to investigate the effectiveness of scapular stabilization exercises in patients with chronic neck pain and scapular dyskinesis. Patients and methods This single-center, prospective study included a total of 36 patients (17 males, 19 females; mean age: 41±12.8 years; range, 25 to 57 years) with chronic neck pain and scapular dyskinesis between April 2018 and September 2018. The patients were randomly assigned to three treatment groups. Group 1 (n=13) consisted of those receiving scapular stabilization exercises by a physiotherapy specialist control in addition to the routine physiotherapy and rehabilitation program; Group 2 (n=12) consisted of those receiving the routine physiotherapy and rehabilitation program in addition to scapular stabilization exercises in-home training program; and Group 3 (n=11) consisted of those receiving the routine physiotherapy and rehabilitation program alone. The assessments were made using the Visual Analog Scale (VAS) and Northwick Park Neck Pain Questionnaire (NPQ). Results Significant differences were found in the pre- and post-treatment VAS scores, and Group 1 and Group 2 created this significant difference (p

Objectives Trigger points are thought to be associated with chronic neck pain and can be treated with massage self-care techniques such as trigger point self-care. We sought to examine the feasibility of a developed group training approach for trigger point self-care to inform future efficacy focused clinical trials for chronic neck pain. Methods Self-identified adults with chronic neck pain were recruited to participate in one of two scheduled group training sessions. Data was collected pre- and post-training with follow-up at 1-, 4-, and 8-weeks. Measures included a trigger point self-care training objectives survey, daily self-report logs, and neck disability and pain via the Neck Disability Index. Training included interactive lecture, demonstration, supervised practice, and assessment for an individualized trigger point self-care plan. Handouts and tools were provided for training and home use. Results Five participants (women = 3; ages 22–58; White = 4) enrolled and completed the study. All participants completed each data collection point, attended a post-intervention focus group or interview, submitted their completed daily self-care log, and reported achieving all intended training objectives. All participants felt the downtown university location was convenient and non-clinical environment simulated a real-world educational/training experience. Two participants reported having some discomfort the day after training, most expected the training would help them, and several expressed excitement about learned content and empowerment to manage their own pain. Neck Disability Index scores at week-1 did not change for 1 participant, worsened for 1 participant, and improved for 3 participants. All participants’ Neck Disability Index scores were better than baseline at week-4 and week-8. Conclusions Our trigger point self-care group training approach was acceptable to study participants and is feasible to implement in future clinical trials. Larger studies including participants with more severe neck pain and disability are needed to test the trigger point self-care approach.

BACKGROUND: Non-neutral postures during computerised device use coupled with increased usage may increase the risk of neck pain. Greater knowledge of postures that individuals with neck pain adopt during computerised device use is warranted. OBJECTIVE: To evaluate neck and upper limb posture while using a tablet, laptop and desktop computer (sitting and standing) in individuals with chronic neck pain. METHODS: Differences in three-dimensional kinematic variables were assessed during four conditions: tablet, laptop, desktop computer (sitting and standing) in 22 individuals with chronic neck pain >3 months. Differences between kinematic variables were determined using one-way repeated measures ANOVA with Bonferroni post-hoc tests. RESULTS: Compared to the desktop (sitting), tablet and laptop use resulted in increased neck flexion (mean difference tablet – 14.42°, 95% CI – 19.88, –8.96, P

Introduction: Acupressure is known to be effective for some types of chronic pain. However, the effect of acupressure on chronic neck pain has not been investigated. Accordingly, the authors aimed ...

Response surface model (RSM) is used to detect the variable values that make the response variable maximum or minimum. Besides, the effect of exploratory variables on the response variable is determined. Thus, this method can be referred as a combination of regression analysis and optimization. RSM is mostly used in many fields such as industry and chemistry. However, it has limited application in the field of health. The upper limb performance assessment is a two-stage assessment of upper limb contributions to task performance. In this study, the upper limb performance of chronic neck pain patients is examined on 63 patients. The upper extremity functional index (UEFI-20) identifying the performance of upper limb is assigned as response variable. Input variables are taken as the variables related the pain-rating scales of patients at rest or in activity. The central composite model is implemented to estimate the model. The artificial neural network (ANN) approach is also applied to upper limb performance data. The mean absolute error, correlation coefficients, standard error of prediction are obtained from evaluating the experimental and predicted values of both models. The comparative analysis for both models is made on the prediction accuracy.

Objective: To determine the effectiveness of mobilizations along with hot therapy versus mobilizations for the management of chronic neck pain due to over usage of smart phones among young. Materials and Methods: This interventional clinical trial was conducted at OPD, Institute of Physiotherapy & Rehabilitation Sciences (IPRS) in Liaquat University Medical and Health Sciences Jamshoro (LUMHS). All the individuals from LUMHS Jamshoro including students, age 18-35 years and either of gender were included. All the individuals were divided in two groups (group A and group B). Cases of group A were underwent management of mobilization with hot therapy and cases of group B underwent only mobilization management. Outcome was observed in the terms of decrease the pain during work, reading and sleeping. All the data was recorded via study proforma. Results: Total 64 individuals were studied. Mean age was 26.2+4.2 years in group A and 28.6+5.3years. Males were in majority in both groups. According to the pain assessment on movement, mild pain was in 18.8%, moderate pain was 50.0%, severe pain was in 12.5% and very severe pain was in 18.85 of the patients of group A. However in group B most of the patients 93.8% had mild pain and 6.2% patients had severe pain, while no any patients with moderate pain and very severe pain was found in group B. After treatment pain was more decreased in patients of group A as pain during work, reading and sleeping was significantly higher in only mobilizations treatment group as compared to those underwent mobilizations with hot therapy treatment, p-values were quite significant. Conclusion: It was concluded that the treatment of mobilization with Hot pack was more effective than treatment only mobilization.

Chronic neck pain may affect sensorimotor integration, which is critical for postural control. Accordingly, this study investigated whether individuals with chronic neck pain display altered muscle activation and postural control compared with those of healthy adults while performing functional reach tasks. Three-dimensional kinematic analyses and electromyographic analyses were performed. 20 individuals with chronic neck pain and twenty healthy adults were recruited. The reach distance, anterior displacements of the centers of mass and pressure, and activity of the cervical muscles were recorded during functional reach tasks. Compared with the healthy adults, the individuals with chronic neck pain showed significantly smaller anterior displacements of the centers of mass and pressure and reduced muscle activity of the upper trapezius muscle. However, no difference in the reach distance was observed between the two groups. It is speculated that a functional reach task may not be sensitive enough to detect changes in the postural control of individuals with chronic neck pain. For individuals with chronic neck pain, a combination of clinical measures and quantitative assessments of the centers of mass and pressure is suggested to facilitate the early detection of changes in postural control.

Background: Neck pain is a real public health problem. Its treatment uses different techniques, such as functional rehabilitation, whose results are not widely popularized, from developing countries in Black Africa. Objective: To assess the result of rehabilitation of chronic common neck pain (CCNP) at the CNHU-HKM in Cotonou. Methods: Cross-sectional, retrospective, descriptive and analytical study. It was carried out from May to September 2020, based on the files of former patients followed in functional rehabilitation department at CNHU-HKM in Cotonou, from 2015 to 2019, for CCNP. The result of rehabilitation was assessed based on the progress, between the start and the end of the rehabilitation sessions, of pain intensity, mobility of the cervical spine, muscle strength and functional capacity of the patient. Anova and chi-square tests were used for the analysis of factors associated with the result of rehabilitation. Results: The sample consisted to 73 patients. They were predominantly female (58.90%), with a mean age of 53.60 ± 14.08 years. The neck pain, at least of moderate intensity (97.26%), was present since 12.54 ± 8.54 months, on average. Patients have done 10 to 20 functional rehabilitation sessions, the result of which was satisfactory in 67.12%. This result was mainly associated with patient’s age, sports practice and the seniority of pain progression. Discussion-Conclusion: Rehabilitation results in the management of CCNP are interesting. They prove the need to sensitize patients and prescribers on the importance of early treatment of CCNP.

Background With the popularity of smartphones, cervical spondylosis is becoming more and more common among young people. The aim of this study was to investigate the association between excessive smartphone use and cervical disc degeneration in young patients suffering from chronic neck pain. Methods A total of 2438 young patients suffering from chronic neck pain were included into this study. All patients underwent the Magnetic Resonance Imaging (MRI) examination of the cervical spine. The degree of cervical disc degeneration, the dependent variable, was evaluated by Cervical Disc Degeneration Scale (CDDS) which was developed from Pfirrmann classification. Smartphone use, the primary independent variable, was assessed by Smartphone Addiction Scale (SAS). Results In all, 52.9% patients were categorized as smartphone overuse. Patients with overuse of smartphones had higher CDDS scores than those who did not use smartphone excessively. Conclusions The results indicate that cervical disc degeneration may be associated with excessive smartphone use, such use may lead to cervical spondylosis.

Regarding the number of years lived with a disability, neck pain is an important condition worldwide and at least one episode affects an individ during a lifetime.The aim of this study was to investigate the effectiveness of dry needling in addition to routine care in patients with idiopathic chronic neck pain. The study was performed on a sample on 20 females, aged 32-45 years, with this condition. Chosen patiens were grouped into two groups. In Group 1 the patientsbenefited from a protocol which included specific rehabilitation exercises focused on neck, upper limbs, mobility, strength and stretching exercices. The Group 2 included patients who benefited from a rehabilitation program which included exercises and dry needling therapy performed on the shoulder area, trapezius muscle, splenius, elevator scapulae, paravertebral muscles. The treatment lasted 8 weeks, with a frequency of dry needling of1 session/week.To monitor the evolution of the research subjects, were used The Visual Analog Pain Scale (VAS) and Neck Disability Index (NDI).NDI values showed improvements in both groups from 34.8 to 25.4 in Group 2 and from 35.6 to 30.0 in Group 1. So, NDI values showed a better functional status in both groups after 8 weeks of treatment.The mean results of VAS and NDI at the final evaluations showed a higher efficacy of the conservative treatment associated with dry needling, with a major statistical significance (p

Objective: Cervicogenic headache has been known to originate from the convergence of the upper 3 cervical and trigeminal afferents. The administration of conservative treatments, interventional procedures, and more recently, pulsed radiofrequency, has been used to relieve cervicogenic headache. In this study, the authors evaluated the clinical efficacy and safety of pulsed radiofrequency targeting the mid-cervical medial branches. Materials and Methods: From September 2012 until December 2017, 395 patients were diagnosed with cervicogenic headache based on the third edition of the International Classification of Headache Disorders. The authors treated them conservatively at first, and those patients with nonresolution of pain were treated with mid-cervical medial branches block applied from C3 to C5 twice. Subsequently, if any patient continued to experience persistent pain, the authors classified them as having intractable cervicogenic headache and performed pulsed radiofrequency treatment targeting the mid-cervical medial branches from C3 to C5 bilaterally. The authors analyzed their demographics and used a Visual Analogue Scale to assess their pain for 12 months. Results: Fifty-seven patients were enrolled in this study. The mean age was 49.8 years, and the mean duration of symptoms was 47.7 months. The mean Visual Analogue Scale score was 6.21 before pulsed radiofrequency treatment, and it improved to 1.54 immediately after the procedure without the symptoms recurring for a minimum of 12 months. There were no severe complications, such as vascular or nerve injuries. Conclusions: In patients with intractable cervicogenic headache, pulsed radiofrequency treatment targeting the mid-cervical medial branches resulted in a satisfactory, long-lasting outcome without serious complications.

Background Chronic neck pain (CNP) is a significant health problem with only a few evidence-based treatment options. There is growing evidence for the effectiveness of kinaesthetic rehabilitation in musculoskeletal disorders. This study aims to assess kinaesthetic exercise programs' efficacy on cervical position sense, pain, and disability in subjects with cervical spondylosis (CS). Methods CNP subjects (>3 months) with a diagnosis of CS were randomly assigned to either a study group (n=125) who received kinesthetic exercises or to a comparative group (n=125) who received isometric neck exercises and deep cervical flexor (DCF) strengthening exercises. Both group subjects participated in the individualized training program for 24 sessions in 6 weeks. The outcome measures were cervical joint position errors (JPE’s) in flexion, extension, rotation left and right, pain intensity, and neck disability. Results All outcomes were improved significantly from baseline to post 24 sessions of intervention. When compared between groups, there was a significant reduction in JPE’s in flexion (mean difference [MD]= 071, CI=0.22–1.20, p=0.001), extension (MD=1.26, CI=0.70–1.81, p< 0.001) and right rotation (MD=1.08, CI=0.58–1.58, p Conclusion Study group subjects who received kinesthetic rehabilitation showed more significant improvements in terms of improved proprioception, decreased pain intensity and disability following 24 sessions of interventions compared with the comparative group.

Background: Individuals with forward head posture (FHP) have neck pain. To correct the FHP, a posture correction band is commonly used. However, we do not know the posture correction band influenced the pulmonary function in individuals with FHP. Objects: This study aimed to elucidate the effects of the posture correction band on the pulmonary function in young adults with neck pain and FHP and to monitor how the pulmonary function changed over time. Methods: Twenty subjects with chronic neck pain and forward head posture were recruited. Subjects performed pulmonary function test four times: before, immediately, and 2 hours after wearing the postural band, and immediately after undressing the postural band. Vital capacity (VC), forced vital capacity (FVC), peak expiratory flow (PEF), and forced expiratory volume at one second (FEV1) were measured. The modified Borg dyspnea scale was used to measure each subject’s responses to the posture correction band. The mixed-effect linear regression was used to the effect of the posture correction band over time. Results: There were no significant differences in VC, FVC, PEF, FEV1 values over time (p > 0.05), although all values slightly decreased after applying posture correction band. However, the score of the modified Borg scale significantly changed after wearing the postural bands (p < 0.05), indicating the subject felt discomfort with posture correction band during breathing. Conclusion: Because the posture correction band did not change the pulmonary function over time, but it induces psychological discomforts during breathing in people with FHP. Therefore, this posture correction band can be used for FHP realignment after discussion with the subjects.

Objective: This review aims to assess the effectiveness of yoga for neck pain. Methods: Three electronic databases (PubMed/Medline, Scopus, and Web of Science) were searched to identify studies on ...

Background: This study was conducted to investigate the effect of Dalk and Ghamz on pain and disability in patients with nonspecific chronic neck pain. Patients and Methods: This study was conducted on 37 patients with nonspecific chronic neck pain. Dalk and Ghamz massage were performed once a week for four sessions and the neck pain was evaluated by visual analog scale (VAS). In addition, the neck disability index (NDI) was used to assess the disability related to neck disorder. Data were analyzed with the SPSS software. Results: Among 37 patients, 85.5% were female and 13.5% were male. A significant decrease in VAS score was observed during the study (F = 57.77, p < 0.001). The NDI score decreased from 27.27 ± 5.83 to 19.08 ± 7.71 (p < 0.001). Conclusion: Dalk and Ghamz massage in patients with nonspecific neck pain could reduce pain and disability.

While neck pain can be severely disabling and costly, treatment options have shown moderate evidence of effectiveness.The objective of this study was to explore the effects of a 4-week active program based on myofascial release and neurodynamics on trigger point (TrP) examination, pain, and functionality in patients with chronic neck pain.Randomized controlled trial. A total of 40 patients with chronic neck pain were randomly allocated to an experimental or a control group (n = 20). The primary outcome measure was TrP examination. Secondary outcomes were pain, assessed with the Brief Pain Inventory and a visual analogue scale, and functionality, evaluated with the Neck Outcome Score.A between-group analysis showed significant differences (A 4-week self-administered program for patients with chronic neck pain was effective in reducing the presence of active TrPs. Pain severity, average pain, and some aspects of functionality also improved significantly after the intervention.

Amaç: Kronik spinal ağrı postural control kaybına yol açan bir durumdur. Egzersiz, postural kontrolü artırmada kullanışlıdır fakat kronik boyun ağrılı hastalarda (KBAH) Pilates egzersizlerinin postural kontrolü artırdığına yönelik kanıtlar yetersizdir. Çalışmanın amacı KBAH’da Pilates egzersizlerinin postural kontrole etkisinin araştırmaktı.Gereç ve Yöntem: Otuz altı KBAH randomize olarak iki gruba ayrıldı: Pilates (n=18) ve ev egzersiz (kontrol) grubu (n=18). Her iki gruba sekiz haftalık Pilates ve ev egzersiz eğitimi uygulandı. Postüral kontrolü değerlendirmek için kararlılık sınırları, postural stabilite ve klinik duyusal etkileşim denge testleri kullanıldı. Değerlendirmeler eğitim seanslarının tamamlandığı 8. haftada tekrarlandı. Bulgular: Ağrı, özürlülük, toplam kararlılık sınırları ve toplam postural stabilite skorları her iki grupta da gelişti. Anteroposterior postural stabilite ve gözler açık-kapalı sert zemin duyusal etkileşim denge sadece Pilates grubunda anlamlı şekilde gelişme gösterdi. Gruplar arası analizlerde Pilates eğitimi, anteroposterior postural stabiliteyi artırmada control grubuna göre üstün etki gösterdi. Sonuç: Pilates egzersizleri anteroposterior postural stabilite ve duyusal etkileşim dengenin gelişmesini sağlamada kullanışlı olabilir. Pilates eğitimi, KBAH’da postural kontrolü geliştirmek istendiğinde fizyoterapi programlarına dahil edilebilir., Purpose: Chronic spinal pain is a condition that causes loss of postural control. Exercise is useful to improve postural control however there has been lack of evidence that Pilates exercises increases postural control in patients with chronic neck pain (PwCNP). The aim of the study was to determine the effects of Pilates exercises on postural control in PwCNP.Materials and Methods: Thirty-six PwCNP randomly divided into two groups: Pilates (n=18) and home exercise (control) group (n=18). Eight-week Pilates and home exercise training performed for both groups. Limits of stability, postural stability and clinical test for sensory interaction balance tests were used to evaluate postural control. Evaluations were repeated in 8th week, when training sessions were completed. Results: Pain, disability, overall limits of stability and overall postural stability scores were improved for both groups. Anteroposterior postural stability and eyes open-eyes closed firm surface sensory interaction for balance showed significant improvement only in Pilates group. Pilates training showed superior effect over home exercise group for improving anteroposterior postural stability in between group analysis. Conclusion: Pilates exercises can be useful to provide improvement in anteroposterior postural stability and sensory interaction for balance. Pilates training should be included physical therapy programs when postural control improvement is desired in PwCNP.

Postoperative neck pain is a relatively common consequence of cervical spine surgeries such as anterior cervical discectomy with fusion and laminoplasty. Botulinum toxin injections are a relatively new treatment option to target muscle spasms, a possible cause of postoperative neck pain. This systematic review aims to evaluate the current literature highlighting the utilization of botulinum toxin for treating postoperative neck pain. The literature search resulted in one preliminary case–control trial, one case series and one case report. The use of Botox in these studies had promising benefits on postoperative neck pain, by reducing visual analog scores and improving objective measures of muscle tone such as cervical lordosis angle. While not seen in these studies, the use of botulinum toxin injections into the muscles of the region of the head, neck, and shoulder is not without risks such as focal muscle loss, joint instability, and respiratory and swallowing difficulty. With this in mind, while botulinum toxin may be a promising treatment for these patients, further well-designed studies are needed to further assess the treatments efficacy and safety in this patient population.

Introduction: Cervical joint dysfunction may interfere with the sensorimotor afferent response, interfering with neck neck Joint Position Sense error (JPS). Objective: The aim of this study was to evaluate the influence of Cervical Spine Manipulation (CSM) on neck JPS error in patients with chronic neck pain. Method: 21 patients with chronic neck pain were divided into 2 groups: Spinal Manipulation Group (MG) or Sham Group (SG) who received 4 sessions of CSM and Sham CSM respectively. JPS was assessed in three different time frames: 1) pre-intervention; 2) Right after the first intervention (post-intervention 1); and 3) After a chronic intervention (post-intervention 2). The outcome measured in this study was the head reposition accuracy test with the Revel’s Test. Results: The JPS showed no significant differences between pre- and post-intervention 1 and 2 for any of the assessed groups. Conclusion: We conclude that, for this sample, neither the CSM nor the Sham CSM statistically changed the JPS error for neither groups. We believe that the changes in JPS after CSM were concealed because the ability of other sensory system information to compensate for inadequacies in any other component. Therefore, more studies have to be done with a stronger methodological rigor, clinical prediction rule for spinal manipulation, bigger sample and a blind assessment.

Objective: The aim of this study was to compare the effectiveness of scapular exercises alone and combined with cognitive functional therapy in treating patients with chronic neck pain and scapular downward rotation impairment. Design: Single-blind randomized controlled trial. Setting: Outpatient. Subjects: A total of 72 patients (20–45 years old) with chronic neck pain were studied. Intervention: Allocation was undertaken into three groups: scapular exercise ( n = 24), scapular exercise with cognitive functional therapy ( n = 24) and control ( n = 24) groups. Each programme lasted three times a week for six weeks. Main outcomes: The primary outcome measure was pain intensity measured by the visual analogue scale scores. The secondary outcome measures included kinesiophobia and muscles activity. Results: Statistically significant differences in pain intensity were found when multidisciplinary physiotherapy group including a cognitive functional approach was compared with the scapular exercise alone group at six weeks (effect size (95% CI) = −2.56 (−3.32 to −1.80); P = 0.019). Regarding kinesiophobia, a significant between-group difference was observed at six-week (effect size (95% CI) = −2.20 (−2.92 to −1.49); P = 0.005), with the superiority of effect in multidisciplinary physiotherapy group. A significant between-group differences was observed in muscle activity. Also, there were significant between-group differences favouring experimental groups versus control. Conclusion: A group-based multidisciplinary rehabilitation programme including scapular exercise plus cognitive functional therapy was superior to group-based scapular exercise alone for improving pain intensity, kinesiophobia and muscle activation in participants with chronic neck pain.

BACKGROUND CONTEXT Multisensory afferent inputs to the cervical spine affect the generation of neck muscle control. Chronic neck pain (CNP) and muscle fatigue are factors that disturb somatosensory function. Whether they affect postural control under self-initiated perturbation in daily activities is still unclear. PURPOSE To investigate the effect of CNP and neck flexor muscle fatigue on muscle control strategy and postural control in young patients performing voluntary shoulder flexion movements. STUDY DESIGN Cross-sectional case-control study. PATIENT SAMPLE Twenty-five patients with CNP and 25 age-matched asymptomatic controls. OUTCOME MEASURES The postural sway, muscle onset time, and activation level of the erector spinae, rectus abdominal, semispinalis capitis (SSC), and sternocleidomastoid (SCM) muscles were recorded and analyzed using two-way ANOVA to evaluate the interaction of CNP and muscle fatigue on standing balance and muscle control upon self-initiated perturbations. METHODS All participants were instructed to perform shoulder flexion movements in the standing position before and after a neck flexor muscle fatigue exercise under either the eyes-open or eyes-closed condition. RESULTS The CNP group exhibited significantly larger body sway, greater neck muscle activation (SCM and SSC), and longer onset time of neck flexor muscle (SCM) compared with the control group. The CNP group also demonstrated a trend of greater postural sway and shorter muscle onset under the eyes-closed condition than those under the eyes-open condition. After muscle fatigue, the CNP group further exhibited (1) greater body sway during the eyes-open condition but decreased body sway during the eyes-closed condition, (2) higher activation of the neck flexor (SCM) and lower activation of the trunk extensor (erector spinae), and (3) early onset of the neck muscles (SCM and SSC). CONCLUSIONS CNP causes poor postural control and altered neck muscle control patterns. The addition of neck flexor muscle fatigue further decreases balance stability and provokes a protective neck muscle control strategy during the shoulder flexion movement. Those findings facilitate the understanding of the strategies adopted by patients and suggest that neck endurance training programs may be beneficial to improve whole postural control in patients with CNP.

Visual disturbances are commonly reported in patients with neck pain. Smooth pursuit neck torsion (SPNT) test performed in neutral position and with trunk rotated under the stationary head has been used to discriminate between those with cervical component and those without. However, no studies investigated the reliability of the SPNT-test in patients with chronic neck pain and healthy controls. The aim of this study was to assess inter-visit reliability of the SPNT-test while applying different amplitudes and velocities of target movement. Thirty-two controls and thirty-one patients were enrolled in the study. The SPNT-test was performed in neutral position and through 45° torsion positions. The test was performed at 20°/s, 30°/s and 40°/s velocities and at 30°, 40° and 50° amplitudes of cyclic sinusoidal target movements. Interclass correlation coefficient and smallest detectable change were calculated for parameters of gain and SPNT-differences. In patients, moderate to good reliability was observed for gain at 40° and 50° amplitudes and for 20°/s and 30°/s velocities, while moderate to excellent reliability for gain was observed in controls. Both groups presented with moderate to good reliability for SPNT-difference. Our findings imply that amplitudes of 40° and 50° and velocities of 20°/s and 30°/s are the most reliable and should be applied in future studies assessing oculomotor functions during the SPNT test.

Aim of the study: To study the correlation between neck pain, forward head posture and protracted shoulders in students aged 18-25yrs with chronic neck pain. 36 subjects, male and female were included in this cross s Material and Method: ectional, correlation study as per the inclusion and exclusion criteria. A written informed consent was signed by the subjects in their own language. Neck pain was measured using Numerical Rating Scale (NRS), Forward Head Posture (FHP) was measured using CVA angle by photogrammetry and Protracted Shoulders were measured using a Double Square Instrument. The results were compared and correlated using appropriate statistical tools. There was no signicant Results: correlation between CVA and protracted shoulders with severity of neck pain (p=0.54 and p= 1.64 respectively) in students aged 18-25 years. The comparison of CVA values in students with and without pain was signicant (p

Background: Chronic neck pain (CNP) is common, but methods that focus on the cervical spine have not met the patients' medical expectations.Objective: To investigate the global postural difference between students with CNP and healthy people.Design: Cross-sectional study.Methods: Twenty-seven healthy college students without neck pain and 31 students with CNP were recruited and allocated into a control group and a CNP group. Differences in standing postural indicators between the two groups were compared.Results: Compared to the control group, the leg length discrepancy and the right rearfoot angle were larger and the anterior lower limb alignment angle was smaller. In the sagittal plane, the left sagittal lower limb alignment and right cervical alignment angles were larger, while the left and right sagittal body alignment angles in the CNP group were smaller. The odds ratio calculation for the trunk forward lean, right foot valgus, and knee flexion on both sides indicated that these are risk factors for CNP, while knee varus is not a risk factor for CNP. The remaining abnormal postures were shown not to be associated with CNP.Limitation: This study did not conduct in-depth research on the physiological state of the muscles, joints, and other structures, and we did not apply these theories to practice.Conclusions: Abnormal posture in students with CNP is mainly concentrated in the sagittal plane. Trunk forward lean, foot valgus, and knee flexion on both sides are risk factors for CNP.

Introduction: Chronic neck pain is a common complaint among office workers. The aim of the present study was to compare the efficacy of a high-intensity laser and physiotherapy in office workers who were diagnosed with chronic non-specific neck pain.Methods: This study was a single-blind randomized controlled trial, with parallel allocation. Sixty office workers with chronic neck pain, aged between 25 and 55 years, participated in the study. The participants were randomly divided into two groups: photobiomodulation (by a high-level laser) and physiotherapy. Visual analog scale (VAS), Neck Disability Index (NDI), Neck Pain and Disability Scale (NPDS), and Bournemouth Questionnaire (BQN) were completed on three occasions (before, immediately, and 2 weeks after the intervention) to assess and compare the efficacy of the high-intensity laser and physiotherapy in neck pain. Data were analyzed by SPSS 23 software using the chi-square test, Student’s t-test, multivariate tests, and Fisher’s exact test.Results: The mean age of the participants was 37.53±9.52 and 41.16±7.85 years in physiotherapy and laser therapy respectively. The VAS score and NDI scores decreased after both kinds of interventions, and the effect of photobiomodulation was significantly higher than physiotherapy (P

Purpose To pilot feasibility and assess preliminary effectiveness of standard and culture-sensitive Pain Neuroscience Education (PNE) among Hausa-speaking patients with Chronic Neck Pain (CNP). Methods Adverts (online & clinic-based) were used to recruit Hausa-speaking patients with nonspecific CNP in Kano, Nigeria. Selected participants were randomized to culture-sensitive PNE (CSPNE), standard PNE (PNE), or control groups. Each group received bi-weekly sessions of exercise therapy for 6 weeks. Two sessions of PNE plus a home-based session were administered before exercise therapy in the PNE groups. Primary (pain-intensity and disability) and secondary (pain-knowledge, pain catastrophizing, and quality of life) outcomes were measured. The study was pre-registered (PACTR201902788269426). Results Fifty-three (out of 64) participants met the inclusion criteria. The majority of them were recruited through radio adverts (83%). Interventions were successfully administered and data collection was completed for the participants. About 15% and 17% drop-out rate was recorded before intervention (post-randomization) and during follow-up, respectively. Main results indicated that significant within-group improvements in disability and pain knowledge scores were found in favor of the PNE groups. Conclusion Culture-sensitive and standard PNE plus exercise therapy are feasible for Hausa patients with CNP, and current findings indicate support for reducing disability and increasing pain knowledge among them.Implications for rehabilitationBoth standard PNE and culture-sensitive PNE are feasible for administration as interventions for Hausa-speaking patients with CNP.Radio adverts may be necessary for patients recruitment in addition to specialists' referrals.Culturally sensitive PNE materials may be more desirable as an intervention option due to the low literacy level among the Hausa population.

OBJECTIVE This study aimed to assess pain sensitization in individual office workers with chronic neck pain through simple bedside quantitative sensory tests (QST) and to associate the findings with pain intensity and pain catastrophizing. METHODS One hundred-and-four office workers with chronic neck pain were assessed using pressure pain threshold (PPT) considering pain sensitive if PPTs were lower than 155 kPa in the upper trapezius and 245 kPa in the tibialis anterior. Pain sensitive to temporal summation of pain (TSP) was considered if there was a difference of two points in the visual analogue scale (VAS) comparing the first and last stimulus. Pain sensitive was considered to conditioned pain modulation (CPM) if the CPM-effect was less than -7.5%. Pain intensity and catastrophizing were measured using VAS and with the Pain Catastrophizing Scale. RESULTS There was at least one pain sensitive QST finding in 66 office workers (63.5%). TSP findings were the most common (48.1%), followed by PPT's (31.7%) and CPM (20.2%). Based on the QST findings, office workers were divided based on the number of individual QST findings, and higher pain intensity and pain catastrophizing scores were found in office workers with one (N = 38, P < 0.05) or two (N = 28, P < 0.05) compared with office workers with no QST findings (N = 38). CONCLUSION This study demonstrated that most office workers with chronic neck pain exhibit either widespread pressure hyperalgesia, facilitated TSP or impaired CPM, indicating pain sensitization within the central nervous system. This was associated with increased clinical pain and pain catastrophizing rumination scores.