Combining targeted instrument-assisted soft tissue mobilization applications and neuromuscular exercises can correct forward head posture and improve the functionality of patients with mechanical neck pain: a randomized control study

Abstract

Background The purpose of this study was to evaluate the short- and intermediate-term effects of the combined application of instrument-assisted soft tissue mobilization (IASTM) techniques and neuromuscular exercises of the cervical and thoracic area on the improvement of the functionality of patients with mechanical neck pain and accompanying forward head posture (FHP). Methods Twenty patients with neck pain and FHP were randomized and received eight treatment sessions of either targeted IASTM in combination with neuromuscular exercises (Group A) or a classical massage and the same set of exercises (Group B). The cervical vertebral angle (CVA), cervical range of motion (ROM) and strength, pain (visual analogue scale-VAS), and neck disability index (NDI) were measured throughout the treatment period and in the two- and four-week post-treatment periods. Results The combined application of IASTM and neuromuscular exercises contributed to a significantly greater improvement in CVA (Group A: + 7,2 deg vs Group B: + 1,1 deg) and NDI (Group A:-25,2 vs Group B:-5,8) than massage and the application of the same exercises. Both interventions improved cervical ROM and strength in the short term. Pain was also significantly improved in both groups in both the short (Group A VAS: − 5,97 vs Group B VAS: − 3,1) and intermediate term (Group A VAS:-5,5 vs Group B:-1,5). Conclusions Combining IASTM and exercises for the cervical and thoracic area can induce positive postural adaptations and improve the functional status of neck pain patients. Trial registration ISRCTN, ISRCTN54231174. Registered 19 March 2020 - Retrospectively registered.

Compare the Effects of Strengthening Exercises With and Without Soft Tissue Mobilization for the Management of Tension Neck Syndrome in Females: A Randomized Controlled Trial

“…While manual therapy techniques such as STM allow therapists to identify and treat soft tissue dysfunctions, therapeutic exercises increase muscle and ligament strength, improve the mobility of structures, and prevent tendon injuries. It may be that both treatments combined would have helped in the myofascial release, which would have formed the basis for the realignment of the impaired structures and creating appropriate postural adjustments, 29 thus more improvement in the experimental group as compared to the control group in the current study.…”

Description of massage interventions in randomised clinical trials for neck pain; a review using the TIDieR checklist

“…Via the updated search 14 additional trials were added (Figure 1), making a total of 35 studies including 2840 patients with neck pain. 37–71…”

“…Six studies included people with a mean age below 30. 37,38,41,42,67,71 Three studies include only females, 51,57,64 three studies did not specify the proportion of females 42,58,67 and one trial included only males, 50 all other studies included on average 71.3% females.…”

“…[43][44][45]53,55,56,58,60 In nine trials there was no control intervention without massage. 41,43,44,51,53,55,56,58,71 The duration of the massage intervention varied from one to eleven weeks, but most often was confined to two to four weeks. The number of sessions varied from one session 37,41,53,69 to 22 sessions, 57 with the majority between eight and twelve sessions.…”

“…Rodriguez-Huguet, 2020 56 66 1 0 0 0 0 1 0 0 0 0 0 0 2 Poor Ziaeifar, 2014 67 The definition and technique of the massage interventions varied widely across the included trials; including cupping, trigger point pressure massage and western style massage techniques (Table 1). Four trials evaluated Chinese or Thai massage, 38,40,47,52 three trials explicitly evaluated Swedish massage, 39,51,62 six trials performed Trigger point therapy/massage with or without the use of activator IV, 37,41,42,45,48,67 eight evaluated myofascial band or release, 37,45,[53][54][55][56]68,71 four trials performed ischaemic compression 41,42,45,58 and eight did not further specify their technique. 43,44,57,59,60,[64][65][66] Six trials evaluated different dosages and number of sessions of massage.…”