Effects of the Inclusion Thoracic Mobilization into Cranio-Cervical Flexor Exercise in Patients with Chronic Neck Pain

Abstract

Abstract.[Purpose] The purpose of this study was to investigate whether a cranio-cervical flexor exercise and thoracic mobilization are effective for muscular endurance (Endurance), visual analog scale (VAS) pain, and neck disability index (NDI) of patients with chronic neck pain.[Subjects] The subjects in this study were 53 patients who had chronic neck pain.[Methods] The experimental group (n=27) did both cranio-cervical flexor exercises and thoracic mobilizations and the control group (n=26) did cranio-cervical flexor exercises.[Results] A paired t-test analysis revealed significant pre-post score changes within both groups. The 2-way group time interaction for the repeated measures ANOVA was statistically significant for Endurance, VAS and NDI. The experimental group showed greater improvement in Endurance, with a between-group difference of 14.26 seconds, VAS pain, with a between-group difference of 2.02 points, and NDI, with a between-group difference of 2.07 points.[Conclusion] These results suggest that the combination of thoracic mobilization with cranio-cervical flexor exercise was more effective at increasing Endurance and reducing VAS pain and NDI.

Thoracic manipulation versus mobilization in patients with mechanical neck pain: a systematic review

“…Ten of the included studies were randomized controlled trials. 2,4,8,10,11,14,17,20,24,25 The remaining four studies included one quasi-experimental study lacking randomization 27 , one prospective cohort study 3 , one case series 26 , and one secondary analysis of a randomized controlled trial. 9 The 14 included studies had a mixed population of men and women.…”

“…The two most commonly used outcome measures in the included studies were the NPRS [2][3][4]10,11,14,20,26 and the NDI. [2][3][4]14,27 The physical impairment of cervical ROM was measured postintervention in six of the studies. [9][10][11]17,20,24,26 All of these have been shown to be reliable as measures of improvement in the clinic.…”

“…21 According to Maher 23 the reliability of the PEDro scale is considered 'fair to good' when studies were rated by a committee. Therefore, four individuals (KD, NH, SS, DW) individually rated the remaining five studies 3,9,10,26,27 , and discrepancies in the scoring of four studies 3,9,26,27 were resolved by discussion until a consensus was met. The trials included in this review were assigned methodological quality ratings proposed by Walser et al 16 A study was considered to be of 'high' quality if it received a PEDro score of seven or above.…”

Effects of Exercise on Deep Cervical Flexors in Patients with Chronic Neck Pain

“…Ko et al 17) investigated the effect of neck pain on daily activites, and found that NDI was decreased from 18.35 to 12.45 by cranio-cervical flexor exercise. Jull et al 28) found that NDI was decreased from 11.0 to 6.0 by cranio-cervical flexor exercise, and from 9.6 to 6.1 by muscle exercises.…”

“…To accurately perform the exercises, a pressurized biofeedback instrument (PBU-1 Weart Inc., Korea) was used to gradually increase the pressure from 20 mm Hg to 40 mm Hg in increments of 4 mm Hg 5) . On the first, second, third and fourth week, 12 repeats of 10-second, 15 repeats of 10-second, 15 repeats of 15-second, and 15 repeats of 20-second exercises were performed 17) , respectively. Each set was repeated three times and a one-minute rest was given between the sets.…”