Journal ArticleDOI
Supervised exercise with and without spinal manipulation performs similarly and better than home exercise for chronic neck pain: a randomized controlled trial.
Roni Evans,Gert Bronfort,Craig Schulz,Michele Maiers,Yiscah Bracha,Kenneth H. Svendsen,Richard H. Grimm,Timothy A. Garvey,Ensor E. Transfeldt +8 more
TLDR
Supervised strengthening exercise with and without spinal manipulation performed similarly, yielding better outcomes than home exercise particularly in the short term.Abstract:
Study design Randomized controlled trial using mixed methods. Objective To evaluate the relative effectiveness of high-dose supervised exercise with and without spinal manipulation and low-dose home exercise for chronic neck pain. Summary of background data Neck pain is a common global health care complaint with considerable social and economic impact. Systematic reviews have found exercise therapy (ET) to be effective for neck pain, either alone or in combination with spinal manipulation. However, it is unclear to what extent spinal manipulation adds to supervised exercise or how supervised high-dose exercise compares with low-dose home exercise. Methods Two hundred and seventy patients with chronic neck pain were studied at an outpatient clinic. Patients were randomly assigned one of the following interventions: (1) high-dose supervised strengthening exercise with spinal manipulation (exercise therapy combined with spinal manipulation therapy [ET + SMT]), (2) high-dose supervised strengthening exercise (ET) alone, or (3) low-dose home exercise and advice (HEA). The primary outcome was patient-rated pain at baseline and at 4, 12, 26, and 52 weeks. Secondary measures were disability, health status, global perceived effect, medication use, and satisfaction. Results At 12 weeks, there was a significant difference in patient-rated pain between ET + SMT and HEA (1.3 points, P 0.05; ET vs. HEA, 0.3 points, P > 0.05), linear mixed model analyses incorporating all time points yielded a significant advantage for the 2 supervised exercise groups (ET + SMT vs. HEA, P = 0.03; ET vs. HEA, P = 0.02). Similar results were observed for global perceived effect and satisfaction. Conclusion Supervised strengthening exercise with and without spinal manipulation performed similarly, yielding better outcomes than home exercise particularly in the short term. Various stakeholders' perspectives should be considered carefully when making recommendations regarding these therapies, taking into account side effects, preferences, and costs.read more
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Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States.
TL;DR: Clinical trial evidence for the efficacy and safety of several specific approaches-acupuncture, manipulation, massage therapy, relaxation techniques including meditation, selected natural product supplements, and yoga-as used to manage chronic pain and related disability associated with back pain, fibromyalgia, osteoarthritis, neck pain, and severe headaches or migraines are examined.
Journal ArticleDOI
Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment
Anita Gross,Pierre Langevin,Stephen J Burnie,Marie Sophie Bédard-Brochu,Brian Empey,Estelle Dugas,Michael Faber-Dobrescu,Cristy Andres,Nadine Graham,Charles H. Goldsmith,Gert Bronfort,Jan L. Hoving,Francis Leblanc +12 more
TL;DR: Randomised controlled trials undertaken to assess whether manipulation or mobilisation improves clinical outcomes for adults with acute/subacute/chronic neck pain suggest multiple sessions of cervical manipulation may be favoured over transcutaneous electrical nerve stimulation for pain reduction at short-term follow-up.
Journal ArticleDOI
The efficacy of manual therapy and exercise for treating non-specific neck pain: A systematic review.
TL;DR: It is shown that combining different forms of MT with exercise is better than MT or exercise alone, and the second one is that mobilization need not be applied at the symptomatic level(s) for improvements of NP patients.
Journal ArticleDOI
The Treatment of Neck Pain-Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline.
André Bussières,André Bussières,Gregory Stewart,Fadi Al-Zoubi,Philip Decina,Martin Descarreaux,Jill A. Hayden,Brenda Hendrickson,Cesar A. Hincapié,Isabelle Pagé,Steven R. Passmore,John Srbely,Maja Stupar,Joel Weisberg,Joseph Ornelas +14 more
TL;DR: This guideline replaces 2 prior chiropractic guidelines on NADs and WADs and suggests a multimodal approach including manual therapy, self-management advice, and exercise is an effective treatment strategy for recent-onset and persistent neck pain.
Journal ArticleDOI
Chronic neck pain and exercise interventions: frequency, intensity, time, and type principle.
TL;DR: Physiotherapy interventions using a multimodal approach appear to produce more beneficial outcomes in terms of increased strength, improved function, and health-related quality of life and reduced pain scores.
References
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Statistical Power Analysis for the Behavioral Sciences
TL;DR: The concepts of power analysis are discussed in this paper, where Chi-square Tests for Goodness of Fit and Contingency Tables, t-Test for Means, and Sign Test are used.
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TL;DR: In this article, it was shown that ignoring the process that causes missing data when making sampling distribution inferences about the parameter of the data, θ, is generally appropriate if and only if the missing data are missing at random and the observed data are observed at random, and then such inferences are generally conditional on the observed pattern of missing data.