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Open AccessArticle

Does the Addition of Manual Therapy Approach to a Cervical Exercise Program Improve Clinical Outcomes for Patients with Chronic Neck Pain in Short- and Mid-Term? A Randomized Controlled Trial

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Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain
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Faculty of Health Sciences, Universidad de Zaragoza, 50009 Zaragoza, Spain
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Physiotherapy Research Unit, Universidad de Zaragoza, 50009 Zaragoza, Spain
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Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, 08007 Barcelona, Spain
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Impact Laboratory, Aragón Institute of Engineering Research (I3A), Universidad de Zaragoza, 50018 Zaragoza, Spain
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Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(18), 6601; https://doi.org/10.3390/ijerph17186601
Received: 20 July 2020 / Revised: 26 August 2020 / Accepted: 2 September 2020 / Published: 10 September 2020
(This article belongs to the Section Health Care Sciences & Services)
Chronic neck pain is one of today’s most prevalent pathologies. The International Classification of Diseases categorizes four subgroups based on patients’ associated symptoms. However, this classification does not encompass upper cervical spine dysfunction. The aim is to compare the short- and mid-term effectiveness of adding a manual therapy approach to a cervical exercise protocol in patients with chronic neck pain and upper cervical spine dysfunction. Fifty-eight subjects with chronic neck pain and upper cervical spine dysfunction were recruited (29 = Manual therapy + Exercise; 29 = Exercise). Each group received four 20-min sessions, one per week during four consecutive weeks, and a home exercise regime. Upper flexion and flexion-rotation test range of motion, neck disability index, craniocervical flexion test, visual analogue scale, pressure pain threshold, global rating of change scale, and adherence to self-treatment were assessed at the beginning, end of the intervention and at 3- and 6-month follow-ups. The Manual therapy + Exercise group statistically improved short- and medium-term in all variables compared to the Exercise group. Four 20-min sessions of Manual therapy + Exercise along with a home-exercise program is more effective in the short- to mid-term than an exercise protocol and a home-exercise program for patients with chronic neck pain and upper cervical dysfunction. View Full-Text
Keywords: upper cervical spine; manual therapy; training; neck pain upper cervical spine; manual therapy; training; neck pain
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Rodríguez-Sanz, J.; Malo-Urriés, M.; Corral-de-Toro, J.; López-de-Celis, C.; Lucha-López, M.O.; Tricás-Moreno, J.M.; Lorente, A.I.; Hidalgo-García, C. Does the Addition of Manual Therapy Approach to a Cervical Exercise Program Improve Clinical Outcomes for Patients with Chronic Neck Pain in Short- and Mid-Term? A Randomized Controlled Trial. Int. J. Environ. Res. Public Health 2020, 17, 6601.

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