Cervical Pain, Posterior, Extracorporeal Shock Wave Therapy, Mechanical Neck Pain, Neck Pain, Neck Pain Musculoskeletal, Pain Threshold
Conditions
Keywords
Neck pain, Cervical joint position sense, Cervical range of motion, Pressure pain threshold, Extracorporeal shock wave therapy, Chronic mechanical neck pain
Brief summary
Purpose: The study aimed to determine whether adding extracorporeal shockwave therapy (ESWT) to a standardized physiotherapy program provides additional benefits for patients with chronic mechanical neck pain. Specifically, it examined effects on pain intensity, pressure pain threshold (PPT), neck disability index (NDI), cervical active range of motion (AROM), and joint position sense (JPS).
Detailed description
Study Summary Summary of the Study: Influence of Extracorporeal Shockwave Therapy in Patients with Mechanical Neck Pain Purpose: The study aimed to determine whether adding extracorporeal shockwave therapy (ESWT) to a standardized physiotherapy program provides additional benefits for patients with chronic mechanical neck pain. Specifically, it examined effects on pain intensity, pressure pain threshold (PPT), neck disability index (NDI), cervical active range of motion (AROM), and joint position sense (JPS). Key Details: * Study Design: Double-blinded, pretest-posttest controlled clinical trial. * Participants: 52 patients aged 18-29 with chronic mechanical neck pain for over 3 months. * Groups: * Group A: Standardized physiotherapy only (stretching, isometric exercises, posture training). * Group B: ESWT + standardized physiotherapy. * Duration: 4 weeks, 2 sessions/week (1 ESWT + 1 physiotherapy in Group B). * Assessments: NPRS for pain, pressure algometer for PPT, Arabic NDI, goniometer for AROM & JPS. * Results: * Adding ESWT significantly improved PPT, left cervical rotation AROM, cervical extension JPS, and right cervical rotation JPS. * No significant differences between groups in other measures. * Conclusion: ESWT combined with physiotherapy may enhance pain threshold, AROM in rotation, and proprioception compared to physiotherapy alone. Sources of Strength in the Study: 1. Double-blind design reduces bias. 2. Randomized allocation with adequate sample size determined by power analysis. 3. Use of validated measurement tools (NPRS, NDI Arabic version, Wagner algometer, standard goniometer). 4. Clearly defined inclusion/exclusion criteria ensuring sample homogeneity. 5. Use of standardized physiotherapy protocol enhances reproducibility.
Interventions
DEVICEExtracorporeal Shockwave therapy
Radial, pneumatic extracorporeal shockwave therapy: The ESWT was applied using the following treatment parameters: 2,000 pulses, intensity of 1 to 1.2 bars, and 10 Hz frequency
OTHERExercise
Stretch + isometrics + postural correction
Sponsors
Benha University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Masking description
Statistician and outcome assessor who is also an investigator.
Eligibility
Sex/Gender
ALL
Age
18 Years to 29 Years
Healthy volunteers
No
Inclusion criteria
1. The patients (both males and females) with chronic non-specific neck pain for more than three months. 2. The patient's age is between 18 and 29 years old. 3. The patient has at least one taut band at the upper fibers of the trapezius as described in assessment procedures. 4. patient's numeric pain rating scale (NPRS) was 3 to 8 out of 10
Exclusion criteria
1. Were treated for neck or shoulder pain during the last three months. 2. Had a neck or shoulder operation during the last two years. 3. Had any structural pathology of the cervical spine, such as disk prolapse, spinal stenosis, or cervical spondylosis. 4. Had a traumatic history, instability, and spasmodic torticollis. 5. Had cardiovascular, respiratory, or allergic disease or neck osteoarthritis. 6. Had homeostatic disorders. 7. Fibromyalgia, shoulder diseases (tendonitis, bursitis, capsulitis). 8. Inflammatory rheumatic diseases. 9. Severe psychiatric illness and other diseases that restrict physical loading, and pregnancy (Salo et al., 2010). 10. Patients with vertebrobasilar insufficiency and vertigo.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pressure pain threshold (PPT) | 4 weeks | The minimum amount of pressure applied to body tissue that a person perceives as pain, rather than just pressure, is measured by an algometer. Another definition is the point at which a sensation changes from pressure to pain. measured by an algometer. A higher score is better, and a lower score is worse. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Active cervical range of motion | 4 weeks | Active cervical range of motion in 6 directions: flexion, extension, sidebending in both directions, and rotation in both directions. The higher score is better, and the lower score is worse. |
| Joint position sense | 4 weeks | Joint position sense is measured by joint position error via the head repositioning test. The head repositioning test is the ability of the individual to detect the predetermined position again using the neck's sense of position and movement in 6 directions. The lower score is better, and the higher score is worse. The lowest score is zero. |
| Neck Pain | 4 weeks | Pain is an unpleasant sensation measured by numeric pain rating score (NPRS) The highest score is 10, and the lowest score is zero. Ten is maximum pain, and zero is no pain. The higher score is worse, and the lower score is better. |
| Neck disability index (NDI) | 4 weeks | The index displays the level of neck disability (questionnaire). The higher score is worse, and the lower score is better. Percentage score: The highest score is 100%, and the lowest score is 0%. Raw score: the lowest score is 0, and the highest score is 50. |
Countries
Egypt
Outcome results
None listed