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This study compared the effectiveness of pain neurophysiology education and neck/shoulder exercises with no intervention in adolescents with chronic idiopathic neck pain (CINP).
Forty three adolescents with chronic idiopathic neck pain were randomly allocated to receive pain neurophysiology education and shoulder/neck exercises (n=21) or no intervention (n=22). Data on pain intensity (Visual Analogue Scale), pain disability, neck flexor and extensor muscles endurance, scapulae stabilizers endurance, pain catastrophizing (Pain catastrophizing Scale), trait and state anxiety (State-Trait Anxiety Inventory) and knowledge of pain neurophysiology (Neurophysiology of Pain Questionnaire) were collected. Measurements were taken before and after the intervention.
Statistical analysis were performed using a mixed-methods ANOVA.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Education and exercise | Experimental | The intervention included neurophysiology of pain education and exercises. |
|
| No intervention | No Intervention | This group received no intervention as participants were students that were not seeking treatment for their pain. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| neurophysiology of pain education and exercises | Other | Pain neurophysiology education covered the neurophysiology of pain, transition from acute to chronic pain and the nervous system ability to modulate the pain experience. It was delivered in small groups (4 to 7 participants). A total of 4 sessions were delivered over 4 weeks (1 session per week). Each session took between 45 minutes and 1 hour. Exercises were aimed at increasing the endurance and strength of the deep neck flexor and extensor muscles and of the scapular muscles delivered over 3 sessions (the first session covered pain neurophysiology education only). Each exercise was performed in 3 series of 10 repetitions. The number of exercises targeting the same group of muscles increased from one in the 2nd session to 2/3 in the 4th session. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain intensity | Method of assessment - Visual analogue scale | At the beginning |
| Pain intensity | Method of assessment - Visual analogue scale | 5 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Neck pain frequency | Method of assessment - a question on neck pain frequency in the previous week (never, seldom, occasionally, often, always) | At the beginning |
| Neck pain frequency | Method of assessment - a question on neck pain frequency in the previous week (never, seldom, occasionally, often, always) |
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Inclusion Criteria:
Exclusion Criteria:
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| ID | Term |
|---|---|
| D019547 | Neck Pain |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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|
| 5 weeks |
| Neck pain duration | Method of assessment - a question on neck pain duration (how long have you have neck pain?) | At the beginning |
| Neck pain duration | Method of assessment - a question on neck pain duration (how long have you have neck pain?) | 5 weeks |
| Neck pain associated disability | Method of assessment - a disability index with 5 questions on neck pain associated disability | At the beginning |
| Neck pain associated disability | Method of assessment - a disability index with 5 questions on neck pain associated disability | 5 weeks |
| Neck flexor muscles endurance test | Method of assessment - physical test; the participant is in supine and he/she is asked to flex the upper cervical spine, move their head away from the couch approximately 2.5 cm and then maintain this position for as long as possible. The test result is the time (in seconds) that each participant holds the position. | At the beginning |
| Neck flexor muscles endurance test | Method of assessment - physical test; the participant is in supine and he/she is asked to flex the upper cervical spine, move their head away from the couch approximately 2.5 cm and then maintain this position for as long as possible. The test result is the time (in seconds) that each participant holds the position. | 5 weeks |
| Neck extensor muscles endurance test | Method of assessment - physical test; the participant is in prone and position, head neutral, and supporting 2 Kg weight hanging from it. Participants were asked to support this weight for as long as possible while maintaining the neutral head positioning. The test result is the time (in seconds) that each participant holds the position. | At the beginning |
| Neck extensor muscles endurance test | Method of assessment - physical test; the participant is in prone and position, head neutral, and supporting 2 Kg weight hanging from it. Participants were asked to support this weight for as long as possible while maintaining the neutral head positioning. The test result is the time (in seconds) that each participant holds the position. | 5 weeks |
| Scapular stabilizers' endurance test | Method of assessment - physical test; Method of assessment - physical test; Participants were standing with the shoulders and elbows flexed at 90º, while pulling both extremities of a dynamometer to reach 1 Kg of force. The test result is the time (in seconds) that each participants was able to hold this position. | At the beginning |
| Scapular stabilizers' endurance test | Method of assessment - physical test; Method of assessment - physical test; Participants were standing with the shoulders and elbows flexed at 90º, while pulling both extremities of a dynamometer to reach 1 Kg of force. The test result is the time (in seconds) that each participants was able to hold this position. | 5 weeks |
| State-trait anxiety inventory | Method of assessment - scale | At the beginning |
| State-trait anxiety inventory | Method of assessment - scale | 5 weeks |
| Pain Catastrophizing Scale | Method of assessment - scale | At the beginning |
| Pain Catastrophizing Scale | Method of assessment - scale | 5 weeks |
| Neurophysiology of pain questionnaire | Method of assessment - questionnaire | At the beginning |
| Neurophysiology of pain questionnaire | Method of assessment - questionnaire | 5 weeks |
| Patients' Global Impression of Change | Method of assessment - scale | 5 weeks |