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ORIGINAL ARTICLE   Open accessopen access

European Journal of Physical and Rehabilitation Medicine 2023 February;59(1):42-53

DOI: 10.23736/S1973-9087.22.07554-2

Copyright © 2022 THE AUTHORS

This is an open access article distributed under the terms of the CC BY-NC-ND 4.0 license which allows users to copy and distribute the manuscript, as long as this is not done for commercial purposes and further does not permit distribution of the manuscript if it is changed or edited in any way, and as long as the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI) and provides a link to the license.

language: English

A randomized controlled trial on the effects of “Global Postural Re-education” versus neck specific exercise on pain, disability, postural control, and neuromuscular features in women with chronic non-specific neck pain

Tânia MENDES FERNANDES 1, 2, Roberto MÉNDEZ-SÁNCHEZ 2, 3, Ana S. PUENTE-GONZÁLEZ 2, 3, Francisco J. MARTÍN-VALLEJO 3, 4, Deborah FALLA 5, Carolina VILA-CHÃ 6, 7

1 Centro EMA, Guarda, Portugal; 2 Department of Nursing and Physical Therapy, University of Salamanca, Salamanca, Spain; 3 Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain; 4 Department of Statistics, Faculty of Medicine, University of Salamanca, Salamanca, Spain; 5 Center of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK; 6 Sports Department, Polytechnic Institute of Guarda, Guarda, Portugal; 7 Research Center in Sports Sciences, Health and Human Development (CIDESD), Vila Real, Portugal

BACKGROUND: Neck pain is associated with decreased health-related quality of life, decreased work productivity, and increased visits to health care providers.
AIM: The aim of this study was to assess the effectiveness of “Global Postural Re-education” (GPR) versus a neck specific exercise (SE) program on neck pain, disability, cervical range of movement, postural stability, and activity of the superficial cervical flexor muscles.
DESIGN: A parallel-group and single-blinded clinical trial.
SETTING: Community interventions.
POPULATION: Fifty women with non-specific chronic neck pain (NSCNP).
METHODS: Participants were randomly assigned to one of the two intervention groups (GPR [N.=25] or SE [N.=25]). Both interventions consisted of eight sessions of ~40 minutes duration, performed twice a week, for four weeks. Outcomes included neck pain intensity and disability, cervical range of motion (CROM), postural sway, and activity of the superficial neck flexor muscles during a cranio-cervical flexion test (CCFT). All outcomes were assessed twice before the intervention and immediately following eight treatment sessions over four weeks.
RESULTS: Both interventions were equally effective in reducing neck pain (P<0.001, ŋp2=0.770) and disability (P<0.001, ŋp2=0.306), improving neck mobility (P<0.001, 0.385≤ŋp2≤0.623, for all measurements) and decreasing the activity of the superficial cervical flexor muscles (P>0.001). Neither intervention altered postural sway.
CONCLUSIONS: Our results revealed that GPR and SE induced significant positive results in all measures apart from postural stability but with no difference between the interventions.
CLINICAL REHABILITATION IMPACT: “Global Postural Re-education” (GPR) and neck SE interventions are equally effective in reducing neck pain and disability, and improving neck mobility in women with NSCNP. Overall, this study indicates that GPR and SE interventions can be used to effectively manage patients with NSCNP.

KEY WORDS: Neck pain; Exercise; Electromyography; Postural balance

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