Comparison of the Effect of Eight Weeks of Neck Stabilization Exercises with and without Thoracic Mobility Exercises on Pain, Proprioception, and Posture of Women with Chronic ‎Neck Pain and Forward Head Posture

Document Type : Original Article

Authors

Department of Biomechanics and Sports Injuries, Faculty of Physical Education and Sports ‎Sciences, Kharazmi University, Tehran, Iran

Abstract

Purpose:
The effectiveness of neck stabilization exercises in reducing the pain of patients with neck pain has been reported in previous studies. Most of the interventions to improve thoracic mobility are dedicated to manual therapy, and the role of exercise therapy has received less attention. Therefore, the aim of this study was to compare the effect of neck stabilization exercises with and without thoracic mobility exercises on pain, proprioception, and posture of women with chronic neck pain and forward head posture.
Methods:
36 women with chronic neck pain and forward head posture were randomly divided into three groups of control, stabilization exercises, and stabilization exercises with thoracic mobility. The intervention groups did the exercises for 8 weeks, 3 sessions a week, and 45-60 minutes, and the control group continued their normal life. Pain, proprioception, and forward head posture angle were evaluated by visual analogue scale, cervical-cephalic relocation test, and craniovertebral angle, respectively. Data analysis was performed using repeated measure ANOVA and Bonferroni's post hoc test at an error level of 0.05 and using SPSS software version 26.
Results:
The stabilization exercises group with and without thoracic mobility showed significant improvement in proprioception, pain, and posture compared to the control group (p≤0.001). There was no significant difference between the experimental groups (p≥0.05). However, the stabilization exercises group with thoracic mobility had more improvement in posture and pain.
Conclusion:
Performing neck stabilization with and without thoracic mobility exercises is an effective intervention in improving posture, proprioception, and reducing pain in women with chronic neck pain. Therefore, the use of this exercise protocol is recommended as an effective treatment approach for women with neck pain.

Keywords

References

  1. Ganesh GS, Mohanty P, Pattnaik M, Mishra C. Effectiveness of mobilization therapy and exercises in mechanical neck pain. Physiother Theory Pract 2015; 31(2): 99-106.
  2. Ylinen J, Takala E-P, Kautiainen H, Nykänen M, et al. Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain. Eur J Pain 2004; 8(5): 473-478.
  3. Wu B, Yuan H, Geng D, Zhang L, Zhang C. The impact of a stabilization exercise on neck pain: a systematic review and meta-analysis. J Neurol Surg A Cent Eur Neurosurg 2020; 81(04): 342-347.
  4. Price J, Rushton A, Tyros I, Tyros V, Heneghan NR. Effectiveness and optimal dosage of exercise training for chronic non-specific neck pain: A systematic review with a narrative synthesis. PloS One 2020; 15(6): e0234511.
  5. Beneka A, Malliou P, Gioftsidou A. Neck pain and office workers: An exercise program for the workplace. ACSM's Health & Fitness Journal. 2014; 18(3): 18-24.
  6. Chiu T, Ku W, Lee M, Sum W, et al. A study on the prevalence of and risk factors for neck pain among university academic staff in Hong Kong. J Occup Rehabil 2002; 12(2): 77-91.
  7. Im B, Kim Y, Chung Y, Hwang S. Effects of scapular stabilization exercise on neck posture and muscle activation in individuals with neck pain and forward head posture. J Phys Ther Sci 2015; 28(3): 951-955.
  8. Ghaderi F, Jafarabadi MA, Javanshir K. The clinical and EMG assessment of the effects of stabilization exercise on nonspecific chronic neck pain: A randomized controlled trial. J Back Musculoskelet Rehabil 2017; 30(2): 211-219.
  9. Kuo Y-L, Lee T-H, Tsai Y-J. Evaluation of a cervical stabilization exercise program for pain, disability, and physical impairments in university violinists with nonspecific neck pain. Int J Environ Res Public Health 2020; 17(15): 5430.
  10. Celenay ST, Akbayrak T, Kaya DO. A comparison of the effects of stabilization exercises plus manual therapy to those of stabilization exercises alone in patients with nonspecific mechanical neck pain: a randomized clinical trial. J Orthop Sports Phys Ther 2016; 46(2): 44-55.
  11. Jull G, Falla D, Treleaven J, Hodges P, Vicenzino B. Retraining cervical joint position sense: the effect of two exercise regimes. J Orthop Res 2007; 25(3): 404-412.
  12. Moreira C, Bassi AR, Brandão MP, Silva AG. Do patients with chronic neck pain have distorted body image and tactile dysfunction? Eur J Phys 2017; 19(4): 215-221.
  13. Strimpakos N, Sakellari V, Gioftsos G, Kapreli E, Oldham J. Cervical joint position sense: an intra-and inter-examiner reliability study. Gait Posture 2006; 23(1): 22-31.
  14. Şekeröz S, Aslan Telci E, Akkaya N. Effect of chronic neck pain on balance, cervical proprioception, head posture, and deep neck flexor muscle endurance in the elderly.Turkish Journal of Geriatrics 2019; 22(2): 163-171.
  15. Graham N, Gross AR, Carlesso LC, Santaguida PL, et al. Suppl 4: An ICON Overview on Physical Modalities for Neck Pain and Associated Disorders. Open Orthop J 2013; 7: 440-460.
  16. Griffiths C, Dziedzic K, Waterfield J, Sim J. Effectiveness of specific neck stabilization exercises or a general neck exercise program for chronic neck disorders: a randomized controlled trial. J Rheumatol 2009; 36(2): 390-397.
  17. Joshi S, Balthillaya G, Neelapala YR. Thoracic posture and mobility in mechanical neck pain population: A review of the literature. Asian spine J 2019; 13(5): 849-860.
  18. Cleland J, Selleck B, Stowell T, Browne L, Alberini S, St. Cyr H, et al. Short-term effects of thoracic manipulation on lower trapezius muscle strength. JMMT 2004; 12(2): 82-90.
  19. Dareh-Deh HR, Hadadnezhad M, Letafatkar A, Peolsson A. Therapeutic routine with respiratory exercises improves posture, muscle activity, and respiratory pattern of patients with neck pain: a randomized controlled trial. Sci Rep 2022; 12(1): 4149.
  20. Cleland JA, Glynn P, Whitman JM, Eberhart SL, et al. Short-term effects of thrust versus nonthrust mobilization/manipulation directed at the thoracic spine in patients with neck pain: a randomized clinical trial. Phys Ther 2007; 87(4): 431-440.
  21. Lau HMC, Chiu TTW, Lam T-H. The effectiveness of thoracic manipulation on patients with chronic mechanical neck pain–a randomized controlled trial. Man Ther 2011; 16(2): 141-147.
  22. Cho J, Lee E, Lee S. Upper thoracic spine mobilization and mobility exercise versus upper cervical spine mobilization and stabilization exercise in individuals with forward head posture: a randomized clinical trial. BMC Musculoskelet Disord 2017; 18(1): 525.
  23. Lee H-j, Kim S-y. Effects of thoracic mobility exercise on cervicothoracic function, posture and pain in individuals with mechanical neck pain. Phys Ther Korea 2019; 26(3): 42-56.
  24. Park G-W, An J, Kim S-W, Lee B-H. Effects of sling-based thoracic active exercise on pain and function and quality of life in female patients with neck pain: A randomized controlled trial. Healthcare 2021; 9(11): 1415
  25. Collins SL, Moore RA, McQuay HJ. The visual analogue pain intensity scale: what is moderate pain in millimetres? Pain 1997; 72(1-2): 95-97.
  26. Salahzadeh Z, Maroufi N, Ahmadi A, Behtash H, et al. Assessment of forward head posture in females: observational and photogrammetry methods. J Back Musculoskelet Rehabil 2014; 27(2): 131-139.
  27. Chen X, Treleaven J. The effect of neck torsion on joint position error in subjects with chronic neck pain. Man Ther 2013; 18(6): 562-567.
  28. Mazidi M, Sakinepoor A, Letafatkar A. Effect of Sensorimotor Training on Proprioception, Posture and Pain in Subjects with Chronic Non-specific Neck Pain. IJRN 2021; 7(4): 61-71. [Persian]
  29. tohidi Serveh, Hadadnezhad Malihe, Shojaedin Sadreddin. The effect of adding gaze direction recognition to stabilizing exercises on painintensity, muscular endurance and proprioception of women with chronic non-specific neck pain. Journal of Anesthesiology and Pain 2021; 11(4): 55-67.
  30. Dusunceli Y, Ozturk C, Atamaz F, Hepguler S, Durmaz B. Efficacy of neck stabilization exercises for neck pain: a randomized controlled study. J Rehabil Med 2009; 41(8): 626-631.
  31. Kamble A, Naik S, Phadke S, Tilak P. Analysis of Working Posture Using Kinovea Software to Identify the Incidence of Forward Head Among Bank Employees: A Cross-Sectional Study. IJFMR 2022; 4(6): 1-8.
  32. Roren A, Mayoux-Benhamou M-A, Fayad F, Poiraudeau S, et al. Comparison of visual and ultrasound based techniques to measure head repositioning in healthy and neck-pain subjects. Man Ther 2009; 14(3): 270-277.
  33. Akodu A, Nwanne C, Fapojuwo O. Efficacy of neck stabilization and Pilates exercises on pain, sleep disturbance and kinesiophobia in patients with non-specific chronic neck pain: A randomized controlled trial. J Bodyw Mov Ther 2021; 26: 411-9.
  34. Shiravi S, Letafatkar A, Bertozzi L, Pillastrini P, Khaleghi Tazji M. Efficacy of abdominal control feedback and scapula stabilization exercises in participants with forward head, round shoulder postures and neck movement impairment. Sports Health 2019; 11(3): 272-279.
  35. Jull G, Sterling M, Kenardy J, Beller E. Does the presence of sensory hypersensitivity influence outcomes of physical rehabilitation for chronic whiplash?–A preliminary RCT. Pain 2007; 129(1-2): 28-34.
  36. Khosrokiani Z, Letafatkar A, Hadadnezhad M, Sokhanguei Y. Comparison the effect of pain neuroscience and pain biomechanics education on neck pain and fear of movement in patients with chronic nonspecific neck pain during the COVID-19 pandemic. Pain Ther 2022; 11(2): 601-611
  37. Mehri A, Letafatkar A. Efficacy of corrective exercise intervention on forward head angle, pain and timing of superficial neck muscles activation during posterior-anterior perturbation in women with chronic neck pain. Medical J Tabriz Uni Med Sciences Health Services 2018; 40(1): 66-76.
  38. Chung S, Jeong Y-G. Effects of the craniocervical flexion and isometric neck exercise compared in patients with chronic neck pain: A randomized controlled trial. Physiother Theory Pract 2018; 34(12): 916-925.
  39. Rudolfsson T, Djupsjöbacka M, Häger C, Björklund M. Effects of neck coordination exercise on sensorimotor function in chronic neck pain: a randomized controlled trial. J Rehabil Med 2014; 46(9): 908-914.
  40. Oxland TR. Fundamental biomechanics of the spine—What we have learned in the past 25 years and future directions. J Biomech 2016; 49(6): 817-832.
  41. Jang H-J, Hughes LC, Oh D-W, Kim S-Y. Effects of corrective exercise for thoracic hyperkyphosis on posture, balance, and well-being in older women: a double-blind, group-matched design. J Geriatr Phys Ther 2019; 42(3): E17-E27.
Journal of Paramedical Sciences & Rehabilitation
Volume 13, Issue 1
April 2024
Pages 27-41

Files

Share

How to cite

Statistics