Effect of global posture reeducation and of static stretching on pain, range of motion, and quality of life in women with chronic neck pain: a randomized clinical trial

Ana Cláudia Violino Cunha, Thomaz Nogueira Burke, Fábio Jorge Renovato França, Amélia Pasqual Marques, Ana Cláudia Violino Cunha, Thomaz Nogueira Burke, Fábio Jorge Renovato França, Amélia Pasqual Marques

Abstract

Purpose: Compare the effect of conventional static stretching and muscle chain stretching, as proposed by the global posture reeducation method, in the manual therapy of patients with chronic neck pain.

Methods: Thirty-three female patients aged 35 to 60 years old, 31 of whom completed the program, were randomly divided into two groups: The global posture reeducation group (n=15) performed muscle chain stretching, while the conventional stretching group (n=16) performed conventional static muscle stretching. Both groups also underwent manual therapy. Patients were evaluated before and after treatment and at a six-week follow-up appointment and tested for pain intensity (by means of visual analog scale), range of motion (by goniometry), and health-related quality of life (by the SF-36 questionnaire). The treatment program consisted of two 1-hour individual sessions per week for six weeks. Data were statistically analyzed at a significance level of p<0.05.

Results: Significant pain relief and range of motion improvement were observed after treatment in both groups, with a slight reduction at follow-up time. Quality of life also improved after treatment, except for the global posture reeducation group in one domain; at follow-up, there was improvement in all domains, except that both groups reported increased pain. There were no significant differences between groups

Conclusion: Conventional stretching and muscle chain stretching in association with manual therapy were equally effective in reducing pain and improving the range of motion and quality of life of female patients with chronic neck pain, both immediately after treatment and at a six-week follow-up, suggesting that stretching exercises should be prescribed to chronic neck pain patients.

Figures

Figure 1
Figure 1
Global posture reeducation stretching positions: a) posterior muscle chain stretching; b) anterior muscle chain stretching

References

    1. Merskey H, Bogduk N, editors. Classification of chronic pain. 2nd ed. Seattle: IASP Task Force on Taxonomy; 1994.
    1. Farina S, Tinazzi M, Le Pera D, Valeriani M. Pain-related modulation of the human motor cortex. Neurol Res. 2003;25:130–42.
    1. Häkkinen A, Salo P, Tarvainen U, Wiren K, Ylinen J. Effect of manual therapy and stretching on neck muscle strength and mobility in chronic neck pain. J Rehabil Med. 2007;39:575–9.
    1. Ylinen J. Physical exercises and functional rehabilitation for the management of chronic neck pain. Eura Medicophys. 2007;43:119–32.
    1. Bogduk N. Neck pain: an update. Aust Fam Physician. 1988;17:75–80.
    1. Bovim G, Schrader H, Sand T. Neck pain in general population. Spine. 1994;19:1307–9.
    1. Hanten WP, Olson SL, Russel JL, Lucio RM, Campbell AH. Total head excursion and resting head posture: normal and patient comparisons. Arch Phys Med Rehabil. 2000;81:62–6.
    1. Lee H, Nicholson LL, Adams RD. Cervical range of motion associations with subclinical neck pain. Spine. 2004;29:33–40.
    1. Barnsley L. Neck pain. In: Klippel JH, Dieppe PA, editors. Rheumatology. 2nd ed. London: Mosby-Year Book; 1998. pp. 41–2.
    1. Wang WTJ, Olson SL, Campbell AH, Hanten WP, Gleeson PB. Effectiveness of physical therapy for patients with neck pain: an individual approach using a clinical decision-making algorithm. Am J Phys Med Rehabil. 2003;82:203–18.
    1. Souchard PE. Principes et originalité de la reéducation posturale globale. Paris: Le Pousoë; 2003.
    1. Marques AP. Cadeias musculares: um programa para ensinar avaliação fisioterapêutica global. São Paulo: Manole; 2005.
    1. Bandy WD, Irion JM, Briggler M. The effect of time and frequency of static stretching on flexibility of the hamstring muscles. Phys Ther. 1997;77:1090–6.
    1. Bertherat T. Le corps a ses raisons: auto-guérison et anti-gymnastique . Paris: Seuil; 1976.
    1. Gajdosik RL, Bohannon RW. Clinical measurement of range of motion. Review of goniometry emphasizing reliability and validity. Phys Ther. 1987;67:1867–72.
    1. Tousignant M, de Bellefeuille L, O’Donoughue S, Grahovac S. Criterion validity of the cervical range of motion (CROM) goniometer for cervical flexion and extension. Spine. 2000;1(25):324–30.
    1. Ciconelli RM, Ferraz MB, Santos W. Tradução para a língua portuguesa e validação do questionário genérico de qualidade de vida SF-36. Rev Bras Reumatol. 1999;39:143–9.
    1. Bienfait M. Fáscias e pompages. São Paulo: Summus; 1999.
    1. Kisner C, Colby LA. Exercícios terapêuticos – fundamentos e técnicas. São Paulo: Manole; 1992.
    1. Halbertsma JPK, Mulder I, Göeken LNH, Eisma WH. Repeated passive stretching: acute effect on the passive muscle moment and extensibility of short hamstrings. Arch Phys Med Rehabil. 1999;80:407–14.
    1. Taylor DC, Brooks DE, Ryan JB. Viscoelastic characteristics of muscle: passive stretching versus muscular contractions. Med Sci Sports Exerc. 1997;29:1619–24.
    1. Ferreira GNT, Teixeira-Salmela LF, Guimarães CQ. Gains in flexibility related to measures of muscular performance: impact of flexibility on muscular performance. Clin J Sport Med. 2007;17:276–81.
    1. Chan SP, Hong Y, Robinson PD. Flexibility and passive resistance of the hamstrings of young adults using two different static stretching protocols. Scand J Med Sci Sports. 2001;11:81–6.
    1. Coutinho EL, Gomes ARS, França CN, Oishi J, Salvini TF. Effect of passive stretching on the immobilized soleus muscle fiber morphology. Braz J Med Biol Res. 2004;37:1853–61.
    1. Bronfort G, Evans R, Nelson B, Aker PD, Goldsmith CH, Vernon H. A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain. Spine. 2001;26:788–99.
    1. Vasseljen O, Johansen BM, Westgaard RH. The effect of pain reduction on perceived tension and EMG-recorded trapezius muscle activity in workers with shoulder and neck pain. Scand J Rehabil Med. 1995;27:243–52.
    1. Provinciali L, Baroni M, Illuminati L, Ceravolo MG. Multimodal treatment to prevent the late whiplash syndrome. Scand J Rehabil Med. 1996;28:105–11.
    1. Gross AR, Kay TM, Hondras M, Goldsmith C, Haines T, Peloso P, et al. Manual therapy for mechanical neck disorders: a systematic review. Man Ther. 2002;7:131–49.
    1. Evans R, Bronfort G, Nelson B, Goldsmith CH. Two-year follow-up of a randomized clinical trial of spinal manipulation and two types of exercise for patients with chronic neck pain. Spine. 2002;27:2383–9.
    1. McHugh MP, Magnusson SP, Gleim GW, Nicholas JA. Viscoelastic stress relaxation in human skeletal muscle. Med Sci Sports Exerc. 1992;24:1375–82.
    1. Rosário JLP, Sousa A, Cabral CMN, João SMA, Marques AP. Reeducação postural global e alongamento estático segmentar na melhora da flexibilidade, força muscular e amplitude de movimento: um estudo comparativo. Fisioter Pesq. 2008;15:12–8.
    1. Cabral CMN, Yumi C, Sacco ICN, Casarotto RA, Marques AP. Eficácia de duas técnicas de alongamento muscular no tratamento da síndrome femoropatelar: um estudo comparativo. Fisioter Pesq. 2007;14:48–56.
    1. Maluf SA. Efeito da reeducação postural global e do alongamento estático analítico em portadores de disfunção temporomandibular: um estudo comparativo [Tese] São Paulo: Faculdade de Medicina, Universidade de São Paulo; 2007.
    1. Vanti C, Generali A, Ferrari S, Nava T, Dosarelli T, Pillastrini P. La rieducazione posturale globale nelle patologie muscolo-scheletriche: evidenze scientifiche e indicazioni cliniche (Rééducation Posturale Globale in musculoskeletal diseases: scientific evidence and clinical practice) Reumatismo. 2007;59:192–201.
    1. Fernández-de-las-Peñas C, Alonso-Blanco C, Morales-Cabezas M, Miangolarra-Page JC. Two exercise interventions for the management of patients with ankylosing spondylitis. Am J Phys Med Rehabil. 2005;84:407–19.

Source: PubMed

3
S'abonner