Effects of Global Postural Reeducation versus Specific Therapeutic Neck Exercises on Pain, Disability, Postural Control, and Neuromuscular Efficiency in Women with Chronic Nonspecific Neck Pain: Study Protocol for a Randomized, Parallel, Clinical Trial

Tânia Mendes-Fernandes, Ana Silvia Puente-González, Manuel Antonio Márquez-Vera, Carolina Vila-Chã, Roberto Méndez-Sánchez, Tânia Mendes-Fernandes, Ana Silvia Puente-González, Manuel Antonio Márquez-Vera, Carolina Vila-Chã, Roberto Méndez-Sánchez

Abstract

Background: Chronic nonspecific neck pain is the most frequent form of neck pain. It is more prevalent in women, and a costly public health issue. It is commonly associated with biomechanical, functional, proprioceptive, and postural impairments. The aim of this trial is to compare the effects of global postural exercises versus specific therapeutic exercises on neck pain, disability, mobility, pressure pain threshold, kinesiophobia, pain catastrophizing, postural control, and neuromuscular efficiency in women with chronic nonspecific neck pain. Methods and analysis: This study is a randomized, parallel-group and single blinded clinical trial. Sixty-two women with nonspecific chronic neck pain were recruited from the community of Guarda, Portugal, and randomly assigned to one of two intervention groups: (1) global postural reeducation (GPR group), (2) specific therapeutic exercises (STE group). The intervention was carried out over 4 weeks, with two sessions per week (eight sessions), and applied by a physiotherapist and paired with a daily individual at-home-exercise program. Primary outcomes are neck pain intensity and disability (Numerical Pain Rating Scale, Neck Disability Index). Secondary outcomes are cervical mobility and pressure pain threshold (CROM, algometry), attitude to pain (kinesiophobia, pain catastrophizing), standing postural control (Center of Pressure (COP) displacements), and neuromuscular efficiency (electromyography). There are four points of evaluation where the outcomes were assessed twice before the intervention, 1 week apart, and the two post-intervention assessments will be carried out after four and eight sessions. The objective was to increase scientific knowledge of different exercise modalities, such as global postural reeducation, in musculoskeletal disorders.

Trial registration: ClínicalTrials.gov (NCT04402463), prospectively registered (data 22 May 2020).

Keywords: chronic neck pain; disability; electromyography; global postural reeducation; neuromuscular efficiency; postural control; postural exercise; therapeutic exercise.

Conflict of interest statement

R.M.-S. and A.S.P.-G. received fees from the University of Salamanca, for services rendered to THERMA SL as physiotherapists (art. 83 LOU) during 2020. For the remaining authors no conflicts were declared. R.M.-S. has some shareholdings in the company Therma SL.

Figures

Figure 1
Figure 1
Flow chart of participants in the study. GPR: Global Postural Reeducation; STE: Specific Therapeutic Exercises.
Figure 2
Figure 2
The 3 positions of the Global Postural Reeducation intervention. (A) Lying posture to stretches the anterior muscle chain; (B) lying posture to stretches the posterior muscle chain; (C) standing posture.
Figure 3
Figure 3
Specific Therapeutic Exercise intervention. Exercises with visual feedback with a laser sensor (Motion Guidance).
Figure 4
Figure 4
Cranio-cervical flexion test (CCFT) with visual feedback (Stabilizer).

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