The efficacy of Sustained Natural Apophyseal Glides with and without Isometric Exercise Training in Non-specific Neck Pain

Abid Ali, Syed Shakil-Ur-Rehman, Fozia Sibtain, Abid Ali, Syed Shakil-Ur-Rehman, Fozia Sibtain

Abstract

Objective: To determine the efficacy of Sustained Natural Apophyseal Glides (SNAGs) with and without Isometric Exercise Training Program (IETP) in Non-specific Neck Pain (NSNP) Methods: This randomized control trial of one year duration was conducted at out-patient department of Physiotherapy and Rehabilitation, Khyber Teaching Hospital (KTH) Peshawar, Pakistan from July 2012 to June 2013. The sample of 102 patients of NSNP were randomly selected through simple random sampling technique, and placed into two groups. The SNAGs manual physical therapy technique with IETP was applied on 51 patients in group A and SNAGs manual physical therapy techniques was applied alone on 51 patients in group B. The duration of intervention was 6 weeks, at 4 times per week. The Neck Disability Index (NDI) and Visual Analog Scale (VAS) for neck pain were assessment tools used for all patients before and after 6 weeks of physical therapy intervention. All the patients were assessed through NDI and VAS before intervention and at the completion of 6 weeks program. The data of all 102 was analyzed by SPSS-20 and statistical test was applied at 95% level of significance determine the efficacy of both the treatments interventions and compare with each other.

Results: The patients in group A, treated with SNAGs and followed by IETP for 6 weeks, demonstrated more improvement in pain and physical activity as assessed by VAS (p=0.013) and NDI (p=0.003), as compared to the patients treated with SNAGS alone, as pain and function assessed by VAS (p=0.047) and NDI (p=0.164). In group A the NDI score improved from 40 to 15 and VAS from 7 to 4, while in group B the NDI score improved from 42 to 30 and VAS from 7 to 4.

Conclusion: Patients with non-specific neck pain treated with SNAGs manual physical therapy techniques and followed by IETP was more effective in reduction of pain and enhancement of function, as compared to those patients treated with SNAGs manual physical therapy techniques alone.

Keywords: Isometric Exercise Training; Non-specific Neck Pain; Sustained Natural Apophyseal Glides.

References

    1. Binder AI. Cervical spondylosis and neck pain. BMJ. 2007;334(7592) doi:10.1136/bmj.39127.608299.80.
    1. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2013;380(9859):2163–2196. doi:10.1016/S0140-6736(12)61729-2.
    1. Casazza BA. Diagnosis and treatment of acute low back pain. Am Family Phys. 2012;85(4):343–350.
    1. Garra G, Singer AJ, Leno R, Taira BR, Gupta N, Mathaikutty B. Heat or cold packs for neck and back strain: a randomized controlled trial of efficacy. Acad Emerg Med. 2010;17(5):484–489. doi:10.1111/j.1553-2712.2010.00735.
    1. Reid SA, Rivett DA, Katekar MG, Callister R. Sustained natural apophyseal glides (SNAGs) are an effective treatment for cervicogenic dizziness. Manual Therapy. 2008;13(4):357–366. doi:10.1016/j.math.2007.03.006.
    1. Hall T, Chan HT, Christensen L, Odenthal B, Wells C, Robinson K. Efficacy of a C1-C2 self-sustained natural apophyseal glide (SNAG) in the management of cervicogenic headache. J Orthop Sports Phys Ther. 2007;37(3):100–107. doi:10.2519/jospt.2007.2379.
    1. González-Iglesias J, Cleland JA, Neto F, Hall T, Fernández-de-las-Peñas C. Mobilization with movement, thoracic spine manipulation, and dry needling for the management of temporomandibular disorder: A prospective case series. Physiother Theory Pract. 2013;29(8):586–595. doi: 10.3109/09593985.2013.783895.
    1. Kazmi SAM, Iqbal S, Rafi MS, Hamidi K. Immediate Effects of Spinal Manipulation Compared to Mulligan Sustained Natural Apophyseal Glide Mobilization Technique in Cervical Pain. Pak J Rehabil. 2012;1(2):1–8.
    1. Brosseau L, Wells GA, Tugwell P, Casimiro L, Novikov M, Loew L, et al. Ottawa panel evidence-based clinical practice guidelines on therapeutic massage for neck pain. J Bodyw Mov Ther. 2012;16(3):300–325. doi:10.1016/j.jbmt.2012.04.001.
    1. Rubinstein SM, Terwee CB, Assendelft WJ, de Boer MR, van Tulder MW. Spinal manipulative therapy for acute low-back pain. Cochrane Database Syst Rev. 2012;12;9:CD008880. doi: 10.1002/14651858.CD008880.
    1. Tsakitzidis G, Remmen R, Dankaerts W, Van Royen P. Non-specific neck pain and evidence-based practice. Europ Sci J. 2013;9(3)
    1. Gross A, Miller J, D’Sylva J, Burnie SJ, Goldsmith CH, Graham N, et al. Manipulation or mobilization for neck pain: a cochrane review. Manual Therapy. 2010;15(4):315–33. doi:10.1016/j.math.2010.04.002.
    1. Miller J, Grossemail A, D'Sylva J, Burnie SJ, Goldsmith CH, Graham N, et al. Manual therapy and exercise for neck pain: a systematic review. Manual Therapy. 2010;15(4):334–354. doi:10.1016/j.math.2010.02.007.
    1. Leaver AM, Maher CG, Herbert RD, Latimer J, McAuley JH, Jull G, et al. A randomized controlled trial comparing manipulation with mobilization for recent onset neck pain. Arch Phys Med Rehabil. 2010;91(9):1313–1318. doi:10.1016/j.apmr.2010.06.006.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj