PICO
Patient/Population
Chronic neck pain CNP
(n=60)
Intervention
SCM Neck health training + exercise + Hot-pack + ultrasound + conventional TENS + Sternocleidomastoid stretching and massage
Comparison
SCM neck health training + exercise + Hot-pack + ultrasound + conventional TENS
Outcomes
Pain
Disability
ROM (extension, left-lateral flexion, and right/left-rotation)
Endurance
Kinesiophobia
Translatability: (3/3) Easy
Comments: “Improvements in pain, disability, ROM (extension, left-lateral flexion, and right/left-rotation), and endurance were found to be greater in the SCM-Group compared to the CG (p < 0.05). Changes in flexion and right-lateral flexion ROM and kinesiophobia did not significantly differ between the groups”
Limitations: “No long-term effects of the stretching and massage investigated. Inclusion and exclusion criteria are not clear as to pathologies such as radiculopathy, disc herniation, nerve irritation, spondylosis, whiplash and mechanical pain.”
Appraisals:
PEDro Scale – (9/10) Blind therapists: No.
BTB
Intervention – 1
- Neck Health Training
Dose
- 60min
Periodicity
- One session
Local/Technic:
- Key information regarding the anatomy of the neck, the definition and risk factors of neck pain, treatment options, preventive methods, and necessary modifications to daily life activities.
Intervention – 2
- Hot-pack
Dose
- 15min
Periodicity
- 3 times a week for 5 weeks.
Local/Technic:
Trapezius muscle – prior to any intervention
Intervention – 3
- Ultrasound
Dose
- ERA: 4cm2, frequency:1 MHz, power:1.5 w/cm2, 5 min.
Periodicity
- 3 times a week for 5 weeks.
Local/Technic:
- Circular motion.
Intervention – 4
- Conventional TENS.
Dose
- 50 Hz, pulse duration, 150 μs, 20 min.
Periodicity
- 3 times a week for 5 weeks.
Local/Technic:
- Applied to the neck region for, centered on the area reported as the most painful.
Intervention – 5
- Exercise.
Dose
- Slow and controlled – 3 sets of 3 repetitions for each movement
- Dynamic isometric – 3 repetitions sustained for 10 s for each muscle group. MORE
Periodicity
- 3 times a week for 5 weeks.
Local/Technic:
The patients were asked to perform each movement, either sitting or standing, in a controlled manner, and to breathe deeply during each movement.
During the first week – slow and controlled neck flexion, extension, lateral flexion and rotation in combination with respiration, and also posture-related exercises.
During the second and third weeks – idem plus dynamic isometric exercises with a yellow elasticated band, slow and controlled neck flexion, extension, lateral flexion, and rotation.
The posture exercises continued throughout the duration of the treatment program.
Intervention – 6
- Swedish classical massage.
Dose
- —
Periodicity
- 3 times a week for 5 weeks.
Local/Technic:
- Including three strokes, three kneads, and three strokes.
Intervention – 7
- Stretching
Dose
- 15 sec period of stretching followed by a 10 sec rest interval.
Periodicity
- 3 times a week for 5 weeks.
Local/Technic:
Administered by the physiotherapist and within the home (self-administered by the patient).
In supine position, to keep their neck elongated, and then to rotate their head to the right as far as possible within a pain-free range. The physiotherapist’s right hand was then placed underneath the patient’s head. With the left hand placed just above the patient’s left ear, the therapist applied a final maximum stretch without causing pain to the patient.
Citation:
Büyükturan, B., Şaş, S., Kararti, C., & Büyükturan, Ö. (2021). The effects of combined sternocleidomastoid muscle stretching and massage on pain, disability, endurance, kinesiophobia, and range of motion in individuals with chronic neck pain: A randomized, single-blind study. Musculoskeletal science & practice, 55, 102417. https://doi.org/10.1016/j.msksp.2021.102417