PT Critically Appraised Topics
 

Document Type

Critically Appraised Topic

Publication Date

2012

Clinical Scenario

There have been several patients who led me to pursue this clinical question. One example is a 28-year-old female who works part-time in a bakery. She works most of the time in a seated position. She reported an insidious onset of neck pain three months prior to seeking physical therapy. Her neck pain is worst in the morning, greatest on the left side, and does not peripheralize into her upper extremities. Her BMI is 23.5 kg/m2 and she has no known comorbidities. Her physical therapy plan of care includes: hot compresses, TENS, and ultrasound. I would like to know if she would benefit from neck stabilization exercises.

Clinical Question

Are neck stabilization exercises more efficacious than physical therapy modalities in decreasing insidious neck pain?

Clinical Bottom Line

Based on the articles by Chiu et al. and Dusunceli et al., there is strong evidence to support the use of neck stabilization exercises to reduce the report of insidious neck pain in adults. The article by Chiu et al. concluded that 4 hours of neck exercises over 6 weeks produced statistically and clinically significant improvements in neck pain that were maintained over 6 months. These were statistically significantly improvements compared to the group that received only a physical therapy modality. In the article by Dusunceli et al., 10 hours of neck stabilization exercises over 3 weeks and a home exercise program for the rest of the year produced statistically and clinically significant improvements in neck pain over 12 months. It is unclear if the improvements were statistically significantly more efficacious than an intervention of only physical therapy modalities. Further research should include subjects with cervical radiculopathy since this is a common symptom associated with insidious neck pain. The treatment intervention should consist of only neck stabilization exercises to confirm their efficacy in decreasing neck pain when no physical therapy modalities or dynamic strengthening exercises are used.

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