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The Effects of Neck-Specific Training Versus Prescribed Physical Activity on Pain and Disability in Patients With Cervical Radiculopathy: A Randomized Controlled Trial
Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0002-6075-4432
Franklin Pierce Univ, NH USA.
Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
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2018 (English)In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 99, no 12, p. 2447-2456Article in journal (Refereed) Published
Abstract [en]

Objective: To compare the effects of a neck-specific training program to prescribed physical activity with both groups receiving a cognitive behavioral approach, on pain and disability in patients with cervical radiculopathy (CR). Design: Parallel-group randomized clinical trial with follow-up at 3, 6, 12, and 24 months. Setting: Recruitment and assessments of participants were performed at a university hospital. Interventions were performed in primary care setting at outpatient physiotherapy clinics. Participants: Patients (N=144) with CR were recruited to participate in this clinical trial. Interventions: Patients were randomly assigned to 3 months of either of a neck-specific training program or prescribed physical activity. Main Outcome Measures: Primary outcomes included self-rated neck and arm pain as collected by the visual analog scale (VAS). Secondary outcomes were self-rated headache measured with the VAS, the Neck Disability Index, the EuroQol 5D, the Fear Avoidance Beliefs Questionnaire, and the Hospital Anxiety and Depression Scale. Assessments were performed at baseline and at 3-, 6-, 12-, and 24-month follow-up periods. Results: Intention-to-treat and per-protocol analyses showed no significant interaction (group x time) or group effects. There were, however, significant time effects indicating improvement over time for both groups for all outcomes except for levels of depression. Conclusions: The study revealed that neck-specific training as well as prescribed physical activity both including additional cognitive behavioral approach decreased the pain in patients with CR, that is, participants improved regardless of the intervention received. There is a lack of consensus of how to best manage individuals with CR. However, our findings suggest that CR has a natural favorable long-term outcome when patients are prescribed neck-specific training and exercise in combination with a behavioral approach. (C) 2018 by the American Congress of Rehabilitation Medicine

Place, publisher, year, edition, pages
W B SAUNDERS CO-ELSEVIER INC , 2018. Vol. 99, no 12, p. 2447-2456
Keywords [en]
Cervical radiculopathy; Exercise; Neck pain; Physical activity; Rehabilitation
National Category
Physiotherapy
Identifiers
URN: urn:nbn:se:liu:diva-153688DOI: 10.1016/j.apmr.2018.06.008ISI: 000453113200005PubMedID: 30473018OAI: oai:DiVA.org:liu-153688DiVA, id: diva2:1276225
Note

Funding Agencies|Swedish Government through the Karolinska Institute; Stockholm County Council Funding ALF Medicine [20110071]

Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-01-07

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