A Comparative Study of a Novel Postural Garment Versus Exercise for Women with Nonspecific Cervical Pain: A Randomized Cross-over Trial

Overview

Journal Spine (Phila Pa 1976)

Specialty Orthopedics

Date 2021 Jul 22

PMID 34292213

Authors

Merce Avellanet

Anna Boada-Pladellorens

Esther Pages

Aleix Dorca

Betlem Sabria

Michael Pfeifer

Elvira Gea

Affiliations

Soon will be listed here.

Abstract

Study Design: Randomized cross-over study.

Objective: The aim of this study was to compare exercise, the criterion standard, to the postural garment PosturePlusForce in the management of nonspecific cervical pain in women. We also analyzed both interventions with regards to baseline posture, use of pharmacological pain relievers, compliance, and comfort.

Summary Of Background Data: The prevalence of neck pain has increased during the last decade, preferentially affecting women. Those suffering from this condition may manifest a decrease in quality of life and inability to work. Consistent recommendations highlight the importance of exercise and posture for neck pain improvement.

Methods: A total of 32 female health care professionals with cervical pain (≥3 on the visual analogue scale) entered the trial. Participants were allocated to either performing exercises or wearing the postural garment. The cross-over between interventions was separated by a 3-month washout period. Primary outcomes included pain intensity and posture. Secondary outcomes comprised cervical pain-related disability, psychological factors, physical activity, global perceived effect of treatment, and garment comfort. Treatment compliance, medication use, and adverse events were also recorded.

Results: Both interventions showed a significant improvement in pain in subjects with an adherence >60%. However, in participants with dorsal hyperkyphosis (>45°), the garment demonstrated a greater reduction in pain than exercise (P = 0.019). Additionally, those wearing the garment needed fewer pain relievers than those performing exercises (P = 0.007). Compliance was >50% for both interventions and comfort was contingent on season.

Conclusion: In our study, PosturePlusForce showed, at least, a similar effect on pain to exercise, although those with dorsal hyperkyphosis exhibited a greater reduction in pain and related variables with the garment. Pain relievers were less required by those wearing PosturePlusForce than by those performing the exercises.Level of Evidence: 1.

References

Lin I, Wiles L, Waller R, Goucke R, Nagree Y, Gibberd M . What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. Br J Sports Med. 2019; 54(2):79-86. DOI: 10.1136/bjsports-2018-099878. View

Livanelioglu A, Kaya F, Nabiyev V, Demirkiran G, Firat T . The validity and reliability of "Spinal Mouse" assessment of spinal curvatures in the frontal plane in pediatric adolescent idiopathic thoraco-lumbar curves. Eur Spine J. 2015; 25(2):476-82. DOI: 10.1007/s00586-015-3945-7. View

. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016; 388(10053):1545-1602. PMC: 5055577. DOI: 10.1016/S0140-6736(16)31678-6. View

Kelly A . The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain. Emerg Med J. 2001; 18(3):205-7. PMC: 1725574. DOI: 10.1136/emj.18.3.205. View

Hurwitz E, Randhawa K, Yu H, Cote P, Haldeman S . The Global Spine Care Initiative: a summary of the global burden of low back and neck pain studies. Eur Spine J. 2018; 27(Suppl 6):796-801. DOI: 10.1007/s00586-017-5432-9. View

Cheon J, Lim N, Lee G, Won K, Lee S, Kang E . Differences of Spinal Curvature, Thoracic Mobility, and Respiratory Strength Between Chronic Neck Pain Patients and People Without Cervical Pain. Ann Rehabil Med. 2020; 44(1):58-68. PMC: 7056330. DOI: 10.5535/arm.2020.44.1.58. View

Cote P, Cassidy D, Carroll L, Kristman V . The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain. 2004; 112(3):267-273. DOI: 10.1016/j.pain.2004.09.004. View

Hawker G, Mian S, Kendzerska T, French M . Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain.... Arthritis Care Res (Hoboken). 2012; 63 Suppl 11:S240-52. DOI: 10.1002/acr.20543. View

Darnall B, Sturgeon J, Cook K, Taub C, Roy A, Burns J . Development and Validation of a Daily Pain Catastrophizing Scale. J Pain. 2017; 18(9):1139-1149. PMC: 5581222. DOI: 10.1016/j.jpain.2017.05.003. View

10.

Olsen M, Bjerre E, Hansen M, Tendal B, Hilden J, Hrobjartsson A . Minimum clinically important differences in chronic pain vary considerably by baseline pain and methodological factors: systematic review of empirical studies. J Clin Epidemiol. 2018; 101:87-106.e2. DOI: 10.1016/j.jclinepi.2018.05.007. View

11.

Wingbermuhle R, van Trijffel E, Nelissen P, Koes B, Verhagen A . Few promising multivariable prognostic models exist for recovery of people with non-specific neck pain in musculoskeletal primary care: a systematic review. J Physiother. 2018; 64(1):16-23. DOI: 10.1016/j.jphys.2017.11.013. View

12.

Dwan K, Li T, Altman D, Elbourne D . CONSORT 2010 statement: extension to randomised crossover trials. BMJ. 2019; 366:l4378. PMC: 6667942. DOI: 10.1136/bmj.l4378. View

13.

Ay S, Konak H, Evcik D, Kibar S . The effectiveness of Kinesio Taping on pain and disability in cervical myofascial pain syndrome. Rev Bras Reumatol Engl Ed. 2017; 57(2):93-99. DOI: 10.1016/j.rbre.2016.03.012. View

14.

Tsunoda D, Iizuka Y, Iizuka H, Nishinome M, Kobayashi R, Ara T . Associations between neck and shoulder pain (called katakori in Japanese) and sagittal spinal alignment parameters among the general population. J Orthop Sci. 2012; 18(2):216-9. DOI: 10.1007/s00776-012-0341-6. View

15.

Avellanet M, Boada-Pladellorens A, Perrot J, Loro L, Rodrigo Cansado L, Monterde D . Comparative Study of Postural Garment Versus Exercises for Patients With Nonspecific Cervical Pain: Protocol for a Randomized Crossover Trial. JMIR Res Protoc. 2020; 9(4):e14807. PMC: 7193442. DOI: 10.2196/14807. View

16.

Gascon S, Gilmer G, Hanks M, Washington J, Oliver G . BIOMECHANICAL INFLUENCES OF A POSTURAL COMPRESSION GARMENT ON SCAPULAR POSITIONING. Int J Sports Phys Ther. 2018; 13(4):700-706. PMC: 6088124. View

17.

Jensen M, Tome-Pires C, Vega R, Galan S, Sole E, Miro J . What Determines Whether a Pain is Rated as Mild, Moderate, or Severe? The Importance of Pain Beliefs and Pain Interference. Clin J Pain. 2016; 33(5):414-421. PMC: 5332521. DOI: 10.1097/AJP.0000000000000429. View

18.

. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017; 390(10100):1211-1259. PMC: 5605509. DOI: 10.1016/S0140-6736(17)32154-2. View

19.

Cole A, McGrath M, Harrington S, Padua D, Rucinski T, Prentice W . Scapular bracing and alteration of posture and muscle activity in overhead athletes with poor posture. J Athl Train. 2013; 48(1):12-24. PMC: 3554027. DOI: 10.4085/1062-6050-48.1.13. View

20.

Shiravi S, Letafatkar A, Bertozzi L, Pillastrini P, Tazji M . Efficacy of Abdominal Control Feedback and Scapula Stabilization Exercises in Participants With Forward Head, Round Shoulder Postures and Neck Movement Impairment. Sports Health. 2019; 11(3):272-279. PMC: 6537319. DOI: 10.1177/1941738119835223. View