Focus on the Scapular Region in the Rehabilitation of Chronic Neck Pain Is Effective in Improving the Symptoms: A Randomized Controlled Trial

Overview

Journal J Clin Med

Specialty General Medicine

Date 2021 Aug 27

PMID 34441791

Citations 3

Authors

Norollah Javdaneh

Tadeusz Ambrozy

Amir Hossein Barati

Esmaeil Mozafaripour

Lukasz Rydzik

Affiliations

Soon will be listed here.

Abstract

Chronic neck pain is a common human health problem. Changes in scapular posture and alteration of muscle activation patterns of scapulothoracic muscles are cited as potential risk factors for neck pain. The purpose of this study was to compare the effects of neck exercise training (NET) with and without scapular stabilization training (SST) on pain intensity, the scapula downward rotation index (SDRI), forward head angle (FHA) and neck range of motion (ROM) in patients with chronic neck pain and scapular dyskinesia. A total of sixty-six subjects with chronic neck pain and scapular dyskinesia were randomly divided into three groups: neck exercise training, n = 24, combined training (NET + SST), n = 24 and a control group, n = 24. Pain intensity, SDRI, FHA and ROM were measured by the numerical rating scale, caliper, photogrammetry and IMU sensor, respectively. When the combined intervention group consisting of NET and SST was compared with NET alone at six weeks, there was a statistically significant difference in pain intensity, SDRI, FHA and cervical ROM for flexion and extension ( ≤ 0.05). Adding scapular exercises to neck exercises had a more significant effect in decreasing pain intensity, SDRI, FHA and increased cervical ROM than neck exercises alone in patients with chronic neck pain. These findings indicate that focus on the scapular posture in the rehabilitation of chronic neck pain effectively improves the symptoms.

Citing Articles

Effects of scapular treatment on chronic neck pain: a systematic review and meta-analysis of randomized controlled trials.

Chen Y, Yang C, Nie K, Huang J, Qu Y, Wang T BMC Musculoskelet Disord. 2024; 25(1):252.

PMID: 38561733 PMC: 10983729. DOI: 10.1186/s12891-024-07220-8.

Effects of Scapular Interventions on Pain and Disability in Subjects with Neck Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Prakash N, Harikesavan K, Cleland J Spine Surg Relat Res. 2024; 8(1):1-9.

PMID: 38343415 PMC: 10853621. DOI: 10.22603/ssrr.2022-0237.

Effects of active scapular correction on cervical range of motion, pain, and pressure pain threshold in patients with chronic neck pain and depressed scapula: a randomized controlled trial.

Srikrajang S, Kanlayanaphotporn R J Man Manip Ther. 2022; 31(1):24-31.

PMID: 35588354 PMC: 9848379. DOI: 10.1080/10669817.2022.2077515.

References

Helgadottir H, Kristjansson E, Mottram S, Karduna A, Jonsson Jr H . Altered alignment of the shoulder girdle and cervical spine in patients with insidious onset neck pain and whiplash-associated disorder. J Appl Biomech. 2011; 27(3):181-91. DOI: 10.1123/jab.27.3.181. View

Javdaneh N, Molayei F, Kamranifraz N . Effect of adding motor imagery training to neck stabilization exercises on pain, disability and kinesiophobia in patients with chronic neck pain. Complement Ther Clin Pract. 2020; 42:101263. DOI: 10.1016/j.ctcp.2020.101263. View

Christian G, STANTON G, Sissons D, How H, Jamison J, Alder B . Immunoreactive ACTH, beta-endorphin, and cortisol levels in plasma following spinal manipulative therapy. Spine (Phila Pa 1976). 1988; 13(12):1411-7. DOI: 10.1097/00007632-198812000-00014. View

Chung S, Jeong Y . Effects of the craniocervical flexion and isometric neck exercise compared in patients with chronic neck pain: A randomized controlled trial. Physiother Theory Pract. 2018; 34(12):916-925. DOI: 10.1080/09593985.2018.1430876. View

Seo Y, Park W, Lee C, Kang K, Min K, Lee S . Is Scapular Stabilization Exercise Effective for Managing Nonspecific Chronic Neck Pain?: A Systematic Review. Asian Spine J. 2019; 14(1):122-129. PMC: 7010515. DOI: 10.31616/asj.2019.0055. View

Yildiz T, Turgut E, Duzgun I . Neck and Scapula-Focused Exercise Training on Patients With Nonspecific Neck Pain: A Randomized Controlled Trial. J Sport Rehabil. 2017; 27(5):403-412. DOI: 10.1123/jsr.2017-0024. View

Miller J, Gross A, DSylva J, Burnie S, Goldsmith C, Graham N . Manual therapy and exercise for neck pain: a systematic review. Man Ther. 2010; 15(4):334-54. View

Toprak Celenay S, Kaya D, Akbayrak T . Cervical and scapulothoracic stabilization exercises with and without connective tissue massage for chronic mechanical neck pain: A prospective, randomised controlled trial. Man Ther. 2015; 21:144-50. DOI: 10.1016/j.math.2015.07.003. View

Lee J, Cynn H, Choi W, Jeong H, Yoon T . Various shrug exercises can change scapular kinematics and scapular rotator muscle activities in subjects with scapular downward rotation syndrome. Hum Mov Sci. 2015; 45:119-29. DOI: 10.1016/j.humov.2015.11.016. View

10.

Struyf F, Nijs J, Mollekens S, Jeurissen I, Truijen S, Mottram S . Scapular-focused treatment in patients with shoulder impingement syndrome: a randomized clinical trial. Clin Rheumatol. 2012; 32(1):73-85. DOI: 10.1007/s10067-012-2093-2. View

11.

Ekstrom R, Donatelli R, Soderberg G . Surface electromyographic analysis of exercises for the trapezius and serratus anterior muscles. J Orthop Sports Phys Ther. 2003; 33(5):247-58. DOI: 10.2519/jospt.2003.33.5.247. View

12.

Lynch S, Thigpen C, Mihalik J, Prentice W, Padua D . The effects of an exercise intervention on forward head and rounded shoulder postures in elite swimmers. Br J Sports Med. 2010; 44(5):376-81. DOI: 10.1136/bjsm.2009.066837. View

13.

van Dillen L, Mcdonnell M, Susco T, Sahrmann S . The immediate effect of passive scapular elevation on symptoms with active neck rotation in patients with neck pain. Clin J Pain. 2007; 23(8):641-7. DOI: 10.1097/AJP.0b013e318125c5b6. View

14.

Yildiz T, Cools A, Duzgun I . Alterations in the 3-dimensional scapular orientation in patients with non-specific neck pain. Clin Biomech (Bristol). 2019; 70:97-106. DOI: 10.1016/j.clinbiomech.2019.08.007. View

15.

Christensen S, Hirata R, Graven-Nielsen T . Altered pain sensitivity and axioscapular muscle activity in neck pain patients compared with healthy controls. Eur J Pain. 2017; 21(10):1763-1771. DOI: 10.1002/ejp.1088. View

16.

Yoon T, Kim H, Min J . Validity and Reliability of an Inertial Measurement Unit-based 3-Dimensional Angular Measurement of Cervical Range of Motion. J Manipulative Physiol Ther. 2019; 42(1):75-81. DOI: 10.1016/j.jmpt.2018.06.001. View

17.

Pool J, Ostelo R, Hoving J, Bouter L, de Vet H . Minimal clinically important change of the Neck Disability Index and the Numerical Rating Scale for patients with neck pain. Spine (Phila Pa 1976). 2007; 32(26):3047-51. DOI: 10.1097/BRS.0b013e31815cf75b. View

18.

Gross A, Kay T, Paquin J, Blanchette S, Lalonde P, Christie T . Exercises for mechanical neck disorders. Cochrane Database Syst Rev. 2015; 1:CD004250. PMC: 9508492. DOI: 10.1002/14651858.CD004250.pub5. View

19.

Jull G, Richardson C . Motor control problems in patients with spinal pain: a new direction for therapeutic exercise. J Manipulative Physiol Ther. 2000; 23(2):115-7. View

20.

Ha S, Kwon O, Yi C, Jeon H, Lee W . Effects of passive correction of scapular position on pain, proprioception, and range of motion in neck-pain patients with bilateral scapular downward-rotation syndrome. Man Ther. 2011; 16(6):585-9. DOI: 10.1016/j.math.2011.05.011. View