Effectiveness of Neck-specific Exercises on Neck Disability Index, Scapular Pain, and Cervical Range of Motion in Cervical Radiculopathy Patients
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Abstract
Background: Scapular pain is a common complaint among patients with herniated nucleus pulposus (HNP). This later results in peripheral numbness and weakness as well as abnormal movements of upper limbs in activities of daily living. In long term, inappropriate managements can cause musculoskeletal imbalance and recurrence of symptoms. Therapeutic exercises have been proposed as the tools for scapular pain syndrome managements.
Objective: This present study was aimed to investigate effects of a cervical exercise program on neck disability index (NDI), numerical pain rating scale (NPRS), and cervical range of motion in flexion and extension (CROM in Flexion/Extension).
Methods: Twenty-two participants were divided into control and experimental groups. The experimental group (n=11) received an 8-week cervical exercise program (sequential scapular retraction, deep cervical flexion, and cervical extension exercises) for 1-2 sessions/week and routine treatments while the control group (n=11) received only routine treatments.
Results: Results showed that, at baseline, NDI, NPRS and CROM in Flexion/Extension between control and experimental groups were not significantly different. Posttest analysis with Wilcoxon signed-rank test showed significant reduction in NDI in both groups and the experimental group reduced more significantly than the control [median (min-max) were 4.0(0.0-18.0) and 15.0 (4.0-28.0)], respectively (Mann-Whitney U test=-2.869, p-value=0.003). Similarly, posttest results illustrated that NPRS reduction was more significantly prominent in the experimental group [10.0 (0.0-30.0)] than the control[50.0(20.0-70.0)] with U=-3.776,p-value=0.000. For CROM in Flexion and Extension, posttest revealed no significant differences. However, posttest showed an increase in CROM in Flexion in the control group (Wilcoxon signed-rank test z=2.196,p-value = 0.028) and an increase in CROM in Extension in the experimental group (z=2.667,p-value = 0.008).
Conclusion: In combination withneck-specific exercise program, physical therapy program was effective to improve disability, pain, and joint motion in the patients with cervicogenicscapular pain. This might be further implemented in a larger of patients in clinical settings in order to prevent symptom recurrence.
Keywords: cervical herniated nucleus pulposus, neck disability index, scapular pain, exercise, physical therapy
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References
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