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Exercises for mechanical neck disorders: A Cochrane review update

Gross Anita, Paquin Jean-Philippe, Dupont Geneviève, Blanchette Samuel, Lalonde Patrick, Christie Trevor, Graham Nadine, Kay Theresa M., Burnie Stephen J., Gelley Geoff, Goldsmith Charles H., Forget Mario, Santaguida Pasqualina L., Yee A. J., Radisic G. G., Hoving Jan L. et Bronfort Gert. (2016). Exercises for mechanical neck disorders: A Cochrane review update. Manual Therapy, 24, p. 25-45.

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BACKGROUND: Neck pain (NP) is disabling and costly.

OBJECTIVES: To assess the effectiveness of exercise on pain, disability, function, patient satisfaction, quality of life (QoL) and global perceived effect (GPE) in adults with NP.

METHODS: We searched computerised databases up to May 2014 for randomized controlled trials (RCTs) comparing exercise to a control in adults with NP with/without cervicogenic headache (CGH) or radiculopathy. Two reviewers independently conducted selection, data abstraction and assessed risk of bias. Meta-analyses were performed to establish pooled standardised mean differences (SMDp). The Grade of Recommendation, Assessment, Development and Evaluation (GRADE) was used to summarise the body of evidence.

MAIN RESULTS: The following exercises (27 trials) were supported by 'Moderate GRADE' evidence: For chronic NP, 1) cervico-scapulothoracic and upper extremity (UE) strengthening for moderate to large pain reduction immediately post treatment (IP) and at short-term (ST) follow-up; 2) scapulothoracic and UE endurance training for a small pain reduction (IP/ST); 3) cervical, shoulder and scapulothoracic strengthening and stretching exercise for a small to large pain reduction in the long-term (LT) (SMDp -0.45 [95%CI: -0.72 to -0.18]) and function improvement; 4) cervico-scapulothoracic strengthening/stabilisation exercises for pain and function at intermediate-term (IT) (SMDp -14.90 [95%CI: -22.40 to -7.39]). 5) mindfulness exercises (Qigong) for minor improved function but not GPE (ST). For chronic CGH, cervico-scapulothoracic strengthening and endurance exercises including pressure biofeedback for small/moderate improvement of pain, function and GPE (IP/LT).

AUTHORS' CONCLUSIONS: Specific strengthening exercises of the neck, scapulothoracic and shoulder for chronic NP and chronic CGH are beneficial. Future research should explore optimal dosage.

Type de document:Article publié dans une revue avec comité d'évaluation
Pages:p. 25-45
Version évaluée par les pairs:Oui
Sujets:Sciences de la santé
Sciences de la santé > Sciences de l'activité physique et réadaptation
Sciences de la santé > Sciences de l'activité physique et réadaptation > Physiothérapie
Département, module, service et unité de recherche:Départements et modules > Département des sciences de la santé > Unité d'enseignement en physiothérapie
Mots-clés:aged, chronic pain, exercise therapy, neck pain, physical therapy, quality of life, whiplash injuries, personnes âgées, douleur chronique, traitement par les exercices physiques, douleur cervicale, douleur au cou, physiothérapie, qualité de vie, traumatismes cervicaux en coup de fouet
Déposé le:28 août 2019 22:41
Dernière modification:28 août 2019 22:41
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