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Immediate effects of osteopathic treatment versus therapeutic exercise on patients with chronic cervical pain [Epub ahead of print]

Galindez-Ibarbengoetxea X, Setuain I, Ramirez-Velez R, et al. Immediate effects of osteopathic treatment versus therapeutic exercise on patients with chronic cervical pain [Epub ahead of print]. Alternative Therapies in Health and Medicine 2017;
Date: 2017
Scientific Article
Context * Alternatives to medication for immediate pain relief are needed because long-term use of pain medication has been associated with adverse effects. High-velocity, low-amplitude (HVLA) manipulation techniques (MTs) and craniocervical flexion (CCF) exercises have been frequently used in the management of chronic cervical pain. Objective * The study intended to compare the immediate effects on pain of a treatment using HVLA manipulation versus one using a CCF exercise protocol. Design * The research team designed a single-blinded, randomized clinical trial. Setting * The study was conducted at osteopathic clinics. Participants * Participants were 25 volunteer patients with chronic neck pain. Intervention * Participants were randomly enrolled in one of 2 groups: the HVLA manipulation group (MT group), n = 12, or the CCF exercise protocol group (CCF group), n = 13. Participants in the CCF group performed the exercise for 10 repetitions of a 10-s duration, with a 10-s rest interval between each contraction, for a total contraction time of 100 s and a total time of the session of 190 s. Outcome Measures * The outcomes were measured at baseline and at 60 s postintervention. The measures included (1) a visual analogue scale (VAS) completed during range of motion (ROM) measurement, (2) an evaluation of the ROM of the cervical spine, (3) a test of pressure pain thresholds (PPTs), and (4) electromyographic (EMG) activation of sternocleidomastoid muscle during a craniocervical flexion test. Results * Following both interventions, significant changes were found between baseline and immediately postintervention in the VAS score during ROM measurement for both groups, with P = .004 and P = .015, respectively. In the MT group, the measures for flexion (P = .001), right-side bending (P = .002), and left rotation (P = .005) changed significantly between baseline and postintervention; however, only flexion (P = .026) and extension (P = .040) ROM changed significantly between b
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