Effects of Thoracic Mobilization and Sling-Based Exercises on Clinical Outcomes in Patients with Non-Specific Neck Pain
DOI:
https://doi.org/10.55735/hjprs.v5i2.344Keywords:
Non-specific neck pain , Sling-based exercises , Thoracic mobilizationAbstract
Background: Non-specific neck pain is the most prevalent musculoskeletal condition and the fourth most common cause worldwide. Middle-aged women are more likely to have it. In addition to being a risk factor for severe spine pathologies and functional impairment, this pain is well-recognized to be linked to worse worker productivity and quality of life. Objective: To determine the effects of thoracic mobilization and sling-based exercises on functional outcomes and quality of life in patients with non-specific neck pain. Methodology: A single-blinded randomised controlled trial consisting of 52 participants was conducted. The participants were randomly allocated into two groups using the lottery method. Group A received sling-based thoracic active exercises and cervical manual therapy, while Group B received thoracic mobilizations and cervical manual therapy. The neck disability index and SF-36 questionnaire were used to measure function and quality of life. The Kolmogorov-Smirnov test shows data was not normally distributed. Mann-Whitney U Test for between-group analysis and Friedman test for within-group analysis was used. Results: The mean rank for neck disability index in group A at the baseline was 27.94 and in group B 25.06 with a Z value of 1.158 and a P-value of 0.247. At the end of treatment eight weeks, the mean rank for neck disability index in group A was 19.30 and in group B 33.70, with a Z value of -4.025 and a p-value of 0.02. Group A shows more significant improvements, at weeks two, four, six, and eight treatment, in the domains of quality-of-life (physical functioning), role limitation due to physical health, emotional problems, emotional wellbeing, social functioning, pain, energy/fatigue, and general health by increasing the mean value of these domains. Conclusion: Both groups experienced significant improvements in their symptoms, but Group A benefits were more apparent. While thoracic mobilization provides faster, short-term relief, the dynamic nature of sling-based exercises gives broader, longer-lasting benefits, especially in the long-term treatment of pain and general patient well-being.
References
Bernal-Utrera C, Gonzalez-Gerez JJ, Anarte-Lazo E, Rodriguez-Blanco C. Manual therapy versus therapeutic exercise in non-specific chronic neck pain: a randomized controlled trial. Trials. 2020 Jul 28;21(1):682.
Waseem I, Tanveer F, Fatima A. Conventional physical therapy with low-level laser therapy on pain and functional disability in patients of upper trapezius muscle trigger point. Rawal Medical Journal. 2020 Oct;45(4):854-6.
Waseem I, Tanveer F, Fatima A. Can addition of low level laser therapy to conventional physical therapy be beneficial for management of pain and cervical range of motion in patients with trigger point of upper trapezius?. Anaesthesia, Pain & Intensive Care. 2020 May 7;24(1):64-8.
Waseem I, Tariq K, Salam A, Mahmood T, Tabassum M. Prevalence of neck pain and its contributing factors among ophthalmologists of Faisalabad, Pakistan. Rawal Medical Journal. 2022 Nov 12;47(4):932-
Khan ZK, Ahmed SI, Baig AAM, Farooqui WA. Effect of post-isometric relaxation versus myofascial release therapy on pain, functional disability, rom and qol in the management of non-specific neck pain: a randomized controlled trial. BMC Musculoskelet Disord. 2022 Jun 13;23(1):567.
Waseem I, Hussain MN, Siddique F, Nawaz U, Azeem A. Effectiveness of Low-level Laser Therapy for Treatment of Cervical Pain in Patients with Trigger Points of Upper Trapezius: Low-level Laser therapy for Trigger Points of Trapezius. The Healer Journal of Physiotherapy and Rehabilitation Sciences. 2023 Jul 7;3(6):552 9.
Hussain Z, Waseem I, Azeem A. Prevalence of myofascial trigger points due to postural stressors among digital product users. Pioneer Journal of Biostatistics and Medical Research. 2023;1(3):29-34.
Mahmood T, Naqvi R, Waseem I, Salam A. Biomechanical effects of high heeled shoes on neck pain among females: A narrative review. JPMA. The Journal of the Pakistan Medical Association. 2023 Feb 1;73(2):357-61.
Mehri A, Letafatkar A, Khosrokiani Z. Effects of Corrective Exercises on Posture, Pain, and Muscle Activation of Patients With Chronic Neck Pain Exposed to Anterior-Posterior Perturbation. Journal of Manipulative and Physiological Therapeutics. 2020 May 1;43(4):311–24.
Mahmood T, Afzal MW, Waseem I, Arif MA, Mahmood W. Comparative effectiveness of routine physical therapy with and without instrument assisted soft tissue mobilization for improving pain and disability in patients with neck pain due to upper crossed syndrome. Annals of Punjab Medical College. 2022 Mar31;16(1):45-50
Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, et al. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskeletal Disorders. 2022 Jan 3;23(1):26.
Moghaddas D, de Zoete RMJ, Edwards S, Snodgrass SJ. Differences in the kinematics of the cervical and thoracic spine during functional movement in individuals with or without chronic neck pain: a systematic review. Physiotherapy. 2019 Dec 1;105(4):421–33.
Erdem EU, Ünver B, Akbas E, Kinikli GI. Immediate effects of thoracic manipulation on cervical joint position sense in individuals with mechanical neck pain: A randomized controlled trial. Journal of Back and Musculoskeletal Rehabilitation. 2021 Jan 1;34(5):735–43.
Safdar M, Sarfraz N, Ishaq I, Sabir M, Mahmooda S, Bashir A. Effectiveness of cervical mobilization and stretching exercise with or without upper thoracic mobilization on non-specific neck pain. 2020;45(1).
Ashfaq A, Waseem I, Hayat MU, Arslan SA, Hanif K. Effects of Shoulder Exercises with and Without Cervical Exercises on Pain and Function in the Patients with Cervical Spondylosis: Randomized Controlled Trial. Annals of King Edward Medical University. 2024 Mar 30;30(1):91-7.
Kim DH, Kim SY. Comparison of immediate effects of sling-based manual therapy on specific spine levels in subjects with neck pain and forward head posture: a randomized clinical trial. Disability and Rehabilitation. 2020 Sep 10;42(19):2735–42.
Liu J, Feng W, Zhou J, Huang F, Long L, Wang Y, et al. Effects of sling exercise therapy on balance, mobility, activities of daily living, quality of life and shoulder pain in stroke patients: a randomized controlled trial. European Journal of Integrative Medicine. 2020 Apr 1;35:101077.
Park GW, An J, Kim SW, Lee BH. Effects of Sling-Based Thoracic Active Exercise on Pain and Function and Quality of Life in Female Patients with Neck Pain: A Randomized Controlled Trial. Healthcare. 2021 Nov;9(11):1514.
Mahmoudabadi Z, Hadadnezhad M, Mimar R, Hamoongard M. The Impacts of Neck Stabilization and Thoracic Mobility Exercises on Disability, Range of Motion, and Endurance of Females with Non-Specific Chronic Neck Pain: A Clinical Trial Study. Journal of Gorgan University of Medical Sciences. 2024;26(1):25–36.
Kim S, Jung J, Kim N. The effects of McKenzie exercise on forward head posture and respiratory function. The Journal of Korean Physical Therapy. 2019;31(6):351–7.
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