【論文摘要】The Comparison of Intermediate, Short-Term, and Long-Term of Treatment Effects Between Manual Therapy and Supervised Therapeutic Exercise for Patients With Chronic Neck Pain: A Systematic Review and Meta-Analysis

【論文摘要】徒手治療與運動治療介入對慢性頸部疼痛之立即、短期和長期效果：系統性回顧與統合分析

黃意雯(Yi Wen Huang) ； 葉于瑞(Yu-Rui Ye) ； 簡婕(Chieh Chien) ； 方麗婭(Wanutchaya Yawichai) ； 端木和頤(Ho-Yi Tuan-Mu)

《物理治療》 47卷2期 (2022/06) Pp. 158-159

https://doi.org/10.6215/FJPT.202206.P50

摘要

Background and Purpose: Chronic neck pain, symptom more than 3 months, is one of the common musculoskeletal problems in the general population. The evidence showed that physical therapy including manual therapy and supervision therapeutic exercises can reduce pain and increase the functional ability in daily life for patients with low back pain. However, inconsistent results were found in the literatures, especially in the comparison between manual therapy and supervision therapeutic exercise in pain and functional ability for patient with chronic neck pain. The purpose of this study was to compare the effects of manual therapy and supervision therapeutic exercise in patients with chronic neck pain. Methods: The articles searched in the databases which published from 2000 to 2021 by using the keywords as therapeutic exercise or general exercise or exercise intervention and manual therapy or mobilization or manipulation or massage and chronic neck pain or chronic cervical pain. The comparisons of pain status, pressure pain threshold, and neck disability index in the cervical spine between groups were analyzed. Specifically, we compared the immediate, short-term, mid-term, and long-term effects between the two interventions. Results: Eight moderate to high level randomized control trial studies were included to compare the therapeutic effects of 3 to 11 weeks' manual therapy and supervision therapeutic exercise interventions for patients with chronic neck pain. The results showed that there were no significant differences in pain reduction, change of pressure pain threshold, and improvement of the neck disability between manual treatment and exercise under supervision in the intermediate, short-term (＜ 3 months), intermediate-term (3 to 6 months) and long-term (＞ 6 months) effects for patients with chronic neck pain. However, therapeutic exercise under supervision is favored in decreasing neck disability for long-term (SMD = 0.49, [0.24-0.73]) follow up comparing to the manual therapy group. Conclusions: Therapeutic exercise under supervision for 3 to 11 weeks is much more favored on improving functional ability in patients with chronic neck pain for long-term followed up. Clinical Relevance: Therapeutic exercise under supervision should be considered for long-term functional improvement for patients with chronic neck pain.