Short-Term Effect of Different Physical Therapy Modalities on Neck Mobility in Healthy Young Adults
Year 2025,
Volume: 9 Issue: 1, 92 - 101, 31.01.2025
Ayşe Nur Oymak Soysal
,
Atiye Kaş Özdemir
,
Şule Şimşek
,
Ummuhan Baş Aslan
,
Merve Bergin
Abstract
Purpose: To investigate the short-term effects of hot pack, intermittent traction and low-level laser combined with stretching exercises and stretching exercises alone on neck mobility in individuals with no past pain history but flexibility loss.
Material and Methods: Sixty (60) participants were randomly divided into 4 groups. All participants performed cervical stretching exercises. Cervical intermittent traction wad added to Group I, low level laser therapy was added to group II, hot pack was added to group III. Cervical range of motion (ROM), occiput-wall distance (OWD) and, coronoid process- tragus distance (TCD) was assessed at the beginning and end of the study.
Results: The results of this study showed that all physical therapy modalities were effective in increasing lateral flexion ROM and OWD score (p<.05). Hot packs combined with stretching exercises increased the CTD score (p=.001) in addition to lateral flexion ROM and OWD score. However, plus interventions were not superior (p>.05) to stretching exercises alone in increasing neck mobility.
Conclusion: In conclusion, both stretching exercises alone and combined with hot pack, intermittent traction, and low-level laser increased neck mobility in healthy individuals. Even if not combined with any modality, stretching exercises alone may increase neck mobility.
Ethical Statement
Pamukkale Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu 26.06.2018 tarih
ve 13 sayılı toplantısında onay alınmıştır.
Supporting Institution
Destekleyen kuruluş bulunmamaktadır.
Thanks
Tüm katılımcılara teşekkür ederiz.
References
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- Rahman S, M Das J. Anatomy, head and neck: cervical spine. StatPearls Treasure Island (FL): StatPearls Publishing; 2024.
- Yajima H, Nobe R, Takayama M, Takakura N. The mode of activity of cervical extensors and flexors in healthy adults: a cross-sectional study. Medicina (Kaunas). 2022;58(6):728.
- Cejudo A, Moreno-Alcaraz VJ, De Ste Croix M, Santonja-Medina F, Sainz de Baranda P. Lower-limb flexibility profile analysis in youth competitive inline hockey players. Int J Environ Res Public Health. 2020;17(12):4338.
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- Cote P, Cassidy JD, Carroll L. The factors associated with neck pain and its related disability in the Saskatchewan population. Spine (Phila Pa 1976). 2000;25(9):1109–17.
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- Ylinen J, Salo P, Nyk.nen M, et al. Decrease isometric neck strength in women with chronic neck pain and the repeatability of neck strength measurements. Arch Phys Med Rehabil. 2004;85(8):1303–8.
- Ylinen J, Takala EP, Kautiainen H, et al. Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain. Eur J Pain 2004;8(5):473–8.
- Andersen LL, Kjaer M, S.gaard K, et al. Effect of two contrasting types of physical exercise on chronic neck muscle pain. Arthritis Rheum 2008;59(1):84–91.
- De Loose V, Van den Oord M, Burnotte F, et al. Functional assessment of the cervical spine in F-16 pilots with and without neck pain. Aviat Space Environ Med 2009;80(5):477–81.
- Bernstetter A. The application of a clinical prediction rule for patients with neck pain likely to benefit from cervical traction: A case report. Physiother Theory Pract 2016;32(7):546-555.
- Shin HJ, Kim SH, Hahm SC, Cho HY. Thermotherapy Plus Neck Stabilization Exercise for Chronic Nonspecific Neck Pain in Elderly: A Single-Blinded Randomized Controlled Trial. Int. J. Environ. Res. Public Health. 2020;17:1-12.
- Wong LKF, Luo Z, Kurusu N, Fujino K. A multi-body model for comparative study of cervical traction simulation – development, improvement and validation. Comput Methods Biomech Biomed Engin. 2019;22(8):806-814.
- Taheri P, Vahdatpour B, Andalib S. Comparative study of shock wave therapy and Laser therapy effect in elimination of symptoms among patients with myofascial pain syndrome in upper trapezius. Adv Biomed Res. 2016;30:5:138.
- Miller J, Gross A, D’Sylva J, et al. Manual ther¬apy and exercise for neck pain: a systematic review. Man Ther 2010;15:334-354.
- Behm DG, Blazevich AJ, Kay AD, McHugh M. Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Applied Physiology, Nutrition, and Metabolism 2016;41(1):1-11.
- Elgendy MH, Thabet T, Ali M, Mohamed GH, Mostafa MSM, Mostafa M. Comparative Study Between Continuous and Intermittent Cervical Traction in Treatment of Chronic Mechanical Neck Dysfunction. Int J Phys Ther Rehab 2021;7:175.
- Akgül Kocabal A, Gündüz OH. Examining the effectiveness of low-level laser treatment applied to the upper back region in ındividuals with myofascial pain syndrome. Cyprus J Med Sci 2024;9(2):93-100.
- Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sport Exerc 2007;39:1423-1434.
- Manske RC, Reiman MP, Stovak ML. Nonoperative and operative management of snapping scapula. Am J Sports Med 2004;32(6):1554-65.
- Harris PR. Cervical traction Review of literature and treatment guidelines. Phys Ther 1977;57(8):910-4.
- Khan RR, Awan WA, Rashid S, Masood T. A randomized controlled trial of intermittent Cervical Traction in sitting Vs. Supine position for the management of Cervical Radiculopathy. Pak J Med Sci 2017;33(6):1333-1338.
- Pan PJ, Tsai PH, Tsai CC, Chou CL, Lo MT, Chiu JH. Clinical response and autonomic modulation as seen in heart rate variability in mechanical intermittent cervical traction: a pilot study. J Rehabil Med 2012;44(3):229-34.
- Hode L, Tuner J, Laser Phototherapy Clinical practice and scientific background. Grangesberg: Prima Books AB, 2014: 271-273.
- Al Ghamdi KM, Kumar A, Moussa NA. Low-level laser therapy: a useful technique for enhancing the proliferation of various cultured cells. Lasers Med Sci 2012;27(1):237-49.
- Audette I, Dumas JP, Côté JN, De Serres SJ. Validity and between-day reliability of the cervical range of motion (CROM) device. J Orthop Sports Phys Ther 2010;40(5):318-23.
- Wiyanad A, Chokphukiao P, Suwannarat P, et al. Is the occiput-wall distance valid and reliable to determine the presence of thoracic hyperkyphosis? Musculoskelet Sci Pract 2018;38:63-68.
- Davis JC, Gladman DD. Spinal mobility measures in spondyloarthritis: application of the OMERACT filter. J Rheumatol 2007;34(4):666-70.
- Calis HT, Berberoglu N, Calis M. Are ultrasound, laser and exercise superior to each other in the treatment of subacromial impingement syndrome? A randomized clinical trial. Eur J Phys Rehabil Med 2011;47(3):375–80.
- Wolan-Nieroda A, Guzik A, Mocur P, Drużbicki M, Maciejczak A. Assessment of Interrater and Intrarater Reliability of Cervical Range of Motion (CROM) Goniometer. Biomed Res Int 2020;2020:8908035.
- Kocur P, Tomczak M, Wiernicka M, Goliwas M, Lewandowski J, Łochyn´ski D. Relationship between age, BMI, head postüre and superficial neck muscle stiffness and elasticity in adult women. Sci Rep 2019;9(1):8515.
- Madson TJ, Hollman JH. Cervical Traction for Managing Neck Pain: A Survey of Physical Therapists in the United States. J Orthop Sports Phys Ther 2017;47(3):200-208.
- Chiu TT, Ng JK, Walther-Zhang B, Lin RJ, Ortelli L, Chua SK. A randomized controlled trial on the efficacy of intermittent cervical traction for patients with chronic neck pain. Clin Rehabil 2011;25(9):814-22.
- Fritz JM, Thackeray A, Brennan GP, Childs JD, Exercise only, exercise with mechanical traction, or exercise with over-door traction for patients with cervical radiculopathy, with or without consideration of status on a previously described subgrouping rule: a randomized clinical trial. J Orthop Sports Phys Ther 2014;44(2):45-57.
- Abd-Eltawab AE, Ameer MA. Effect of Kinesio taping versus mechanical cervical traction combined with physiotherapy program on chronic neck pain in young female university students. Hong Kong Physiotherapy Journal 2024;44(1):69–78.
- Momenzadeh S, Zali A, Razzaghi Z, et al. Efficacy of low-level laser therapy for the treatment of nonspecific chronic neck pain: low-level laser therapy vs. Sham laser. J Lasers Med Sci 2022;13:e74.
- Agung I, Murdana N, Purba H, Fuady A. Low-level laser therapy and dry needling for myofascial pain syndrome of the upper trapezius muscle: An interventional study. Journal of Physics: Conference Series 2018;1073(6): 062045.
- Petrofsky JS, Laymon M, Alshammari F, Khowailed IA, Lee, H. Use of low level of continuous heat and Ibuprofen as an adjunct to physical therapy improves pain relief, range of motion and the compliance for home exercise in patients with nonspecific neck pain: A randomized controlled trial. J Back Musculoskelet Rehabil 2017;30(4):889–896.
- Fujita K, Nakamura M, Umegaki H, et al. Effects of a thermal agent and physical activity on muscle tendon stiffness, as well as the effects combined with static stretching. J Sport Rehabil 2018;27(1):66-72.
- Lee GP, Ng GY. Effects of stretching and heat treatment on hamstring extensibility in children with severe mental retardation and hypertonia. Clin Rehabil 2008;22(9):771-9.
- Anderson B G, Benzinger B, Chickness J, et al. (July 22, 2022) Effects of Cervical Spine Exercise Protocol on Neck Pain, Pericervical Muscle Endurance, and Range of Motion in Medical Students: A Prospective Study. Cureus 2022;14(7):e27160.
- Ibrahim AA, Kamel EM, Mahmoud WSE, Atteya MRM. Comparative Study between Supervised and Unsupervised Exercise Program for Cervical Spondylosis. 2018;7(6): 1-10.
- Szeto GPY, Straker L, Raine S. (2002) A field comparison of neck and shoulder postures in symptomatic and asymptomatic officeworkers. Appl Ergon 2002;33(1):75-84.
- El-Metwally A, Salminen JJ, Auvinen A, Macfarlane G, Mikkelsson M. Risk factors for development of non-specific musculoskeletal pain in preteens and early adolescents: a prospective 1-year follow-up study. BMC Musculoskelet Disord 2007;23(8):46.
- Silva AG, Punt TD, Sharples P, Vilas-Boas JP, Johnson MI. Head posture and neck pain of chronic nontraumatic origin: a comparison between patients and pain-free persons. Arch Phys Med Rehabil 2009;90(4):669-74.
Short-Term Effect of Different Physical Therapy Modalities on Neck Mobility in Healthy Young Adults
Year 2025,
Volume: 9 Issue: 1, 92 - 101, 31.01.2025
Ayşe Nur Oymak Soysal
,
Atiye Kaş Özdemir
,
Şule Şimşek
,
Ummuhan Baş Aslan
,
Merve Bergin
References
- Jung B, Black AC, Bhutta BS. Anatomy, head and neck, neck movements. StatPearls Publishing LLC; 2024
- Rahman S, M Das J. Anatomy, head and neck: cervical spine. StatPearls Treasure Island (FL): StatPearls Publishing; 2024.
- Yajima H, Nobe R, Takayama M, Takakura N. The mode of activity of cervical extensors and flexors in healthy adults: a cross-sectional study. Medicina (Kaunas). 2022;58(6):728.
- Cejudo A, Moreno-Alcaraz VJ, De Ste Croix M, Santonja-Medina F, Sainz de Baranda P. Lower-limb flexibility profile analysis in youth competitive inline hockey players. Int J Environ Res Public Health. 2020;17(12):4338.
- Binder AI. Cervical spondylosis and neck pain. BMJ 2007;334: 527–531.
- Cote P, Cassidy JD, Carroll L. The factors associated with neck pain and its related disability in the Saskatchewan population. Spine (Phila Pa 1976). 2000;25(9):1109–17.
- Murray CJ, Atkinson C, Bhalla K, et al. The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA. 2013;310(6):591–608.
- Hoy D, March L, Woolf A, et al. The global burden of neck pain: estimates from the global burden of disease 2010 study. Ann Rheum Dis 2014;73(7):1309–15.
- Kim R, Wiest C, Clark K, et al. Identifying risk factors for first-episode neck pain: a systematic review. Musculoskelet Sci Pract. 2018;33:77–83.
- Ylinen J, Salo P, Nyk.nen M, et al. Decrease isometric neck strength in women with chronic neck pain and the repeatability of neck strength measurements. Arch Phys Med Rehabil. 2004;85(8):1303–8.
- Ylinen J, Takala EP, Kautiainen H, et al. Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain. Eur J Pain 2004;8(5):473–8.
- Andersen LL, Kjaer M, S.gaard K, et al. Effect of two contrasting types of physical exercise on chronic neck muscle pain. Arthritis Rheum 2008;59(1):84–91.
- De Loose V, Van den Oord M, Burnotte F, et al. Functional assessment of the cervical spine in F-16 pilots with and without neck pain. Aviat Space Environ Med 2009;80(5):477–81.
- Bernstetter A. The application of a clinical prediction rule for patients with neck pain likely to benefit from cervical traction: A case report. Physiother Theory Pract 2016;32(7):546-555.
- Shin HJ, Kim SH, Hahm SC, Cho HY. Thermotherapy Plus Neck Stabilization Exercise for Chronic Nonspecific Neck Pain in Elderly: A Single-Blinded Randomized Controlled Trial. Int. J. Environ. Res. Public Health. 2020;17:1-12.
- Wong LKF, Luo Z, Kurusu N, Fujino K. A multi-body model for comparative study of cervical traction simulation – development, improvement and validation. Comput Methods Biomech Biomed Engin. 2019;22(8):806-814.
- Taheri P, Vahdatpour B, Andalib S. Comparative study of shock wave therapy and Laser therapy effect in elimination of symptoms among patients with myofascial pain syndrome in upper trapezius. Adv Biomed Res. 2016;30:5:138.
- Miller J, Gross A, D’Sylva J, et al. Manual ther¬apy and exercise for neck pain: a systematic review. Man Ther 2010;15:334-354.
- Behm DG, Blazevich AJ, Kay AD, McHugh M. Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Applied Physiology, Nutrition, and Metabolism 2016;41(1):1-11.
- Elgendy MH, Thabet T, Ali M, Mohamed GH, Mostafa MSM, Mostafa M. Comparative Study Between Continuous and Intermittent Cervical Traction in Treatment of Chronic Mechanical Neck Dysfunction. Int J Phys Ther Rehab 2021;7:175.
- Akgül Kocabal A, Gündüz OH. Examining the effectiveness of low-level laser treatment applied to the upper back region in ındividuals with myofascial pain syndrome. Cyprus J Med Sci 2024;9(2):93-100.
- Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sport Exerc 2007;39:1423-1434.
- Manske RC, Reiman MP, Stovak ML. Nonoperative and operative management of snapping scapula. Am J Sports Med 2004;32(6):1554-65.
- Harris PR. Cervical traction Review of literature and treatment guidelines. Phys Ther 1977;57(8):910-4.
- Khan RR, Awan WA, Rashid S, Masood T. A randomized controlled trial of intermittent Cervical Traction in sitting Vs. Supine position for the management of Cervical Radiculopathy. Pak J Med Sci 2017;33(6):1333-1338.
- Pan PJ, Tsai PH, Tsai CC, Chou CL, Lo MT, Chiu JH. Clinical response and autonomic modulation as seen in heart rate variability in mechanical intermittent cervical traction: a pilot study. J Rehabil Med 2012;44(3):229-34.
- Hode L, Tuner J, Laser Phototherapy Clinical practice and scientific background. Grangesberg: Prima Books AB, 2014: 271-273.
- Al Ghamdi KM, Kumar A, Moussa NA. Low-level laser therapy: a useful technique for enhancing the proliferation of various cultured cells. Lasers Med Sci 2012;27(1):237-49.
- Audette I, Dumas JP, Côté JN, De Serres SJ. Validity and between-day reliability of the cervical range of motion (CROM) device. J Orthop Sports Phys Ther 2010;40(5):318-23.
- Wiyanad A, Chokphukiao P, Suwannarat P, et al. Is the occiput-wall distance valid and reliable to determine the presence of thoracic hyperkyphosis? Musculoskelet Sci Pract 2018;38:63-68.
- Davis JC, Gladman DD. Spinal mobility measures in spondyloarthritis: application of the OMERACT filter. J Rheumatol 2007;34(4):666-70.
- Calis HT, Berberoglu N, Calis M. Are ultrasound, laser and exercise superior to each other in the treatment of subacromial impingement syndrome? A randomized clinical trial. Eur J Phys Rehabil Med 2011;47(3):375–80.
- Wolan-Nieroda A, Guzik A, Mocur P, Drużbicki M, Maciejczak A. Assessment of Interrater and Intrarater Reliability of Cervical Range of Motion (CROM) Goniometer. Biomed Res Int 2020;2020:8908035.
- Kocur P, Tomczak M, Wiernicka M, Goliwas M, Lewandowski J, Łochyn´ski D. Relationship between age, BMI, head postüre and superficial neck muscle stiffness and elasticity in adult women. Sci Rep 2019;9(1):8515.
- Madson TJ, Hollman JH. Cervical Traction for Managing Neck Pain: A Survey of Physical Therapists in the United States. J Orthop Sports Phys Ther 2017;47(3):200-208.
- Chiu TT, Ng JK, Walther-Zhang B, Lin RJ, Ortelli L, Chua SK. A randomized controlled trial on the efficacy of intermittent cervical traction for patients with chronic neck pain. Clin Rehabil 2011;25(9):814-22.
- Fritz JM, Thackeray A, Brennan GP, Childs JD, Exercise only, exercise with mechanical traction, or exercise with over-door traction for patients with cervical radiculopathy, with or without consideration of status on a previously described subgrouping rule: a randomized clinical trial. J Orthop Sports Phys Ther 2014;44(2):45-57.
- Abd-Eltawab AE, Ameer MA. Effect of Kinesio taping versus mechanical cervical traction combined with physiotherapy program on chronic neck pain in young female university students. Hong Kong Physiotherapy Journal 2024;44(1):69–78.
- Momenzadeh S, Zali A, Razzaghi Z, et al. Efficacy of low-level laser therapy for the treatment of nonspecific chronic neck pain: low-level laser therapy vs. Sham laser. J Lasers Med Sci 2022;13:e74.
- Agung I, Murdana N, Purba H, Fuady A. Low-level laser therapy and dry needling for myofascial pain syndrome of the upper trapezius muscle: An interventional study. Journal of Physics: Conference Series 2018;1073(6): 062045.
- Petrofsky JS, Laymon M, Alshammari F, Khowailed IA, Lee, H. Use of low level of continuous heat and Ibuprofen as an adjunct to physical therapy improves pain relief, range of motion and the compliance for home exercise in patients with nonspecific neck pain: A randomized controlled trial. J Back Musculoskelet Rehabil 2017;30(4):889–896.
- Fujita K, Nakamura M, Umegaki H, et al. Effects of a thermal agent and physical activity on muscle tendon stiffness, as well as the effects combined with static stretching. J Sport Rehabil 2018;27(1):66-72.
- Lee GP, Ng GY. Effects of stretching and heat treatment on hamstring extensibility in children with severe mental retardation and hypertonia. Clin Rehabil 2008;22(9):771-9.
- Anderson B G, Benzinger B, Chickness J, et al. (July 22, 2022) Effects of Cervical Spine Exercise Protocol on Neck Pain, Pericervical Muscle Endurance, and Range of Motion in Medical Students: A Prospective Study. Cureus 2022;14(7):e27160.
- Ibrahim AA, Kamel EM, Mahmoud WSE, Atteya MRM. Comparative Study between Supervised and Unsupervised Exercise Program for Cervical Spondylosis. 2018;7(6): 1-10.
- Szeto GPY, Straker L, Raine S. (2002) A field comparison of neck and shoulder postures in symptomatic and asymptomatic officeworkers. Appl Ergon 2002;33(1):75-84.
- El-Metwally A, Salminen JJ, Auvinen A, Macfarlane G, Mikkelsson M. Risk factors for development of non-specific musculoskeletal pain in preteens and early adolescents: a prospective 1-year follow-up study. BMC Musculoskelet Disord 2007;23(8):46.
- Silva AG, Punt TD, Sharples P, Vilas-Boas JP, Johnson MI. Head posture and neck pain of chronic nontraumatic origin: a comparison between patients and pain-free persons. Arch Phys Med Rehabil 2009;90(4):669-74.