EFFECTIVENESS OF RELAXATION TRAINING IN ADDITION TO STABILIZATION EXERCISES IN CHRONIC NECK PAIN: A RANDOMIZED CLINICAL TRIAL

Yıl 2019, Cilt: 30 Sayı: 3, 145 - 153, 20.12.2019

Derya Özer Kaya Şeyda Toprak Çelenay

https://doi.org/10.21653/tjpr.665131

Cited By: 3

Öz

Purpose: The study aimed to investigate and compare the effects of a 4-week neck stabilization
exercise program plus progressive muscle relaxation training (PMRT) to stabilization exercise
program alone in patients with chronic neck pain (CNP).
Methods: The patients were randomly divided into two groups: (1) Stabilization Exercise (Exercise)
Group (n=30, age=43.20±14.10 years), and (2) Stabilization Exercise combined with PMRT
(Relaxation) Group (n=28, age=38.43±12.81 years). The programs were carried out three days
per week for four weeks. Before and after the program, pain intensity using Visual Analog Scale,
pressure pain threshold using an algometer, cervical range of motion using a goniometer, disability
using Neck Disability Index, kinesophobia using Tampa Scale, and quality of life using Short Form-
36 were assessed.
Results: After the programs, pain intensity, and disability decreased, cervical flexion, extension,
right lateral flexion, and rotation movements increased in the Exercise Group (p<0.05). In
the Relaxation Group, pain intensity, disability, and kinesiophobia reduced, and pain pressure
threshold, all cervical range of movements, and quality of life scores improved (p<0.05). Intergroup
comparisons showed that the pain pressure threshold, cervical flexion, right lateral flexion, the
right and left rotation range of movements, and kinesiophobia improvements were better in the
Relaxation Group (p<0.05).
Conclusion: The stabilization exercises with and without relaxation were effective in improving
pain, movements, and disability in patients with CNP. Addition of relaxation had superiority to
improve pain pressure threshold, neck movements, and kinesiophobia.

Anahtar Kelimeler

Exercise, Neck Pain, Quality of Life

Kaynakça

• 1. US Burden of Disease Collaborators. The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA. 2013;310(6):591-608.
• 2. Guez M, Hildingsson C, Nilsson M, Toolanen G. The prevalence of neck pain. Acta Orthop Scand. 2002;73(4):455-9.
• 3. Cohen SP. Epidemiology, diagnosis, and treatment of neck pain. Mayo Clin Proc. 2015;90(2):284-99.
• 4. Johnston V, Jull G, Darnell R, Jimmieson NL, Souvlis T. Alterations in cervical muscle activity in functional and stressful tasks TÜRK FİZYOTERAPİ VE REHABİLİTASYON DERGİSİ 2019; 30(3) 153 Özer Kaya D, Toprak Çelenay Ş. in female office workers with neck pain. Eur J Appl Physiol. 2008;103(3):253-64.
• 5. Tsang SM, Szeto GP, Lee RY. Relationship between neck acceleration and muscle activation in people with chronic neck pain: implications for functional disability. Clin Biomech (Bristol, Avon). 2016;35:27-36.
• 6. Thompson DP, Woby SR. Acceptance in chronic neck pain: associations with disability and fear avoidance beliefs. Int J Rehabil Res. 2017;40(3):220-6.
• 7. Park SJ, Lee R, Yoon DM, Yoon KB, Kim K, Kim SH. Factors associated with increased risk for pain catastrophizing in patients with chronic neck pain: a retrospective cross-sectional study. Medicine (Baltimore). 2016;95(37):e4698.
• 8. Gross AR, Paquin JP, Dupont G, Blanchette S, Lalonde P, Cristie T, et al. Exercises for mechanical neck disorders: a Cochrane review update. Man Ther. 2016;24:25-45.
• 9. Kim JY, Kwag KI. Clinical effects of deep cervical flexor muscle activation in patients with chronic neck pain. J Phys Ther Sci. 2016;28(1):269-73.
• 10. Cherkin DC, Herman PM. Cognitive and mind-body therapies for chronic low back pain and neck pain: effectiveness and value. JAMA Intern Med. 2018;178(4):556-7.
• 11. Celenay ST, Kaya DO, Akbayrak T. Cervical and scapulothoracic stabilization exercises with and without connective tissue massage for chronic mechanical neck pain: a prospective, randomised controlled trial. Man Ther. 2016;21:144-50.
• 12. Celenay ST, Akbayrak T, Kaya DO. A comparison of the effects of stabilization exercises plus manual therapy to those of stabilization exercises alone in patients with nonspecific mechanical neck pain: a randomized clinical trial. J Orthop Sports Phys Ther. 2016;46(2):44-55.
• 13. McCallie MS, Blum CM, Hood CJ. Progressive muscle relaxation. J Hum Behav Soc Environ. 2006;13(3):51-66.
• 14. McGuigan FJ, Lehrer PM. Progressive relaxation: origins, principles, and clinical applications. In: Lehrer PM, Woolfolk RL, Sime WE, eds. Principles and practice of stress management. 3rd ed. NewYork: The Guilford Press; 2007: p.57-87.
• 15. Jacobson E. Progressive Relaxation. 2nd ed. Oxford, England: Univ. Chicago Press; 1938.
• 16. Lauche R, Schuth M, Schwickert M, Lüdtke R, Musial F, Michalsen A, et al. Efficacy of the Alexander Technique in treating chronic non-specific neck pain: a randomized controlled trial. Clin Rehabil. 2016;30(3):247-58.
• 17. Gustavsson C, von Koch L. Applied relaxation in the treatment of long-lasting neck pain: a randomized controlled pilot study. J Rehabil Med. 2006;38(2):100-7.
• 18. Viljanen M, Malmivaara A, Uitti J, Rinne M, Palmroos P, Laippala P. Effectiveness of dynamic muscle training, relaxation training, or ordinary activity for chronic neck pain: randomised controlled trial. BMJ. 2003; 30;327(7413):475.
• 19. Clark P, Lavielle P, Martínez H. Learning from pain scales: patient perspective. J Rheumatol. 2003;30(7):1584-8.
• 20. Chung SC, Um BY, Hyung SK. Evaluation of pressure pain threshold in head and neck muscles by electronic algometer: intrarater and interrater reliability. Cranio. 1992;10(1):28-34.
• 21. Cleland JA, Childs JD, Fritz JM, Whitman JM. Interrater reliability of the history and physical examination in patients with mechanical neck pain. Arch Phys Med Rehabil. 2006;87(10):1388-95.
• 22. Telci EA, Karaduman A, Yakut Y, Aras B, Simsek IE, Yagli N. The cultural adaptation, reliability, and validity of Neck Disability Index in patients with neck pain: a Turkish version study. Spine. 2009;34(16):1732-5.
• 23. Yılmaz TÖ, Yakut Y, Uygur F, Uluğ N. Turkish version of the Tampa Scale for Kinesiophobia and its test-retest reliability. Fizyoter Rehabil. 2011;22(1):44-9.
• 24. Kocyigit H, Aydemir O, Olmez N, Memis A. Reliability and validity of the Turkish version of Short-Form-36 (SF-36). Turkish J Drugs Therap. 1999;12(2):102-6.
• 25. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175- 91.
• 26. Dusunceli Y, Ozturk C, Atamaz F, Hepguler S, Durmaz B. Efficacy of neck stabilization exercises for neck pain: a randomized controlled study. J Rehabil Med. 2009;41(8):626-31.
• 27. Akkan H, Gelecek N. The effect of stabilization exercise training on pain and functional status in patients with cervical radiculopathy. J Back Musculoskelet Rehabil. 2018;31(2):247-52.
• 28. Ghaderi F, Jafarabadi MA, Javanshir K. The clinical and EMG assessment of the effects of stabilization exercise on nonspecific chronic neck pain: a randomized controlled trial. J Back Musculoskelet Rehabil. 2017;30(2):211-9.
• 29. Dogan H, Telci EA, Kurtca MP. The effectiveness of kinesio taping on pain, range of motion and disability in patients with chronic neck pain: a randomized controlled study. Ann Phys Rehabil Med. 2018;61:e142.
• 30. Yesil H, Hepguler S, Dundar U, Taravati S, Isleten B. Does the use of electrotherapies increase the effectiveness of neck stabilization exercises for improving pain, disability, mood, and quality of life in chronic neck pain? A randomized, controlled, single-blind study. Spine (Phila Pa 1976). 2018;43(20):E1174- 83.
• 31. Metikaridis DT, Hadjipavlou A, Artemiadis A, Chrousos GP, Darviri C. Effect of a stress management program on subjects with neck pain: a pilot randomized controlled trial. J Back Musculoskelet Rehabil. 2017;30(1):23-33.
• 32. Lauche R, Materdey S, Cramer H, Haller H, Stange R, Dobos G, et al. Effectiveness of home-based cupping massage compared to progressive muscle relaxation in patients with chronic neck pain: a randomized controlled trial. PLoS One. 2013;7;8(6):e65378.
• 33. Kobayashi S, Koitabashi K. Effects of progressive muscle relaxation on cerebral activity: a fMRI investigation. Complement Ther Med. 2016;26:33-9.