Global postural re-education reduces pain and disability in chronic nonspecific neck pain

Study Type: Therapy
OE Level of Evidence: 2
Journal Level of Evidence: N/A
Synopsis
94 patients with chronic nonspecific neck pain were randomized to physical therapy-based treatments using global postural re-education (GPR) or manual therapy. The purpose of this trial was to determine if the global postural re-education therapy could reduce pain and disability in comparison to manual therapy when evaluated over a 6-month follow-up. Results demonstrated that Please login to view the rest of this report. Please login to view the rest of this report.
Funding: Not Reported
Conflicts: None disclosed
CONTENT IS LOCKED
Why was this study needed now?
Patients with chronic neck pain often present with dysfunctional and altered postural muscle control. While the relationship between altered postural muscle control and neck pain has not been fully established, this impairment represents and opportunity for possible therapeutic treatment. Global postural re-education therapy is a conservative intervention that has been developed to promote improved muscle balance and postural symmetry. A number of studies have been conducted that support the clinical effectiveness of global postural re-education therapy, however, a randomized controlled trial that evaluated global postural re-education as a sole intervention for patients with neck pain had not been conducted.
What was the principal research question?
In patients with chronic nonspecific neck pain, did the use of a global posture re-education intervention reduce pain and disability when compared to manual therapy over a 6-month follow-up period?
Population: 94 patients, between the ages of 18-80, with chronic nonspecific neck pain for at least 3 months. Patients were excluded if neck pain was acute, had cognitive impairment, had a history of spinal surgery, or received physical therapy within 6 months of baseline measures.
Intervention: GPR group: Patients received nine 1-hour sessions of global postural re-education therapy provided by a trained physical therapist. GPR included only 2 of the 8 possible postures; the supine posture with leg extension (stretching the anterior chain) and supine posture with hip flexion (stretching the posterior chain). Patients were also provided with advice to follow ergonomic suggestions and to repeat exercises (posture routine) twice per week at home. (n=47, mean age = 47.5 +/- 7.9)
Comparison: MT group: Patients received nine 1-hour sessions of manual therapy that included axial cervical general traction and mobilization of muscle fascia performed for 30 minutes, followed by passive mobilization of the cervical spine and therapeutic massage. Patients were also provided with advice to follow ergonomic suggestions and to repeat exercises (stretching and active range of motion) twice per week at home. (n=47, mean age = 47.4 +/- 13.9)
Outcomes: The primary outcomes included pain and disability measured using a visual analogue scale (VAS) and the Neck Disability Index (NDI). Secondary outcome measures included the perceived effect of the intervention, patient satisfaction, cervical range of motion and kinesophobia via the Tampa Scale of Kinesiophobia.
Methods: RCT: single blind
Time: Outcomes were collected over a 6-month period: at baseline, the end of therapy, and at 6 months.
What were the important findings?
What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.