Effects of internet-based neck-specific training programs on pain and disability in patients with cervical spondylotic radiculopathy_West China Medical Journal

Authors：

ZHANG Ruishi , YANG Haolun , WANG Xiaoyi , WANG Lin , FENG Yuan ,  HE Chengqi

Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

HE Chengqi, Email: hxkfhcq2015@126.com

Keywords：

Cervical spondylotic radiculopathy; telehabilitation; neck-specific training; traditional treatment

DOI：

10.7507/1002-0179.202305003

Video：

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Objective To investigate whether an internet-based neck-specific training program can alleviate pain and disability in participants with cervical spondylotic radiculopathy (CSR). Methods Patients diagnosed with CSR at West China Hospital of Sichuan University between March 2022 and September 2022 were randomly allocated to either an telehabilitation group or a traditional treatment group. The primary outcome measures included Visual Analogue Scale, Neck Disability Index, and patient satisfaction. Secondary outcome measures included the Euroqol group’s 5-Domain questionnaire, Fear-Avoidance Beliefs Questionnaire, Hospital Anxiety and Depression Scale, Tanaka Jingjiu cervical spondylosis symptom scale (20 points) and satisfaction. Quantitative outcome measures were collected at baseline, 12th and 24th weeks after the first intervention, while qualitative outcome measures were collected at 24th weeks after the first intervention. Results A total of 90 patients were included, with 45 in each group. There was no statistically significant difference between the two groups in terms of age, gender and other demography characteristics and general data (P>0.05). There is no interaction effect (group × time) for the Tanaka Jingjiu cervical spondylosis symptom scale (20 points) (P>0.05), the interaction effects (group × time) for other quantitative outcome measures were statistically significant (P<0.05). The time effect showed significant statistical differences across all quantitative outcome measures (P<0.001), while the group effect did not exhibit any significant statistical differences (P>0.05). The comparison results within the group showed that at different time points, the differences between the two groups were statistically significant (P<0.001). There were no significant statistical differences between the two groups in terms of qualitative outcome measures (P>0.05) . Conclusions An internet-based neck-specific training program or traditional treatment for 12 weeks can effectively reduce pain and disability among CSR patients, with significant long-term effects. There was no significant difference in treatment effectiveness between the two groups.

Citation： ZHANG Ruishi, YANG Haolun, WANG Xiaoyi, WANG Lin, FENG Yuan, HE Chengqi. Effects of internet-based neck-specific training programs on pain and disability in patients with cervical spondylotic radiculopathy. West China Medical Journal, 2023, 38(6): 850-858. doi: 10.7507/1002-0179.202305003 Copy

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2.	神经根型颈椎病诊疗规范化的专家共识. 中华外科杂志, 2015, 53(11): 812-814.
3.	Blanpied PR, Gross AR, Elliott JM, et al. Neck pain: revision 2017. J Orthop Sports Phys Ther, 2017, 47(7): A1-A83.
4.	Health Quality Ontario. Structured education and neuromuscular exercise program for hip and/or knee osteoarthritis: a health technology assessment. Ont Health Technol Assess Ser, 2018, 18(8): 1-110.
5.	Özel M, Kaya Ciddi P. The effectiveness of telerehabilitation-based structured exercise therapy for chronic nonspecific neck pain: a randomized controlled trial. J Telemed Telecare, 2022: 1357633X221095782.
6.	Dedering Å, Peolsson A, Cleland JA, et al. The effects of neck-specific training versus prescribed physical activity on pain and disability in patients with cervical radiculopathy: a randomized controlled trial. Arch Phys Med Rehabil, 2018, 99(12): 2447-2456.
7.	Lakens D. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol, 2013, 4: 863.
8.	Shacklock M. Neurodynamics. Physiother, 1995, 81(1): 9-16.
9.	Li Y, Tse MYM. An online pain education program for working adults: pilot randomized controlled trial. J Med Internet Res, 2020, 22(1): e15071.
10.	Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain, 1983, 16(1): 87-101.
11.	Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther, 1991, 14(7): 409-415.
12.	Buchholz I, Janssen MF, Kohlmann T, et al. A systematic review of studies comparing the measurement properties of the three-level and five-level versions of the EQ-5D. Pharmacoeconomics, 2018, 36(6): 645-661.
13.	Dedering A, Börjesson T. Assessing fear-avoidance beliefs in patients with cervical radiculopathy. Physiother Res Int, 2013, 18(4): 193-202.
14.	Castro MM, Quarantini L, Batista-Neves S, et al. Validity of the hospital anxiety and depression scale in patients with chronic pain. Rev Bras Anestesiol, 2006, 56(5): 470-477.
15.	Yang J, Huang H, Shi J, et al. Qihuang needle therapy in senile cervical spondylotic radiculopathy. Front Aging Neurosci, 2023, 15: 1140531.
16.	Cheng CH, Lin KH, Wang JL. Co-contraction of cervical muscles during sagittal and coronal neck motions at different movement speeds. Eur J Appl Physiol, 2008, 103(6): 647-654.
17.	Lindstrøm R, Schomacher J, Farina D, et al. Association between neck muscle coactivation, pain, and strength in women with neck pain. Man Ther, 2011, 16(1): 80-86.
18.	Lee PJ, Rogers EL, Granata KP. Active trunk stiffness increases with co-contraction. J Electromyogr Kinesiol, 2006, 16(1): 51-57.
19.	Choi H. Quantitative assessment of co-contraction in cervical musculature. Med Eng Phys, 2003, 25(2): 133-140.
20.	Halvorsen M, Falla D, Gizzi L, et al. Short- and long-term effects of exercise on neck muscle function in cervical radiculopathy: a randomized clinical trial. J Rehabil Med, 2016, 48(8): 696-704.
21.	Booth J, Moseley GL, Schiltenwolf M, et al. Exercise for chronic musculoskeletal pain: a biopsychosocial approach. Musculoskeletal care, 2017, 15(4): 413-421.
22.	Lima LV, Abner TSS, Sluka KA. Does exercise increase or decrease pain? Central mechanisms underlying these two phenomena. J Physiol, 2017, 595(13): 4141-4150.
23.	Stolzman S, Bement MH. Does exercise decrease pain via conditioned pain modulation in adolescents?. Pediatr Phys Ther, 2016, 28(4): 470-473.

1. Eubanks JD. Cervical radiculopathy: nonoperative management of neck pain and radicular symptoms. Am Fam Physician, 2010, 81(1): 33-40.
2. 神经根型颈椎病诊疗规范化的专家共识. 中华外科杂志, 2015, 53(11): 812-814.
3. Blanpied PR, Gross AR, Elliott JM, et al. Neck pain: revision 2017. J Orthop Sports Phys Ther, 2017, 47(7): A1-A83.
4. Health Quality Ontario. Structured education and neuromuscular exercise program for hip and/or knee osteoarthritis: a health technology assessment. Ont Health Technol Assess Ser, 2018, 18(8): 1-110.
5. Özel M, Kaya Ciddi P. The effectiveness of telerehabilitation-based structured exercise therapy for chronic nonspecific neck pain: a randomized controlled trial. J Telemed Telecare, 2022: 1357633X221095782.
6. Dedering Å, Peolsson A, Cleland JA, et al. The effects of neck-specific training versus prescribed physical activity on pain and disability in patients with cervical radiculopathy: a randomized controlled trial. Arch Phys Med Rehabil, 2018, 99(12): 2447-2456.
7. Lakens D. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol, 2013, 4: 863.
8. Shacklock M. Neurodynamics. Physiother, 1995, 81(1): 9-16.
9. Li Y, Tse MYM. An online pain education program for working adults: pilot randomized controlled trial. J Med Internet Res, 2020, 22(1): e15071.
10. Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain, 1983, 16(1): 87-101.
11. Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther, 1991, 14(7): 409-415.
12. Buchholz I, Janssen MF, Kohlmann T, et al. A systematic review of studies comparing the measurement properties of the three-level and five-level versions of the EQ-5D. Pharmacoeconomics, 2018, 36(6): 645-661.
13. Dedering A, Börjesson T. Assessing fear-avoidance beliefs in patients with cervical radiculopathy. Physiother Res Int, 2013, 18(4): 193-202.
14. Castro MM, Quarantini L, Batista-Neves S, et al. Validity of the hospital anxiety and depression scale in patients with chronic pain. Rev Bras Anestesiol, 2006, 56(5): 470-477.
15. Yang J, Huang H, Shi J, et al. Qihuang needle therapy in senile cervical spondylotic radiculopathy. Front Aging Neurosci, 2023, 15: 1140531.
16. Cheng CH, Lin KH, Wang JL. Co-contraction of cervical muscles during sagittal and coronal neck motions at different movement speeds. Eur J Appl Physiol, 2008, 103(6): 647-654.
17. Lindstrøm R, Schomacher J, Farina D, et al. Association between neck muscle coactivation, pain, and strength in women with neck pain. Man Ther, 2011, 16(1): 80-86.
18. Lee PJ, Rogers EL, Granata KP. Active trunk stiffness increases with co-contraction. J Electromyogr Kinesiol, 2006, 16(1): 51-57.
19. Choi H. Quantitative assessment of co-contraction in cervical musculature. Med Eng Phys, 2003, 25(2): 133-140.
20. Halvorsen M, Falla D, Gizzi L, et al. Short- and long-term effects of exercise on neck muscle function in cervical radiculopathy: a randomized clinical trial. J Rehabil Med, 2016, 48(8): 696-704.
21. Booth J, Moseley GL, Schiltenwolf M, et al. Exercise for chronic musculoskeletal pain: a biopsychosocial approach. Musculoskeletal care, 2017, 15(4): 413-421.
22. Lima LV, Abner TSS, Sluka KA. Does exercise increase or decrease pain? Central mechanisms underlying these two phenomena. J Physiol, 2017, 595(13): 4141-4150.
23. Stolzman S, Bement MH. Does exercise decrease pain via conditioned pain modulation in adolescents?. Pediatr Phys Ther, 2016, 28(4): 470-473.

West China Medical Journal

Effects of internet-based neck-specific training programs on pain and disability in patients with cervical spondylotic radiculopathy

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