AB1471-HPR Investigation of the effect of manual therapy and cervical stabilisation exercises on disability, kinesiophobia, depression and anxiety in chronic neck pain patients: a pilot study
Authors: Y Ozel Aslıyuce, D. Onan, O. Ulger
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Neck pain is a common pain after low back pain and becomes chronic in most of the individuals (43%). Due to the severe pain experienced in chronic neck pain (CNP) individuals, the level of disability, depression and anxiety increases and kinesophobia develops. Cervical stabilisation exercises in individuals with CNP are one of the most effective treatment methods applied recently and the main purpose is to provide training of deep cervical muscles. Manual therapy approaches such as suboccipital release and post-isometric relaxation techniques provide relaxation of the fascia and superficial muscles. These techniques are rarely applied compared to cervical stabilisation exercises and the number of studies done in the literature is very limited. The effects of these three approaches in the treatment of pain severity, disability, kinesophobia, depression and anxiety are not known in the patients with CNP. <h3>Objectives</h3> The aim of this study is to investigate the effect of physiotherapy program consisting of suboccipital relaxation technique, post-isometric relaxation technique and cervical stabilisation exercises on pain severity, disability, kinesophobia, depression and anxiety in individuals with CNP. <h3>Methods</h3> Ten patients who have CNP aged 18–65 years (mean age 37.11±4.26) were included in this study. Pain intensity at rest, activity and night with visual analogue scale (VAS), levels depression with Beck Depression Scale (BDS), anxiety with Beck Anxiety Scale (BAS), kinesiophobia with Tampa Kinesiophobia Scale (TKS) and disability with Neck Disability Index (NDI) were assessed. All participants in the study were included in a 10-session physiotherapy program that included suboccipital relaxation, post-isometric relaxation to the upper part of the trapezius muscle, and cervical stabilisation exercises. <h3>Results</h3> It was found that pain intensity at rest, activity and night were significantly decreased after treatment (p=0.008).Disability (p=0.008) and kinesophobia (p=0.01) level were also significantly dropted. Depression (p=0.015) and anxiety levels (p=0.024) were statistically significantly improved after treatment. <h3>Conclusions</h3> As a result of our study, pain, depression and anxiety levels decreased, kinesophobia and disability were improved after physiotherapy applied to individuals with CNP. The suboccipital relaxation and post-isometric relaxation techniques applied before cervical stabilisation exercises increased the adaptation to the exercise by providing relaxation of the painful and tense region in the patients. We think that the activation of the deep cervical muscles is facilitated when the tension of the superficial muscles and the fascia are relaxed. Soft tissue loosening does not result in pain during and-exercise, which may have reduced the tendency for kinesophobia, anxiety and depression in patients. <h3>References</h3> [1] Gelecek, N. and H. Akkan, <i>The effect of stabilization exercise training on pain and functional status in patients with cervical radiculopathy</i>. J Back Musculoskelet Rehabil, 2017. [2] Strunk, R.G. and M.A. Hondras, <i>A feasibility study assessing manual therapies to different regions of the spine for patients with subacute or chronic neck pain</i>. J Chiropr Med, 2008. 7(1): p. 1–8. <h3>Disclosure of Interest</h3> None declared