Background & Aims
Exercise is considered the recommended evidence-based approach for chronic neck pain management. Cervico-scapulothoracic strengthening or scapular stabilization exercise has proven to improve pain and neck disability index. However, there has yet to be a consensus on the specific type of exercise that is most effective for treating chronic neck pain. This study investigated the efficacy of core stability exercise with shoulder flexion movement (dead bug exercise) compared to scapular stabilization in the prone position with shoulder forward flexion and scapular retraction (prone Y lift exercise).
To study the efficacy of dead bug exercise compare to prone Y, the standard exercise in subacute and chronic work-related non-specific neck pain in pain score (NRS) and neck disability index (NDI) in short, intermediate and long term.
Methods
The study design was randomized control trial, assessor blind, non-inferiority trial. The study were approved by the ethical committee of the Institutional Review Board of the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. All participants who met inclusion criteria received an education in working ergonomics, stretching exercises, and supervised exercise by a different physiotherapist for each group for two sessions, followed by a video call once a week. The exercise protocol was 3 sets/session, at least 3 sessions/week for six weeks. The exercise intensity progressed every 2 weeks by increase the repetition from 10 to 15 and 20 repetitions/set respectively. The NRS and NDI were collected before and after the 6-week exercise, 6-month and 12 months after the complete exercise program.
Results
Sixty four patients were recruited and randomized into two groups (dead bug n= 32, prone Y n=32). The results of the research showed that after 6-week exercise program, NRS and NDI decreased from baseline in both groups. The mean change NRS for the dead bug group after 6-week of exercise was -2.53 (95% CI: -2.95 to -2.10, p<0.001) and for the prone Y lift group was -1.88 (95% CI: -2.36 to -1.39, p<0.001). The mean change NDI for the dead bug group was -6.18, 95% CI: -7.77 to -4.60, p<0.001 and for the prone Y group was -6.61, 95% CI: -8.53 to -5.22, p<0.001). NRS change in dead bug group was non-inferior to prone Y group. In addition, there was significant difference in the amount of change in NRS values of the dead bug group than the prone Y group (d= -0.66, p=0.042). At sixth month and one year after complete the exercises program, the mean difference of NRS and NDI of both exercises still lower than baseline. In addition, the mean difference of NRS and NDI of dead bug group was non-inferior to prone Y lift group.
Conclusions
Dead bug exercise was non-inferior and superior to prone Y lift in pain improvement after complete 6-week exercise program. In addition, dead bug exercise was non-inferior to prone Y lift in pain improvement at 6- and 12-month follow up and neck disability improvement after 6-week exercise, 6-, and 12-month follow up.
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Presenting Author
Timporn Vitoonpong
Poster Authors
Timporn Vitoonpong
M.D. PM&R
King Chulalongkorn Memorial Hospital
Lead Author
Kasidet Kraisorn
Department of Rehabilitation medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross
Lead Author
Sarissa Rangkla
Department of Rehabilitation medicine, Faculty of Medicine, Chulalongkorn University
Lead Author
Chalermdej Prapinpairoj
Department of Rehabilitation medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross
Lead Author
Topics
- Specific Pain Conditions/Pain in Specific Populations: Neck Pain