Effects of Exercise and an Integrated Neuromuscular Inhibition Technique Program in the Management of Chronic Mechanical Neck Pain: A Randomized Controlled Trial

• Published in: Journal of manipulative and physiological therapeutics 2020-02, Vol.43 (2), p.100-113
• Main Authors: Lytras, Dimitrios E., Sykaras, Evaggelos I., Christoulas, Kosmas I., Myrogiannis, Ioannis S., Kellis, Eleftherios
• Format: Article
• Language: English
• Subjects: Adult; Chronic Pain - therapy; Combined Modality Therapy; Exercise; Exercise Therapy - methods; Female; Humans; Male; Middle Aged; Neck Muscles - physiology; Neck Pain; Neck Pain - therapy; Pain Measurement; Pain Threshold - physiology; Quality of Life; Range of Motion, Articular - physiology; Soft Tissue; Therapy; Therapy, Soft Tissue - methods; Visual Analog Scale
• ISSN: 0161-4754; 1532-6586
• DOI: 10.1016/j.jmpt.2019.03.011

The aim of this study was to evaluate the effect of adding the integrated neuromuscular inhibition technique (INIT) to therapeutic exercise (TE) in individuals with chronic mechanical neck pain (CMNP). In this 34-week, assessor-blind randomized controlled trial, 40 participants (men and women) with CMNP with active or latent myofascial trigger points on the neck muscles were divided into 2 groups. The participants followed 4 treatments per week for 10 weeks. The intervention group followed a TE program in combination with the INIT, whereas the control group followed the same program without the INIT. Both protocols were applied by physiotherapists. Pain, disability, pressure pain threshold, active range of motion, and health-related quality of life were evaluated before, during, and after the intervention, whereas patients were followed for 6 months after completion of treatment. Repeated-measures ANOVA was applied. Both groups showed a significant improvement in all dependent measures after the intervention (P < .05). However, the intervention group showed greater improvement in the visual analog scale and neck disability index score, in the neck muscles pressure pain threshold, in the range of motion, and in the 36-Item Short Form Health Survey score, than the control group. In many of the above variables this improvement was seen from the second week and was maintained for 6 months after the intervention. The results of this preliminary study suggest that the addition of the INIT to a TE program had a positive effect on pain, functionality, and the quality of life in individuals with CMNP.