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Psychological Care, Patient Education, Orthotics, Ergonomics and Prevention Strategies for Neck Pain: An Systematic Overview Update as Part of the ICON Project.

Gross AR, Kaplan F, Huang S, Khan M, Santaguida PL, Carlesso LC, Macdermid JC, Walton DM, Kenardy J, Söderlund A, Verhagen A, Hartvigsen J - Open Orthop J (2013)

Bottom Line: For acute whiplash associated disorder (WAD), an education video in emergency rooms (1RCT, 405participants] favoured pain reduction at long-term follow-up thus helping 1 in 23 people [Standard Mean Difference: -0.44(95%CI: -0.66 to -0.23)).Use of a soft collar (2RCTs, 1278participants) was not beneficial in the long-term.A number of psychosocial interventions, workplace interventions, collar use and self-management educational strategies were not beneficial.

View Article: PubMed Central - PubMed

Affiliation: McMaster University, Hamilton, ON, Canada;

ABSTRACT

Objectives: To conduct an overview on psychological interventions, orthoses, patient education, ergonomics, and 1⁰/2⁰ neck pain prevention for adults with acute-chronic neck pain.

Search strategy: Computerized databases and grey literature were searched (2006-2012).

Selection criteria: Systematic reviews of randomized controlled trials (RCTs) on pain, function/disability, global perceived effect, quality-of-life and patient satisfaction were retrieved.

Data collection & analysis: Two independent authors selected articles, assessed risk of bias using AMSTAR tool and extracted data. The GRADE tool was used to evaluate the body of evidence and an external panel to provide critical review.

Main results: We retrieved 30 reviews (5-9 AMSTAR score) reporting on 75 RCTs with the following moderate GRADE evidence. For acute whiplash associated disorder (WAD), an education video in emergency rooms (1RCT, 405participants] favoured pain reduction at long-term follow-up thus helping 1 in 23 people [Standard Mean Difference: -0.44(95%CI: -0.66 to -0.23)). Use of a soft collar (2RCTs, 1278participants) was not beneficial in the long-term. For chronic neck pain, a mind-body intervention (2RCTs, 1 meta-analysis, 191participants) improved short-term pain/function in 1 of 4 or 6 participants. In workers, 2-minutes of daily scapula-thoracic endurance training (1RCT, 127participants) over 10 weeks was beneficial in 1 of 4 participants. A number of psychosocial interventions, workplace interventions, collar use and self-management educational strategies were not beneficial.

Reviewers' conclusions: Moderate evidence exists for quantifying beneficial and non-beneficial effects of a limited number of interventions for acute WAD and chronic neck pain. Larger trials with more rigorous controls need to target promising interventions.

No MeSH data available.


Related in: MedlinePlus

PRISMA diagram showing the flow of reviews on psychology, ergonomics, prevention, orthotics, and patient education for neckpain.
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Figure 1: PRISMA diagram showing the flow of reviews on psychology, ergonomics, prevention, orthotics, and patient education for neckpain.

Mentions: We included 30 reviews on treatment (see Fig. 1 - Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)) [24] flow diagram representing 75 RCTs - 14 RCTs related to psychological interventions, 29 to ergonomic workplace interventions, 22 to orthotics, 22 to patient education, 6 to 1⁰ prevention and 9 to 2⁰ prevention; keep in mind that there was some overlap. We did not retrieve any reviews on harm for these interventions. The AMSTAR score ranged from 5 to 9 and the most common methodological limitation were: assessment of publication bias, stating conflict of interest and inclusion of a list of included and excluded studies [10, 17]. See Appendix 1 for the listing of the 24 excluded reviews and reasons for exclusion. We detailed trial findings by the quality of the evidence (GRADE level) and treatment category in the later sections. Tables 3 and 4 provides summary findings by treatment category. Table 5 summarizes the strong and moderate quality recommendations based on the GRADE approach and details the magnitude of the effect in terms of effect size. The primary studies included in our analyses investigated the following 1)psychological categories: psychological, psychosocial interventions and mind-body; 2) workplace interventions and prevention: physical environment change, individual worker change, ergonomic and mental health education; organizational change; 3) patient education categories: advice on activation, advice on rest, pain and stress coping skills education, workplace ergonomic education +pain and stress coping skills education self-management educational strategies; and 4) orthotics categories: specialized pillow, specialized pillow + therapy, rigid collar, soft collar, soft collar + home exercise + physiotherapy, collar + advice for self-mobilization, kinesio taping, oral splint.


Psychological Care, Patient Education, Orthotics, Ergonomics and Prevention Strategies for Neck Pain: An Systematic Overview Update as Part of the ICON Project.

Gross AR, Kaplan F, Huang S, Khan M, Santaguida PL, Carlesso LC, Macdermid JC, Walton DM, Kenardy J, Söderlund A, Verhagen A, Hartvigsen J - Open Orthop J (2013)

PRISMA diagram showing the flow of reviews on psychology, ergonomics, prevention, orthotics, and patient education for neckpain.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3795400&req=5

Figure 1: PRISMA diagram showing the flow of reviews on psychology, ergonomics, prevention, orthotics, and patient education for neckpain.
Mentions: We included 30 reviews on treatment (see Fig. 1 - Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)) [24] flow diagram representing 75 RCTs - 14 RCTs related to psychological interventions, 29 to ergonomic workplace interventions, 22 to orthotics, 22 to patient education, 6 to 1⁰ prevention and 9 to 2⁰ prevention; keep in mind that there was some overlap. We did not retrieve any reviews on harm for these interventions. The AMSTAR score ranged from 5 to 9 and the most common methodological limitation were: assessment of publication bias, stating conflict of interest and inclusion of a list of included and excluded studies [10, 17]. See Appendix 1 for the listing of the 24 excluded reviews and reasons for exclusion. We detailed trial findings by the quality of the evidence (GRADE level) and treatment category in the later sections. Tables 3 and 4 provides summary findings by treatment category. Table 5 summarizes the strong and moderate quality recommendations based on the GRADE approach and details the magnitude of the effect in terms of effect size. The primary studies included in our analyses investigated the following 1)psychological categories: psychological, psychosocial interventions and mind-body; 2) workplace interventions and prevention: physical environment change, individual worker change, ergonomic and mental health education; organizational change; 3) patient education categories: advice on activation, advice on rest, pain and stress coping skills education, workplace ergonomic education +pain and stress coping skills education self-management educational strategies; and 4) orthotics categories: specialized pillow, specialized pillow + therapy, rigid collar, soft collar, soft collar + home exercise + physiotherapy, collar + advice for self-mobilization, kinesio taping, oral splint.

Bottom Line: For acute whiplash associated disorder (WAD), an education video in emergency rooms (1RCT, 405participants] favoured pain reduction at long-term follow-up thus helping 1 in 23 people [Standard Mean Difference: -0.44(95%CI: -0.66 to -0.23)).Use of a soft collar (2RCTs, 1278participants) was not beneficial in the long-term.A number of psychosocial interventions, workplace interventions, collar use and self-management educational strategies were not beneficial.

View Article: PubMed Central - PubMed

Affiliation: McMaster University, Hamilton, ON, Canada;

ABSTRACT

Objectives: To conduct an overview on psychological interventions, orthoses, patient education, ergonomics, and 1⁰/2⁰ neck pain prevention for adults with acute-chronic neck pain.

Search strategy: Computerized databases and grey literature were searched (2006-2012).

Selection criteria: Systematic reviews of randomized controlled trials (RCTs) on pain, function/disability, global perceived effect, quality-of-life and patient satisfaction were retrieved.

Data collection & analysis: Two independent authors selected articles, assessed risk of bias using AMSTAR tool and extracted data. The GRADE tool was used to evaluate the body of evidence and an external panel to provide critical review.

Main results: We retrieved 30 reviews (5-9 AMSTAR score) reporting on 75 RCTs with the following moderate GRADE evidence. For acute whiplash associated disorder (WAD), an education video in emergency rooms (1RCT, 405participants] favoured pain reduction at long-term follow-up thus helping 1 in 23 people [Standard Mean Difference: -0.44(95%CI: -0.66 to -0.23)). Use of a soft collar (2RCTs, 1278participants) was not beneficial in the long-term. For chronic neck pain, a mind-body intervention (2RCTs, 1 meta-analysis, 191participants) improved short-term pain/function in 1 of 4 or 6 participants. In workers, 2-minutes of daily scapula-thoracic endurance training (1RCT, 127participants) over 10 weeks was beneficial in 1 of 4 participants. A number of psychosocial interventions, workplace interventions, collar use and self-management educational strategies were not beneficial.

Reviewers' conclusions: Moderate evidence exists for quantifying beneficial and non-beneficial effects of a limited number of interventions for acute WAD and chronic neck pain. Larger trials with more rigorous controls need to target promising interventions.

No MeSH data available.


Related in: MedlinePlus