Effectiveness of the Osteopathic Treatment in Patients With Nonspecific Cervical Pain

Summary

Participation Requirements

Description

At the beginning of the 1st session, a battery of questions will be made as an anamnesis with the objective of evidencing possible risk factors at the therapeutic level. The presence of one or more risk factors will suppose the exclusion of the patient from the study. Next, a brief osteopathic muscu...

At the beginning of the 1st session, a battery of questions will be made as an anamnesis with the objective of evidencing possible risk factors at the therapeutic level. The presence of one or more risk factors will suppose the exclusion of the patient from the study. Next, a brief osteopathic musculoskeletal evaluation will be made to the patient. This exploration will follow a standardized protocol for all patients in the experimental groups (1 and 2). The tests to be carried out will be: Observation (standing patient): Assessment of the anterior projection of the head Assessment of the variation in the physiological curves of the spine Active test of the cervical spine with the patient in a sitting position. o Flexo-Extension / Rotations / Lateral inclinations Segmental test of joint mobility of the cervical and dorsal spine (patient in sitting and supine position) Passive mobility test of the cervical spine (patient in the supine position): Flexo-Extension / Rotations / Lateral inclinations The combination of exercises scheduled at home for all groups is based on the conclusions of different studies, and will consist of: Self-resisted active exercise in flexion, rotations and inclinations of the cervical spine. Active mobility in its maximum travel (without forcing pain) in flexion, rotations and inclinations of the cervical spine. Stretching upper trapezius muscles and scalenes. Active mobility in circumferential joints of the glenohumeral joint, and in flexo-extension of the thoracic spine. The work schedule will be carried out for 7 weeks, at a rate of 5 sessions per week. It will be the patient himself who will keep a diary record of the activity carried out during the weeks that the trial lasts. The diary will be facilitated by the therapists, and in it the exercises to be performed will be indicated. For groups 1 and 2, a total of 3 techniques selected from a list of 7 available techniques common to all centers will be applied in each session. The choice of techniques will be based on the results of the examination performed, the particularities of the patient and the clinical experience of the osteopath. In each session the techniques can change under the criteria of the osteopath. However, they will always be 3 and always within the list of available techniques. For groups 1 and 2, a total of 3 techniques selected from a list of 7 available techniques common to all centers will be applied in each session. The choice of techniques will be based on the results of the examination performed, the particularities of the patient and the clinical experience of the osteopath. In each session the techniques can change under the criteria of the osteopath. However, they will always be 3 and always within the list of available techniques. For groups 1 and 2, a total of 3 techniques selected from a list of 7 available techniques common to all centers will be applied in each session. The choice of techniques will be based on the results of the examination performed, the particularities of the patient and the clinical experience of the osteopath. In each session the techniques can change under the criteria of the osteopath. However, they will always be 3 and always within the list of available techniques. The OMT (Osteopathic Manipulative Treatment) techniques that may be applied will be the following: Technique of Inhibition of the suboccipital muscles Functional technique for the middle and deep cervical fascia High-speed cervical spine technique (Cervical wheel C1-C6) High-speed technique in the cervico-dorsal junction (prone position) High speed technique in dorsal column (D1-D12) - (Dog Technique) Muscle stretching technique of the diaphragm (supine decubitus) Thorax joint mobility technique (long lever) Main Variable: o Neck Disability Index (NDI). The investigators establish the minimum change to be detected (minimum clinically relevant change) at 5 points. The Spanish version of the NDI will be used, validated by Andrade Ortega et al.24 Secondary Variable: o Degree of general quality of life, through the "SF-36" Health Survey25. The data will be reported in the form of a report by the patient himself, who will receive via e-mail (whenever possible) or in printed form the questionnaire to be completed and will deliver to the same center in which the intervention has been carried out.

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