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To analyse the effectiveness of yoga, pilates and tai chi exercise for chronic mechanical neck pain -a randomized controlled trial
Abstract
Introduction and Aim: Chronic mechanical neck pain is a common medical complaint with a high socio economic impact .Approximately 70% of individual at some point in their lives being considered a frequent problem of disability. The life time prevalence of chronic mechanical neck pain is approximately 50% and is associated with substantial societal and individual burden. Recent studies estimated its print of prevalence to be between 6 and 22% which increases with age, although symptoms of neck pain are common among the population with the age group of 35-55 years. Conservative treatment such as exercise, massage, stretching, physical therapy, local anaesthetic filtration has been found beneficial for chronic mechanical neck pain. Alternative medicinal approach such as Yoga Pilates, Tai chi have found efficacious for chronic mechanical neck pain. The aim of the study is to analyse and compare the effectiveness of Yoga, Pilates and tai chi exercise for chronic mechanical neck pain. Materials and Methods: Chronic mechanical neck pain is a common medical complaint with a high socio economic impact .Approximately 70% of individual at some point in their lives experience chronic mechanical neck pain. 40 Samples from 60 volunteers were selected based on the inclusion criteria Painful restriction of cervical spine, Neck pain, Age between 35-55 years, more than 40% of Tampa scale for kinesiophobia and Northwick pain park questionnaire. The study excluded those with Whiplash injury, frozen shoulder syndrome, Prolapse or protrusion, invasive treatment (surgery, nerve blocks, and neurotomy) within last 6 weeks, Spinal stenosis, Herniated vertebral disc. 40 samples were equally divided into 4 groups 10 in each. Group A received yoga, B -Tai Chi, C- Pilates, D-Control group. Participant will be given a consent form, Northwick pain park questionnaire and Tampa scale for kinesiophobia for final screening of inclusion and also used as pre -test. Post -test done after 3 weeks of intervention. Results: The analysis was randomized experimental study for the subjects with chronic mechanical neck pain. Statistical analysis was done using SPSS software, All the four Groups showed improvement comparing Pre and Post treatment mean value,while Group A Yoga post-test NPPQ (24.60) and TSK (55.20) showed significant difference compared to Group B Pilates post-test NPPQ (29.20) and TSK (58.10)and Group C Tai chi post-test NPPQ (48.80) and TSK (60.80) and Group D Control Group post-test NPPQ (56.70) and TSK (63.70) in reduction of pain by statistically comparing the mean values of Northwick pain park questionnaire and Tampa scale for kinesiophobia of four treatment groups indicated that Yoga as more efficient than the Pilates, Tai chi and Control group. Conclusion: The study concluded that the Yoga is more effective than the Pilates and Tai chi and Control Group exercise for chronic mechanical neck pain while Pilates,Tai chi and control Group exercise even showed a considerable decrease in symptoms when comparing the post-test mean values. Yoga is effective in reducing pain, disability, quality of life and fear of movements in subjects with mechanical neck pain. Yoga proved to be equally efficacious and safe, it may be considered a suitable alternative in the treatment for subjects with neck pain. © 2018 Indian Association of Biomedical Scientists. All rights reserved.
... Whereas the results of most studies are inconsistent. [17][18][19][20][21][22][23][24][25][26] So conducting a meta-analysis to explore the synthetical effects seems to be necessary. Only one metaanalysis [15] was found in databases up to now, which concluded that yoga has short-term effects on chronic neck pain, which only searched English-language databases and included 3 eligible studies, resulting in a relatively limited overall sample size. ...
... Of these 297 were excluded because of duplication, or because they did not meet our inclusion criteria after going through the titles and abstracts. After reading the full text of the remaining 50 studies, 10 studies [17][18][19][20][21][22][23][24][25][26] including 686 cases were included in the quantitative synthesis and meta-analysis (Fig. 1). ...
... The basic characteristics of these 10 studies were represented in Table 1, including 2 q-RCT [19,21] and 8 RCT. [17][18]20,[22][23][24][25][26] These articles were from Turkey, [17] India, [18,26] Korea, [19] Sweden, [20] United States, [21] Germany, [22,24,25] and China, [20] were published between 2010 and 2018, cover 686 patients, and sample sizes ranging from 38 to 159. All the studies involved yoga intervention, including both exercise-based and meditationbased, and the program length ranging from 10 days to 12 weeks. ...
Background:
Chronic nonspecific neck pain (CNNP) has a high prevalence and is more common among younger people. Clinical practice suggests that yoga is effective in relieving chronic pain.
Objectives:
This meta-analysis aimed to quantitatively summarize the efficacy of yoga for treating CNNP.
Data sources:
We searched for trials in the electronic databases from their inception to January 2019. English databases including PubMed, MEDLINE, Cochrane Library, Embase, Scopus, the Cochrane Central Register of Controlled Trials, and Ind Med; Chinese databases including China National Knowledge Infrastructure (CNKI), WanFang Database, and VIP Information. We also conducted a manual search of key journals and the reference lists of eligible papers to identify any potentially relevant studies we may have missed. We placed no limitations on language or date of publication.
Study eligibility criteria:
We included only randomized controlled trials (RCTs) and q-RCTs evaluating the effects of yoga on patients with CNNP. The primary outcomes for this review were pain and disability, and the secondary outcomes were cervical range of motion (CROM), quality of life (QoL), and mood.
Participants and interventions:
Trails that examined the clinical outcomes of yoga intervention in adults with CNNP compared with those of other therapies except yoga (e.g., exercise, pilates, usual care, et al) were included.
Study appraisal and synthesis methods:
Cochrane risk-of-bias criteria were used to assess the methodological quality, and RevMan 5.3 software was used to conduct the meta-analysis.
Results:
A total of 10 trials (n = 686) comparing yoga and interventions other than yoga were included in the meta-analysis. The results show that yoga had a positive effects on neck pain intensity (total effect: SMD = -1.13, 95% CI [-1.60, -0.66], Z = 4.75, P < .00001), neck pain-related functional disability (total effect: SMD = -0.92, 95% CI [-1.38, -0.47], Z = 3.95, P < .0001), CROM (total effect: SMD = 1.22, 95% CI [0.87, 1.57], Z = 6.83, P < .00001), QoL (total effect: MD = 3.46, 95% CI [0.75, 6.16], Z = 2.51, P = .01), and mood (total effect: SMD = -0.61, 95% CI [-0.95, -0.27], Z = 3.53, P = .0004).
Conclusions and implications of key findings:
It was difficult to make a comprehensive summary of all the evidence due to the different session and duration of the yoga interventions, and the different outcome measurement tools in the study, we draw a very cautious conclusion that yoga can relieve neck pain intensity, improve pain-related function disability, increase CROM, improve QoL, and boost mood. This suggests that yoga might be an important alternative in the treatment of CNNP.
Systematic review registration number:
Details of the protocol for this systematic review and meta-analysis were registered on PROSPERO and can be accessed at www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42018108992.
... Creative gymnastics based on gymnastic groups is included in general gymnastics. However, regional gymnastics are currently starting to fade due to the development of other types of physical activities such as zumba, yoga, pilates and several other gymnastics creations (Kannan et al., 2021;Rajalaxmi et al., 2018). Jalaleota gymnastics is one of the rhythmic gymnastics made by creating movements that contain movements, including walking, running, jumping, throwing and catching. ...
This study aims to describe the development of Jalaleota cheerful creative gymnastics to improve motor skills at an early age with the core movements of gymnastics, including running, throwing and catching. This type of research is research and development which consists of preliminary studies, development models and testing models. The subjects in this study were kindergarten schoolchildren evaluations, product evaluations, initial trials and product trials in early childhood. The data collection techniques were observation, questionnaires and tests of motor skills for early childhood. The data collected was then analysed qualitatively and quantitatively. Qualitative data analysis used the interactive model of Miles and Huberman and quantitative data analysis used paired sample t-test. The results showed that the development of the Jalaleota cheerful creative gymnastic product determined the indicators of motor skills, movement, appearance and early childhood music. The main field test obtained a value of 0.034 < 0.05, indicating that there is a significant influence on the use of creative gymnastics on motor skills at an early age. The motor skills of early childhood using Jalaleota, created by cheerful gymnastics, are better than before they were used. Currently, we have obtained cheerful gymnastics created by Jalaleota that are worthy of use according to the views of experts and users. Keywords: Creative gymnastics, improvement of motor skills, physical activity, early childhood.
... 7 Yoga has been used to improve neck posture and relieve neck pain. [8][9][10][11][12][13][14][15][16][17][18] There are many studies that have assessed the efficacy of yoga for neck pain; however, results are inconsistent. Many studies assessed yoga specifically for chronic neck pain or chronic nonspecific neck pain. ...
... The study concluded that the Yoga is more effective than the Pilates and Tai chi ,Yoga is effective in reducing pain, disability, quality of life and fear of movements in subjects with mechanical neck pain [23]. In this systematic review maximum studies showed that there was some improvement in neck functional abilities and reduction in neck pain in the endurance training group. ...
... The study shows that the positive effect in result of exercise therapy is relieving the pain in neck associated with forward shoulders. (14) In this study the result shows that the statistically highly significance in post test Mean but (Group-A) which has the lower mean value is more effective than (Group-B).The study concluded that the Yoga is more effective than the Pilates and Tai chi and Control Group exercise for chronic mechanical neck pain while Pilates, Tai chi and control Group exercise even showed a considerable decrease in symptoms when comparing the post-test mean values 15 . The study concluded that the postural alignment achieved from schroth method is better than that achieved by yoga 16 . ...
Objective: The study aims to analyse and compare the efficacy of neck stabilization exercise and postural correction exercise over conventional exercises on pain, disability, posture, Respiratory dysfunction in desk job workers with neck pain. Background of The Study: Neck pain is a common disorder mainly caused by awkward posture, tightness in both the neck and upper back muscles and prolonged sitting while using computers, twisting and bending of the trunk. Rounded shoulder is a condition characterized by protracted shoulder girdle from its normal. Imbalance between agonist and antagonist results in muscle imbalance affecting the cervical curvature resulting in pain. Materials and Methods: Once the study is approved by Institutional Review Board Ref no: IV C – 018 / PHYSIO / IRB /2017-2018 50 samples were selected from 60 volunteers based on the inclusion criteria. The study was conducted is the outpatient department of physiotherapy & took nearly 3months (Jan 2018 – May 2018) to complete the study.. Group A received Neck Stabilization exercise and postural correction exercise with deep breathing exercise. Group B received stretch and strengthening exercise with deep breathing exercise. Pre and post-test measured with NDI-Neck disability index, CSBQ-Cervical Spine Bournemouth Questionnaire, SEBQ-Self-Evaluation Breathing Questionnaire, DST-Double square test. Result: On comparing Pre-test and Post-test within Group A and Group B on Double Square Test(Right and Left), Neck Disability Index, Cervical Spine Bournemouth Questionnaire, Self-Evaluation of Breathing Questionnaire shows significant decrease in the post test Mean values but Group A which has the Lower Mean value is more effective than Group B at P ≤ 0.001.
... The study concluded that the Yoga is more effective than the Pilates and Tai chi and Control Group exercise for chronic mechanical neck pain while Pilates,Tai chi and control Group exercise even showed a considerable decrease in symptoms when comparing the post-test mean values 27 . ...
Aim: The aim of the study is to find the efficacy of the Schroth Method and Yoga in improving the postural alignment and pulmonary function in subjects with upper cross syndrome.Background of the study: In today's population, the upper crossed syndrome is a highly prevalent one, among the people who work at desks and computers, laptops or who sit for a majority of the day and continuously exhibit poor posture. It presents with a muscle imbalance between the tonic and phasic muscles and also interrupts the breathing pattern due to the involvement of accessory respiratory muscles. Due to the postural misalignment of head on trunk it is associated with pain in the neck and shoulder. When any attempts to correct this malaligned posture, towards an ideal posture using a combination of strengthening, stretching and feedback training in a three dimensional approach-Schroth method represent a significant component in improving the posture, mobility, balance and also corrective breathing. Methodology: It is an experimental study comparing the Schroth Method and yoga in individuals with upper cross syndrome, conducted in ACS Medical College And Hospital for the duration of 3 months. The study included 30 subjects based on the inclusion criteria. Both male and female subjects between the age group 17-22 years with forward head posture, rounded shoulder, neck pain and those who were observed with abnormal pattern in Janda cervical flexion test, were included in the study. Subjects with trauma, recent injury or surgery, any serious underlying pathology that influence the mobility of upper limb were excluded from the study. The Janda flexion test and accurate posture assessment software, peak expiratory flow rate were used in pre and post-test measurement. Result: Both the groups (A and B) showed significant difference in the post-test mean values, but group-A (schroth method) showed a better significant difference in post-test than group-B (yoga) at ***p<0.001.
Objective: The objective of the study was to determine the efficacy of proprioception and balance exercise along with conventional exercise in patients with neck pain. Methodology: This was an experimental study design 60 samples were selected based on the inclusion criteria, Group A received balance and Proprioception exercise and Group B conventional exercise. Pre and posttest measurement were taken and compared by using outcome measures of VAS, Four-Square Step Test and Modified Clinical Tests of Sensory Interaction in Balance. Results: On comparing the mean value of Group A and Group B, shows significant difference between group A and group B. Group A Balance and proprioception exercise seems to be more effective than Group B conventional exercises.
Neck disorders are common, disabling and costly. Randomized trials were reviewed using a Cochrane format, to determine if manual therapy improves pain, function and patient satisfaction in adults suffering from neck disorders with and without radicular findings or headache. Sequenced computerized searches ended in December 1997. Two independent reviewers extracted data while three assessed trial quality. Standard mean difference and relative risks were translated to number needed to treat (NNT) and the percent treatment advantage. The 20 selected trials' quality was 2.4 (SD: 1.04) on the 5-point scale described by Jadad. Trials were clinically heterogenous. Manipulation alone, mobilizations alone, manipulation/mobilization and treatments including massage consistently showed similar effects to placebo, wait period or control. Multimodal manual therapy care including exercise were superior to a control, to certain physical medicine methods and to rest for pain and patient satisfaction. The NNT for a clinically important reduction in pain varied from 2 to 11 and treatment advantage from 6% to 41% at the cost of benign transient side-effects. While results remain inconclusive, some clinical themes have emerged. For mechanical neck disorder with or without headache, it appears that to be most beneficial, manual therapies should be done with exercise for improving pain and patient satisfaction. Manipulation and mobilization alone appear to be less effective. Factorial design would help delineate the magnitude of effect for each component of care.
Unlabelled:
This study aimed to test the efficacy of Tai Chi for treating chronic neck pain. Subjects with chronic nonspecific neck pain were randomly assigned to 12 weeks of group Tai Chi or conventional neck exercises with weekly sessions of 75 to 90 minutes, or a wait-list control. The primary outcome measure was pain intensity (visual analogue scale). Secondary outcomes included pain on movement, functional disability, quality of life, well-being and perceived stress, postural and interoceptive awareness, satisfaction, and safety. Altogether, 114 participants were included (91 women, 49.4 ± 11.7 years of age). After 12 weeks Tai Chi participants reported significantly less pain compared with the wait list group (average difference in mm on the visual analogue scale: -10.5; 95% confidence interval, -20.3 to -.9; P = .033). Group differences were also found for pain on movement, functional disability, and quality of life compared with the wait list group. No differences were found for Tai Chi compared with neck exercises. Patients' satisfaction with both exercise interventions was high, and only minor side effects were observed. Tai Chi was more effective than no treatment in improving pain in subjects with chronic nonspecific neck pain. Because Tai Chi is probably as effective as neck exercises it may be considered a suitable alternative to conventional exercises for those with a preference toward Tai Chi.
Perspective:
This article presents results of a randomized controlled trial comparing Tai Chi, conventional neck exercises, and no treatment for chronic nonspecific neck pain. Results indicate that Tai Chi exercises and conventional neck exercises are equally effective in improving pain and quality of life therefore representing beneficial interventions for neck pain.
Neck pain is becoming increasingly more common and multiple interventions have been advocated in its management. The literature supports the use of a variety of exercises including specific low load endurance exercises, scapular muscle retraining and neck and upper limb strengthening. Pilates is one form of exercise that is developing in popularity. This pilot uncontrolled study investigates whether a 6-week matwork based Pilates programme can change outcome measures in a group of chronic neck pain patients. Thirteen subjects were assessed on self-report tests; neck disability index (NDI), patient specific functional scale (PSFS), numerical rating pain scale (NRPS) and one objective measure; the abdominal drawing in test (ADIT). A statistically significant improvement was obtained in the disability outcomes (NDI and PSFS) at both 6 and 12 weeks. The NRPS also demonstrated statistical improvement at 12 weeks but not at 6. The minimal clinically important difference (MCID) is the score that reflects a change that is meaningful for the patient and this was achieved at 12-weeks for the NDI (>5 points), PSFS (>3 points) and NRPS (>2 points). Only 2 subjects reached normal levels in the ADIT at 12-weeks. The results of this pilot study suggest that Pilates has a role to play in reducing pain and disability in neck pain patients.
Unlabelled:
We searched databases for controlled clinical studies, and performed a meta-analysis on the effectiveness of yoga interventions on pain and associated disability. Five randomized studies reported single-blinding and had a higher methodological quality; 7 studies were randomized but not blinded and had moderate quality; and 4 nonrandomized studies had low quality. In 6 studies, yoga was used to treat patients with back pain; in 2 studies to treat rheumatoid arthritis; in 2 studies to treat patients with headache/migraine; and 6 studies enrolled individuals for other indications. All studies reported positive effects in favor of the yoga interventions. With respect to pain, a random effect meta-analysis estimated the overall treatment effect at SMD = -.74 (CI: -.97; -.52, P < .0001), and an overall treatment effect at SMD = -.79 (CI: -1.02; -.56, P < .0001) for pain-related disability. Despite some limitations, there is evidence that yoga may be useful for several pain-associated disorders. Moreover, there are hints that even short-term interventions might be effective. Nevertheless, large-scale further studies have to identify which patients may benefit from the respective interventions.
Perspective:
This meta-analysis suggests that yoga is a useful supplementary approach with moderate effect sizes on pain and associated disability.
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