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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, Soderlund A, Verhagen A, Hartvigsen J|
|The Open Orthopaedics Journal 2013 Sep 20;7:530-561|
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 to 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 AND 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 to 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 (1 RCT, 405 participants) 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 (2 RCTs, 1,278 participants) was not beneficial in the long-term. For chronic neck pain, a mind-body intervention (2 RCTs, 1 meta-analysis, 191 participants) improved short-term pain/function in 1 of 4 or 6 participants. In workers, 2-minutes of daily scapula-thoracic endurance training (1 RCT, 127 participants) 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.