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Neck-related physical function, self-efficacy, and coping strategies in patients with cervical radiculopathy: a randomized clinical trial of postoperative physiotherapy [with consumer summary] |
Wibault J, Oberg B, Dedering A, Lofgren H, Zsigmond P, Persson L, Andell M, Jonsson MR, Peolsson A |
Journal of Manipulative and Physiological Therapeutics 2017 Jun;40(5):330-339 |
clinical trial |
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
OBJECTIVE: The purpose of this study was to compare postoperative rehabilitation with structured physiotherapy to the standard approach in patients with cervical radiculopathy (CR) in a prospective randomized study at 6 months follow-up based on measures of neck-related physical function, self-efficacy, and coping strategies. METHODS: Patients with persistent CR and scheduled for surgery (n = 202) were randomly assigned to structured postoperative physiotherapy or a standard postoperative approach. Structured postoperative physiotherapy combined neck-specific exercises with a behavioral approach. Baseline, 3-month, and 6-month evaluations included questionnaires and clinical examinations. Neck muscle endurance, active cervical range of motion, self-efficacy, pain catastrophizing (CSQ-CAT), perceived control over pain, and ability to decrease pain were analyzed for between-group differences using complete case and per-protocol approaches. RESULTS: No between-group difference was reported at the 6-month follow-up (p = 0.05 to 0.99), but all outcomes had improved from baseline (p < 0.001). Patients undergoing structured postoperative physiotherapy with >= 50% attendance at treatment sessions had larger improvements in CSQ-CAT (p = 0.04) during the rehabilitation period from 3 to 6 months after surgery compared with the patients who received standard postoperative approach. CONCLUSIONS: No between-group difference was found at 6 months after surgery based on measures of neck-related physical function, self-efficacy, and coping strategies. However, the results confirm that neck-specific exercises are tolerated by patients with CR after surgery and may suggest a benefit from combining surgery with structured postoperative physiotherapy for patients with CR.
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