The effect of manuel therapy on pulmonary parameters, pain, posture and quality of life in individuals with chronic neck pain

The aim of this study was to investigate the effect of manual therapy on pulmonary parameters, pain, posture and quality life in patients with chronic neck pain. 46 patients with chronic neck pain were divided into three groups by block randomization as, Cervical Mobilization+Exercise Group (SM+E G, n=15, 32.06±2.79 yrs), Thoracic&Cervical Mobilization+Exercise Group (TM+SM+EG, n=16, 31.86±2.98 yrs) and Exercise Group (E G, n=15, 32.73±3.23 yrs). For the manual therapy, Maitland mobilization techniques were applied; for the exercise program, stabilization, neck and scapulo-thoracic strengthening were used. All patients included in the study were treated 2 sessions/week for 6 weeks; and they were evaluated before and after the treatment. Pain severity was evaluated using by Visual Analogue Scale (VAS), cervical range of motion by universal goniometer, neck deep flexor muscle endurance (DFK) by pressure biofeedback and posture (head anterior tilt) by photography method. Short Form-36 (SF-36) and Neck Disability Index (NDI) were used for quality of life and disability. Thoracic expansion and pulmonary functions were measured with tape and spirometer. Maximal inspiratory (MIP) and expiratory pressure (MEP) were measured by mouth pressure device. Pulmonary functions improved in both manuel therapy groups, except the Exercise Group, and axillary expansion showed no improvements in any of the groups after the treatment. There were significant improvements in all parameters exception of pulmonary parameters in three groups. TM+SM+E was found the most effective method in terms of pulmonary functions, MIP, MEP, subcostal expansion, activity pain, cervical left lateral flexion and right rotation, anterior tilt of the head, DFK endurance, NDI, SF-36 (p<0.05). TM+SM+E and SM+E Groups had similar effects for MIP, subcostal expansion and resting pain (p>0.05). SM+E Group was superior to the E Group method on pulmonary functions, MIP, subcostal expansion, resting and activity pain, right rotation and left lateral flexion, anterior tilt, DFK endurance; but they had similar effects on MEP, DFK strength, NDI and SF-36 (p>0.05). Our study showed that all three treatments have some benefits in chronic neck pain patients; however, manual therapy, especially included thoracic region is the most effective method for all parameters, especially pulmonary parameters. Keywords: Chronic neck pain, manual therapy, pulmonary functions, quality of life