Department of Physical Therapy Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Physical Therapy

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

First Advisor

Joshua Cleland

Date of original Performance / Presentation

January 2023

Publication Date / Copyright Date

1-1-2023

Abstract

Background: The current physical therapy evidence for treating patients with the mechanical neck pain recommends both, manual therapy (MT) and dry needling (DN) along with exercises. At present, we still don’t have any evidence suggesting if one treatment approach, the manual therapy and exercises or dry needling and exercises, is superior to the other in treating patients with mechanical neck pain. Objective: To use a randomized comparative trial to compare the effects of DN and MT on pain, disability, range of motion, strength, and patient perceived improvements in the patients with mechanical neck pain. Methods: Seventy-eight patients were randomly assigned to one of the two groups - (1) Dry Needling and Therapeutic Exercises (DNTEx) and (2) Manual Therapy and Therapeutic Exercises (MTTEx). Both groups received seven treatment sessions of 30 minutes each over a maximum of 6 weeks. Outcome measures included: Neck Disability Index (NDI), Numeric Pain Rating Scale (NPRS), Patient-Specific Functional Scale (PSFS), Cervical Active Range of Motion (CAROM), Deep Neck Flexor Endurance Test (DNFET), Fear Avoidance Belief Questionnaire (FABQ), Global Rating of Change (GROC), and Patient Acceptable Symptom State (PASS). Data were collected at baseline, 2weeks, discharge (7th treatment session), and 3 months after discharge. The primary aim was examined with a mixed model analysis of covariance (ANCOVA), using pretest scores as covariates. A Mann-Whitney U test was utilized to analyze GROC scores and independent t-test for PASS scores. Results: The ANCOVA revealed significant group*time interaction for all variables except for DNFET (P = .458). Both groups improved over time for all variables. Results for MT + Ther Exs group exceeded recommended minimal clinically important difference (MCID) for all variables, both at discharge and 3 months, except for FABAw and DNFET. On the other hand, results of DN + Ther Exs group exceeded recommended MCID, both for discharge and 3 months, only on GROC. Conclusion: MT + Ther Exs is more effective, both at short-term and intermediate term, than DN + Ther Exs in reducing pain, disability, fear avoidance behavior, and improving function in patients with mechanical neck pain.

Disciplines

Physical Therapy

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