Randomised Clinical Trial

Effects of breathing re-education on endurance, strength of deep neck flexors and pulmonary function in patients with chronic neck pain: A randomised controlled trial

Sahreen Anwar, Syed A. Arsalan, Hamayun Zafar, Ashfaq Ahmed, Syed A. Gillani, Asif Hanif
South African Journal of Physiotherapy | Vol 78, No 1 | a1611 | DOI: https://doi.org/10.4102/sajp.v78i1.1611 | © 2022 Sahreen Anwar, Syed A. Arsalan, Hamayun Zafar, Ashfaq Ahmed, Syed A. Gillani, Asif Hanif | This work is licensed under CC Attribution 4.0
Submitted: 23 July 2021 | Published: 26 April 2022

About the author(s)

Sahreen Anwar, Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
Syed A. Arsalan, Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
Hamayun Zafar, Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan; and, Department of Physical Therapy, Faculty of Rehabilitation Sciences, King Saud University, Riyadh, Saudi Arabia
Ashfaq Ahmed, Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
Syed A. Gillani, Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
Asif Hanif, Department of Physical Biostatistics, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan


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Abstract

Background: People with chronic neck pain show decreased endurance and strength of cervical muscles with compromised respiratory function. There is little evidence that improvement in breathing function of people with neck pain can help in enhancing cervical muscle strength and pulmonary function. The objective of this our clinical trial was to examine the effects of breathing re-education combined with physiotherapy on endurance and strength of deep neck flexors, and pulmonary function in patients with chronic neck pain.

Methods/design: In this double blind randomised clinical trial, 30 patients with chronic neck pain (25–50 years old) were randomly allocated to two groups. Group A, physiotherapy (n = 15), and Group B, breathing re-education (n = 15). The duration of intervention was eight weeks with treatment five days a week. The endurance was measured with the craniocervical flexion test, strength with a handheld dynamometer (Baseline USA) and pulmonary functions with the Spiro lab 4 (USA) at baseline, at week four and at week eight of the intervention.

Discussion: There was a significant between group improvement in the strength of deep neck flexors and forced vital capacity (FVC) in Group B p = 0.0001 and p = 0.0200 (p ˂ 0.05) respectively. Intergroup comparisons showed no significant differences for endurance, cervical extensor strength, Forced Expiratory Volume in one second (FEV1), and FEV1/FVC percentage.

Conclusion: Our study concluded that breathing re-education combined with other physiotherapy management is effective for improving the strength of neck flexors and increasing FVC in people with chronic neck pain.

Clinical implication: Breathing re-education may be part of physiotherapy management in patients with chronic neck pain.

Trial Registration: Iranian Registry of Clinical Trials, IRCT20200226046623N1, https://www.irct.ir/trial/46240.


Keywords

endurance; neck pain; breathing; re-education; pulmonary function

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