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Physical medicine modalities for mechanical neck disorders
Gross Anita, Aker Peter, Goldsmith Charles H, Peloso Paul Michael J

Gross Anita, Aker Peter, Goldsmith Charles H, Peloso Paul Michael J
Cochrane Database of Systematic Reviews, Issue 07, 2011 (Statusin this issue: WITHDRAWN FROM PUBLICATION FOR REASONS STATED IN THE REVIEW)
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
DOI: 10.1002/14651858.CD000961.pub2
This review should be cited as: Gross Anita, Aker Peter, Goldsmith Charles H, Peloso Paul Michael J. Physical medicine modalities for mechanical neck disorders. Cochrane Database of Systematic Reviews.In: The Cochrane Library, Issue 07, Art. No. CD000961. DOI: 10.1002/14651858.CD000961.pub2
Abstract
Background
Twenty-six to 71 percent of the adult population can recall experiencing an episode of neck pain or stiffness in their lifetime. The treatments that patients receive for neck pain are varied, as are the perceptions of the benefits of these treatments. In this age of increasingaccountability, governmental agencies, third party payers and patients are demanding evidence-based practice performance. To track down the best estimate of efficacy of the various conservative management strategies for mechanical neck disorders, a four-part systematic review was prepared. Part two investigates and reports on the efficacy of physical medicine modalities.
Objective
Multiple physicalmedicine modalities are commonly included as part of
therapeutic interventions for mechanical neck disorders (neck pain). The objective of this review was to assess the effects of physical medicine modalities for pain in adults with mechanical neck disorders.
Criteria for considering studies for this review
We searched Medline, Embase, Chirolars, Index to Chiropractic Literature, Cinahl,Science Citation Index, Conference Proceedings Index, National Technical Information Services and reference lists of the retrieved articles from 1985 to December 1993 and we contacted content experts.
Selection criteria
Randomised trials and controlled trials of physical medicine modalities in adults with mechanical neck disorder.
Data collection and analysis
Three reviewers independently assessedtrial quality and two reviewers independently extracted data. Investigators were contacted to obtain information or data that could not be found in the published reports.
Main results
Thirteen trials were included. The overall quality of the included trials was generally good. Two trials using electromagnetic therapy produced a significant reduction in pain (p 3/5) ( Foley-Nolan 1990 ;Foley-Nolan 1992 ; Levoska 1993 ; Snow 1992 ; Thorsen 1992 ), six were moderately strong (3/5) ( Goldie 1970 ; Lewith 1981 ; Nordemar 1981 ; Petrie 1983 ; Thorsen 1991 ; Waylonis 1988 ) and two were weak (scores 0.05) ( Snow 1992 ). Because of the small sample size (low statistical power), the results of this study must be interpreted with caution.
Laser Therapy:
Three RCTs of laser therapy, whichstudied a total group of 138 persons, were retrieved ( Thorsen 1991 ; Thorsen 1992 ; Waylonis 1988 ). Sufficient data could be extracted from two studies to calculate median effect size (MES) (MES VAS-function at 2 weeks of treatment [ Thorsen 1992 ] = 3.36 [95%CI: 0.62, 2.38]; MES function [ Thorsen 1991 ] = 0.80 [95%CI: -4.07, 9.67]). The p-values was calculated from data provided in Waylonis(1988) (See methods section). The case mix included mechanical neck disorder subgroup myofacial pain syndrome in all cases with subacute ( Thorsen 1991 ) and chronic ( Thorsen 1992 ; Waylonis 1988 ) duration of the disorder. (Subacute [> or = 7 days to < 7 weeks] and chronic [> or = 7 weeks] are based on the definitions of Spitzer [1987].) All conformed to the definition of a mechanical neck...