Neural tissue management provides immediate clinically relevant benefits without harmful effects for patients with nerve-related neck and arm pain: A randomised trial

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Author(s)
Nee, Robert J
Vicenzino, Bill
Jull, Gwendolen A
Cleland, Joshua A
Coppieters, Michel W
Griffith University Author(s)
Year published
2012
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Question: What are the benefits and harms of neural tissue management in the short term for treating nerve-related neck
and arm pain? Design: Randomised controlled trial. Participants: Sixty participants with non-traumatic nerve-related neck
and unilateral arm pain were randomised to experimental (n = 40) or control (n = 20) groups. Intervention: Both groups were
advised to continue usual activities. The experimental group also received education, manual therapy, and nerve gliding
exercises in 4 treatments over 2 weeks. Outcome measures: Primary outcomes were participant-reported improvement and
worsening on a Global Rating ...
View more >Question: What are the benefits and harms of neural tissue management in the short term for treating nerve-related neck and arm pain? Design: Randomised controlled trial. Participants: Sixty participants with non-traumatic nerve-related neck and unilateral arm pain were randomised to experimental (n = 40) or control (n = 20) groups. Intervention: Both groups were advised to continue usual activities. The experimental group also received education, manual therapy, and nerve gliding exercises in 4 treatments over 2 weeks. Outcome measures: Primary outcomes were participant-reported improvement and worsening on a Global Rating of Change scale. Secondary outcomes were neck pain, arm pain, the Neck Disability Index, the Patient-Specific Functional Scale, and adverse events related to treatment. Follow-up occurred 3–4 weeks after baseline. Results: Numbers needed to treat favoured the experimental intervention for participant-reported improvement (2.7, 95% CI 1.7 to 6.5), neck pain (3.6, 95% CI 2.1 to 10), arm pain (3.6, 95% CI 2.1 to 10), Neck Disability Index (4.3, 95% CI 2.4 to 18.2), and Patient-Specific Functional Scale (3.0, 95% CI 1.9 to 6.7). The prevalence of worsening in the experimental (13%) and control (20%) groups were not different (RD –7%, 95% CI –28 to 13). Adverse events had minimal impact on daily activities and did not reduce the chance of improving with the experimental intervention (RR = 1.03, 95% CI 0.58 to 1.84). Conclusion: These results enable physiotherapists to inform patients that neural tissue management provides immediate clinically relevant benefits beyond advice to remain active with no evidence of harmful effects
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View more >Question: What are the benefits and harms of neural tissue management in the short term for treating nerve-related neck and arm pain? Design: Randomised controlled trial. Participants: Sixty participants with non-traumatic nerve-related neck and unilateral arm pain were randomised to experimental (n = 40) or control (n = 20) groups. Intervention: Both groups were advised to continue usual activities. The experimental group also received education, manual therapy, and nerve gliding exercises in 4 treatments over 2 weeks. Outcome measures: Primary outcomes were participant-reported improvement and worsening on a Global Rating of Change scale. Secondary outcomes were neck pain, arm pain, the Neck Disability Index, the Patient-Specific Functional Scale, and adverse events related to treatment. Follow-up occurred 3–4 weeks after baseline. Results: Numbers needed to treat favoured the experimental intervention for participant-reported improvement (2.7, 95% CI 1.7 to 6.5), neck pain (3.6, 95% CI 2.1 to 10), arm pain (3.6, 95% CI 2.1 to 10), Neck Disability Index (4.3, 95% CI 2.4 to 18.2), and Patient-Specific Functional Scale (3.0, 95% CI 1.9 to 6.7). The prevalence of worsening in the experimental (13%) and control (20%) groups were not different (RD –7%, 95% CI –28 to 13). Adverse events had minimal impact on daily activities and did not reduce the chance of improving with the experimental intervention (RR = 1.03, 95% CI 0.58 to 1.84). Conclusion: These results enable physiotherapists to inform patients that neural tissue management provides immediate clinically relevant benefits beyond advice to remain active with no evidence of harmful effects
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Journal Title
Journal of Physiotherapy
Volume
58
Issue
1
Copyright Statement
© Australian Physiotherapy Association 2012. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported (CC BY-NC-ND 3.0) License (http://creativecommons.org/licenses/by-nc-nd/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
Subject
Clinical sciences
Clinical sciences not elsewhere classified
Sports science and exercise