Effects of an exercise program plus manual therapy in a patient with failed neck surgery syndrome: A case report.


Journal

Journal of bodywork and movement therapies
ISSN: 1532-9283
Titre abrégé: J Bodyw Mov Ther
Pays: United States
ID NLM: 9700068

Informations de publication

Date de publication:
01 2023
Historique:
received: 05 08 2021
revised: 18 04 2022
accepted: 17 09 2022
entrez: 12 2 2023
pubmed: 13 2 2023
medline: 15 2 2023
Statut: ppublish

Résumé

Patients who have undergone cervical surgery may present pain and dysfunction in the upper limb, which is often referred to as failed neck surgery syndrome. Little is known about the effects of an exercise program plus manual therapy in the treatment of prolonged neuropathic pain of the upper quadrant in a patient with failed neck surgery. A 66-year-old woman consulted for neuropathic pain and dysfunction during grasping activities, as a result of failed neck surgery after 12 months. Clinical, functional, and electromyographic measurements were recorded at baseline and after treatment. The patient underwent a treatment for six weeks based on manual therapy for the upper limb and cervical spine and an exercise program for the scapular muscles, rotator cuff and wrist extensor muscles. Positive clinically significant changes were observed in the Neuropathic Pain Questionnaire (DN4) (baseline = 7 points; post-treatment = 4 points), Neck Disability Index (NDI) (baseline = 36; post-treatment = 18 points), QuickDASH (baseline = 78; post- treatment = 32 points), Upper Limb Neurodynamic Test 1 (ULNT-1) (baseline = 75°; post- treatment = 42°) and grip strength (GS) (baseline = 23 kgf; post-treatment = to 32 kgf). Improvements in the surface electromyographic (sEMG) activity of the upper trapezius (UT), infraspinatus (IS) and radial wrist extensors (RWE) muscles also seemed to occur after treatment. Treatment helped relieve neuropathic pain, decrease neck disability, and improve general upper limb function.

Sections du résumé

BACKGROUND
Patients who have undergone cervical surgery may present pain and dysfunction in the upper limb, which is often referred to as failed neck surgery syndrome. Little is known about the effects of an exercise program plus manual therapy in the treatment of prolonged neuropathic pain of the upper quadrant in a patient with failed neck surgery.
CASE DESCRIPTION
A 66-year-old woman consulted for neuropathic pain and dysfunction during grasping activities, as a result of failed neck surgery after 12 months. Clinical, functional, and electromyographic measurements were recorded at baseline and after treatment. The patient underwent a treatment for six weeks based on manual therapy for the upper limb and cervical spine and an exercise program for the scapular muscles, rotator cuff and wrist extensor muscles.
OUTCOMES
Positive clinically significant changes were observed in the Neuropathic Pain Questionnaire (DN4) (baseline = 7 points; post-treatment = 4 points), Neck Disability Index (NDI) (baseline = 36; post-treatment = 18 points), QuickDASH (baseline = 78; post- treatment = 32 points), Upper Limb Neurodynamic Test 1 (ULNT-1) (baseline = 75°; post- treatment = 42°) and grip strength (GS) (baseline = 23 kgf; post-treatment = to 32 kgf). Improvements in the surface electromyographic (sEMG) activity of the upper trapezius (UT), infraspinatus (IS) and radial wrist extensors (RWE) muscles also seemed to occur after treatment.
CONCLUSION
Treatment helped relieve neuropathic pain, decrease neck disability, and improve general upper limb function.

Identifiants

pubmed: 36775521
pii: S1360-8592(22)00115-2
doi: 10.1016/j.jbmt.2022.09.006
pii:
doi:

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

216-222

Informations de copyright

Copyright © 2022. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of competing interest There are no conflicts of interest.

Auteurs

Fernando Imaz (F)

Department of Physical Therapy, Musculoskeletal Research Unit - UIM, University Center for Assistance, Teaching and Research - CUADI, University of Gran Rosario - UGR, Rosario, Argentina. Electronic address: fernandoimaz@hotmail.com.

Mauro Barone (M)

Department of Physical Therapy, Musculoskeletal Research Unit - UIM, University Center for Assistance, Teaching and Research - CUADI, University of Gran Rosario - UGR, Rosario, Argentina.

Diego Bordachar (D)

Department of Physical Therapy, Musculoskeletal Research Unit - UIM, University Center for Assistance, Teaching and Research - CUADI, University of Gran Rosario - UGR, Rosario, Argentina.

Isadora Orlando de Oliveira (I)

Instituto Wilson Mello - Campinas, SP, Brazil.

Leonardo Intelangelo (L)

Department of Physical Therapy, Musculoskeletal Research Unit - UIM, University Center for Assistance, Teaching and Research - CUADI, University of Gran Rosario - UGR, Rosario, Argentina.

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Classifications MeSH