Home exercises for neck pain: A Delphi survey.

PURPOSE: The current context of the COVID-19 pandemic has demonstrated the need for home exercise strategies for the relief of neck pain, which, in recent times, has increased. However, there is a gap regarding home exercises that are aimed at reducing neck pain. Therefore, the aim of this study was to develop, validate and culturally adapt a home exercise protocol for neck pain. METHODS: This was an observational study conducted in three stages: (1) Developing an online search of databases for articles on neck pain exercises. (2) Validating a panel of 12 physical therapists, using the Delphi technique, and (3) Cultural adaptation, through face-to-face assessment with individuals aged 18-30 years with neck pain (n = 15). This resulted in the production of a final version of the protocol. Consensus on the protocol items (using the five-point Likert scale) was considered when the percent agreement was equal to or greater than 75%. Individuals were also asked about pain intensity during the last week before and after performing the protocol. RESULTS: A protocol was developed with the principles of neck and scapular stabilization and upper limb movements, for a period of 4 weeks. Nine physical therapists completed two rounds online, and all items in the second version of the protocol presented an agreement of over 75%. The protocol was culturally adapted by the target population, in which 73% of individuals presented pain reduction with a minimally clinically important difference. CONCLUSION: A 4-week home exercise protocol was created based on the best evidence in the literature, was validated by physical therapists and adapted for the population with neck pain. It proved to be an understandable, useful, practical and convenient tool in the treatment of this disorder and demonstrated an improvement in neck pain. CLINICALTRIALS: GOV: (NCT04187001).

Effect of Dry Cupping Therapy on Pain and Functional Disability in Persistent Non-Specific Low Back Pain: A Randomized Controlled Clinical Trial.

Background: Cupping therapy is used to treat musculoskeletal conditions, including low back pain. Objectives: The study assessed the effects of dry cupping on pain and functional disability from persistent nonspecific low back pain. Methods: This was a randomized controlled trial, where participants were allocated to a cupping therapy (n = 19) or sham (n = 18) group, for five 10-minute sessions of cupping therapy, twice a week, to stimulate the acupoints related to low back pain (GV4, BL23, BL24, BL25, and BL30, BL40 and BL58) and emotional aspects (HT3 and ST36). All participants were assessed at baseline, post-treatment and follow up (a finalization period of four weeks) using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Groups were compared using the analysis of covariance (ANCOVA) and the effect size was calculated using Cohen̓s d. Results: The cupping therapy group presented a lower mean VAS when compared to the sham, at post-treatment (mean difference: -2.36; standard error [SE]: 0.58; p < 0.001; "large" effect size: -0.94) and follow up (mean difference: -1.71; SE: 0.81; p < 0.042; 'large' effect size: -0.83). The cupping therapy group presented a lower mean ODI when compared to the sham post-treatment (mean difference: -4.68; SE: 1.85; p: 0.017; 'large' effect size: -0.87), although in follow-up, there was no difference between the groups (mean difference: 4.16; SE: 2.97; p: 0.17; "medium" effect size: -0.70). Conclusion: Dry cupping was more effective in improving pain and functional disability in people with persistent nonspecific low back pain when compared to the sham.