Immediate clinical benefits of combining therapeutic exercise and interferential therapy in adults with chronic neck pain: a randomized controlled trial.

BACKGROUND: Therapeutic exercise (TE) is highly recommended for the management of non-specific neck pain (NSNP) and has shown promising results combined with interferential current therapy. Yet, the clinical relevance of the pooled effect of these approaches remains uncertain. AIM: To investigate the immediate clinical effect size of combining TE and interferential therapy, compared with the isolated use of TE, in adults with chronic NSNP. DESIGN: Randomized, single-blinded, controlled, superiority trial. SETTING: Outpatients, primary care center. POPULATION: Forty-nine adults with chronic NSNP. METHODS: Participants with neck pain (grades I or II) lasting for more than 12 weeks were allocated to a TE plus interferential currents group (N.=25) or to a TE only group (N.=24). All individuals underwent treatment 5 times a week for 2 weeks. The primary outcome was current neck pain intensity (11-point Numeric Pain Rating Scale). Secondary outcomes included neck disability (Neck Disability Index) and active cervical range-of-movement (CROM device). Measurements were taken at baseline and immediately after treatment. An intention-to-treat analysis was carried out. To quantify the effect size of the interventions, the relative risk, the absolute and relative risk reduction, and the number needed to treat (NNT) were calculated. RESULTS: A significant time*group effect was found for pain intensity, disability, and neck flexion and right rotation (all, P<0.05). In the analysis for treatment benefit, the NNT was 2 (95% CI: 2 to 4, P<0.001) for neck pain and disability, and 3 (95% CI: 2 to 11, P=0.029) for neck flexion. CONCLUSIONS: Adding interferential therapy to TE is clinically more effective than TE alone to immediately improve neck pain and disability, but not active cervical range-of-movement, in adults with persistent neck pain. CLINICAL REHABILITATION IMPACT: Our results suggest that this multimodal intervention can be a useful strategy for rehabilitation of patients with NSNP. This is the first study on this topic reporting findings in terms of clinical relevance, which is key to transfer research evidence into practice.

Effectiveness of Tele-Prescription of Therapeutic Physical Exercise in Patellofemoral Pain Syndrome during the COVID-19 Pandemic.

The health crisis caused by COVID-19 has had a huge impact on the provision of physiotherapists' services during the pandemic. Patellofemoral pain syndrome (PFPS) is a major health problem and one of the most common causes of pain in the front of the knee in outpatients. The objective was to evaluate the effectiveness of a therapeutic physical exercise (TPE) program supervised by a physiotherapist using telematic channels in reducing pain and disability in a sample of 54 patients with PFPS in the Physiotherapy Service of the San José de la Rinconada Health Center (Seville). Subjects were evaluated pre- and post-intervention (4 weeks-12 treatment sessions). An analysis was made of perceived pain-using the visual analog scale (VAS) and the DN4 neuropathic pain questionnaire-and functional balance-through the Kujala Score test and the Lower Extremity Functional Scale. The supervised TPE program in patients with PFPS produced a reduction in pain: VAS F1, 52 = 8.68 (p = 0.005) η2 = 0.14 and DN4: F1, 52 = 69.94 (p = 0.000) η2 = 0.57; and in Lower Extremity Functional Scale (LEFS) disability: F1, 52 = 19.1 (p = 0.000) η2 = 0.27 and KUJALA: F1, 52 = 60.28 (p = 0.000) η2 = 0.54, which was statistically significant (p = 0.000 for p < 0.05). Hence, the TPE program presented was effective in reducing pain and disability in patients with PFPS.