Effects of Online Exercise Intervention on Physical and Mental Conditions in Young Adults with Chronic Neck Pain
Description
This study aimed to compare the efficacy of online exercise therapy with conventional exercise therapy on pain, function, psychological status and work efficiency of young adults with chronic neck pain. A randomized clinical trial recruiting 35 university students with self-reported chronic neck pain was conducted. Participants were randomly assigned into the experimental group receiving 6-week online exercise therapy and the active control group receiving the same face-to-face conventional exercise therapy. The primary outcomes were visual analogue scale (VAS) for pain and Neck Disability Index (NDI). The secondary outcomes were Work Limitations Questionnaire (WLQ), the Hospital Anxiety and Depression Scale (HADS) and its subscales (HADS-A and HADS-D). Participants were assessed at baseline and at 6 weeks while the changes in WLQ were assessed biweekly. Both groups had improvements in VAS, NDI and HADS scores from baseline to 6 weeks (p<0.05). The reduction of HADS in both groups was mainly due to the decrease of the HADS-A (p<0.05). There were steady percentage reductions and statistically significant improvements in the last 2 weeks (p<0.05) in both groups. For young adults with chronic neck pain, both the online and conventional exercise interventions could improve their pain level, neck disability, anxiety state and work efficiency. The online exercise intervention appeared feasible as an alternative treatment option for them. Pain level were measured with 100-mm visual analog scale (VAS), in which 0 indicating no pain and 10 indicating unbearable pain. Neck dysfunction was measured with the Neck Disability Index (NDI). The NDI consists of 10 items related to pain intensity, headache, concentration and different physical activities. The score of each item ranges from 0 to 5. The maximum total score is 50 and the final score will be standardized into 0 to 100. The higher the score of the NDI, the more severe the neck dysfunction is. The HADS is a widely used screening tool for clinically relevant anxiety and depression. The scale comprises 14 questions which related 2 underlying sub-scale dimensions, anxiety (HADS-A) and depression (HADS-D) respectively. Each subscale has 7 items and each item is scored with 0-3 points. The higher the score, the more severe the condition is. Those with score ≥8 on HADS-A or HADS-D were considered to be at high risk of having anxiety or depression. The WLQ measures the impact of chronic conditions interfering with a person’s ability to perform job roles. It is a self-reported tool to evaluate the degree of difficulty in completing 25 specific tasks in the past 2 weeks. The score of each task ranges from 1 to 5. The higher the score, the lower the work efficiency is.
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The present study was an assessor blinded randomized controlled trial conducted according to the Declaration of Helsinki. The Institutional Review Board of the Beijing Sport University approved the study. All methods were performed in accordance with the relevant guidelines and regulations. Informed consent was obtained from all participants. The target participants were adults with self-reported non-specific neck pain for more than 3 months. They were recruited through posters and social media in the campus of the Beijing Sport University. The eligibility of the participants was assessed using a standardized questionnaire. Stratified block randomization was performed with gender and status as student athletes as the strata. After baseline assessments, participants were randomized to either the experimental group or active control group. The experimental group received online exercise therapy while the active control group received conventional face-to-face exercise therapy. The list of random allocation with one to one allocation ratio was generated with computer by an independent member of the research team who was not involved in the trial. The allocation sequence was concealed with the use of sealed numbered opaque envelopes. At baseline, the suitable elastic bands (Thera-band®） for performing the exercises in both experimental group and active control group were selected by testing the 15 repetitions maximum (15RM) of the Modified Brügger’s Exercise (MBE) and the Modified Proprioceptive Neuromuscular Facilitation Diagonal Flexion Exercise (MPNFDFE). Participants in the active control group were divided into several small groups of 3-5 participants to perform the certain exercises 3 sessions per week for 6 weeks in the laboratory of the Sport Medicine and Rehabilitation School of the Beijing Sport University. The exercises included: A. Warm-up exercises B. Cranio-cervical flexion exercises C. Strength-endurance exercises D. Scapular stabilization exercises E. Stretching exercises. Participants in the experimental group performed the same set of exercises 3 sessions per week for 6 weeks in their home. The participants had weekly online exercise meetings with the physiotherapist in a group of 3-5 participants using the Tencent Meeting app. Then the participants performed the remaining 2 sessions themselves weekly.
Institutions
- Beijing Sport University