Management of acute neck pain: A case series describing immediate and short term clinical outcomes following use of the Multifidus Isometric Technique

摘要

Background: Acute facet capsular entrapment results in sudden onset of pain and reduced ability to perform active cervical motions. The Multifidus Isometric Technique (MIT) is a type of manual therapy intervention theorized to target the entrapped facet capsule and pull the entrapped synovial folds from the facet joint resulting in decreased pain and increased function. Purpose: To describe immediate MIT clinical outcomes for patients with acute neck pain. Methods: Consecutive patients (n = 30; 70% female) with sudden onset of neck pain received MIT within 48 hours of symptom onset. Clinical outcome measures included: 1) 11-point Numeric Pain Rating Scale (NPRS); 2) cervical AROM, and 3) the Neck Disability Index (NDI). Paired-sample t-testing was used to assess for within and between-session changes in outcome measure scores. Results: Within-session NPRS improvements were observed during all cervical AROM movements (p < .01), with initial treatment associated with greater improvements on average (M = 2.4 ± 1.6 points) compared to the second treatment (M = 0.6 ± 0.9 points). Similarly, most within-session AROM measures improved during both sessions (p<.01) with greater average improvements observed following the initial treatment session and for cervical rotation to the symptomatic side (M = 26.5 ± 9.6 vs. 8.0 ± 9.7°). Between-session NDI scores improved (M = 15.3±9.8, p<.01) with approximately 60% of patients achieving a minimally clinically important difference of 14 percentage points. Discussion: The MIT is a potentially beneficial intervention for patients with acute neck pain. Future studies consisting of longer follow-up time points and comparison treatment groups are needed to test MIT effectiveness.