| Non-specific neck pain is a kind of pain from the maxillary line to the scapula spinal area without specific injury factors and pathological changes.The mechanism of non-specific neck pain is still in a research stage,but after evaluation by musculoskeletal ultrasound and surface electromyography,it may be related to neck muscle atrophy and abnormal activation.The high incidence and recurrence rate of chronic non-specific neck pain seriously affect people’s work and life,and cause economic burden and emotional problems.The loss of healthy life years caused by its remaining disability ranks fourth in the world.Due to the younger trend of chronic non-specific neck pain,people cannot bear the torment,and there is an urgent need to find a cure for both symptoms and root causes.The current manual therapy and physical therapy have limited efficacy,and the recurrence rate has not improved significantly.Although exercise therapy can increase the efficiency of muscle contraction,the treatment cycle is long,which can easily lead to poor patient compliance,and it is not suitable for the acute phase.It needs to be put into effect with other treatments.Extracorporeal shock wave therapy(ESWT)is a burgeoning physical therapy.Its advantages are non-invasive,fast onset,and can effectively make up for the deficiencies of exercise therapy.This study will choose conventional rehabilitation therapy,combined with extracorporeal shock wave therapy and neck resistance training,to observe the improvement of pain,dysfunction and abnormal activation patterns of neck muscles;and compare the efftiveness of conventional rehabilitation treatments assisted by neck resistance training,provide proof for clinical applications.Objective:To observe the rehabilitation effect of applying shock wave therapy and neck resistance training to young people with chronic non-specific neck pain,on the basis of conventional rehabilitation.Methods:Fifty young patients with chronic non-specific neck pain were divided into observation group(group A)and control group(group B)by random number table,with 25 cases in each group.Patients in the two groups were given conventional rehabilitation intervention.On this basis,patients in the control group received resistance training with the neck Thera-band elastic band,and the observation group received shock wave therapy assisted by the same neck resistance training.Before treatment(T1)and 15 days after treatment(T2),the visual analgue scale(VAS)and neck disablity index(NDI)of the two groups of patients were recorded respectively,and surface electromyography was used to collect the root mean square(RMS)of the bilateral sternocleidomastoid muscles in both groups before and after treatment.One month after the end of treatment(T3),the VAS and NDI scores of both groups were assessed again.Result:At the end of the treatment,5 people in the observation group(group A)fell off,and 2 people in the control group(group B)fell off.1.Comparison of VAS scores: Before treatment,the VAS scores of group A and the group B were(5.5±1.2)points and(5.3±1.3)points,there was no statistically significant difference in VAS scores between the two groups(P>0.05).After treatment,the VAS scores of group A and group B were(2.1±1.5)points and(2.8±1.2)points,which were decreased compared with those before treatment,and the difference was statistically significant(P<0.05).And the VAS score of group A was significantly lower than that of group B,the difference was statistically significant(P<0.05).At follow-up,the VAS scores of group A and group B were(2.3±1.3)and(4.3±1.4)points.Compared within the group,the VAS score of group A during follow-up was not statistically different from that after treatment(P>0.05);the VAS score of group B during follow-up was higher than that after treatment,and the difference was statistically significant(P<0.05).In comparison between groups,the VAS of group A during follow-up was significantly lower than that of group B during follow-up,and the difference was statistically significant(P<0.05).2.Comparison of NDI scores: Before treatment,the NDI of group A and group B was(35.8±6.13)% and(35.6±4.7)%,there was no statistically significant difference in NDI between the two groups of patients(P>0.05).After treatment,the NDI of group A and group B were(13.8±6.5)% and(22.8±6.5)%,which were both decreased compared with those in the group before treatment,and the difference was statistically significant(P<0.05).And the NDI of group A was significantly lower than that of group B,the difference was statistically significant(P<0.05).At follow-up,the NDI of group A and group B were(13.9±6.0)% and(30.6±6.7)%.In comparison within the group,there was no statistically significant difference between the observation group’s NDI during follow-up and after treatment(P>0.05);the control group’s NDI during follow-up was higher than that after treatment,and the difference was statistically significant(P<0.05).In comparison between the groups,the NDI of the group A during follow-up was significantly lower than that of group B,and the difference was statistically significant(P<0.05).3.Comparison of EMG signal of sternocleidomastoid muscle:Before treatment,in the resting state,the RMS values of the bilateral sternocleidomastoid muscles in group A were [(9.7±3.9)u V] and[(9.3±3.9)u V];the RMS values of the bilateral sternocleidomastoid muscles in group B were [(8.3±3.2)u V] and [(8.7±3.6)u V].When bending forward,the RMS values of bilateral sternocleidomastoid muscles in group A were[(11.9±3.4)u V] and [(11.0±3.2)u V];the RMS values of bilateral sternocleidomastoid muscles in group B were [(12.0±4.8)u V] and[(11.6±4.4)u V].During extension,the RMS values of the bilateral sternocleidomastoid muscles in group A were [(10.4±3.0)u V] and[(11.3±4.0)u V];the RMS values of the bilateral sternocleidomastoid muscles in group B were [(11.3±4.6)u V] and [(12.6±4.4)u V].When left flexion,theRMS values of the bilateral sternocleidomastoid muscles in group A were[(12.4±4.3)u V] and [(9.6±3.9)u V];the RMS values of the bilateral sternocleidomastoid muscles in group B were [(11.3±3.1)u V] and[(9.3±2.7)u V].In right flexion,the RMS values of bilateral sternocleidomastoid muscles in group A were [(10.9±4.6)u V] and[(13.6±5.0)u V];the RMS values of bilateral sternocleidomastoid muscles in group B were [(11.2±2.8)u V] and [(13.1±4.1)u V].When rotating to the left,the RMS values of the bilateral sternocleidomastoid muscles in group A were [(8.1±2.9)u V] and [(16.5±7.0)u V];the RMS values of the bilateral sternocleidomastoid muscles in group B were [(9.7±3.2)u V] and[(17.8±5.5)u V].When rotating to the right,the RMS values of the bilateral sternocleidomastoid muscles in group A were [(16.2±5.5)u V] and[(8.1±2.9)u V];the RMS values of the bilateral sternocleidomastoid muscles in group B were [(15.8±5.2)u V] and [(9.7±3.5)u V].After statistical analysis,there was no statistically significant difference between the two groups in the RMS of patients at rest and during exercise before treatment(P>0.05).After treatment,in the resting state,the RMS values of the bilateral sternocleidomastoid muscles in group A were [(4.0±0.8)u V] and[(4.1±1.1)u V];the RMS values of bilateral sternocleidomastoid muscles in group B were [(6.3±3.3)u V] and [(5.7±1.7)u V].When bending forward,the RMS values of the bilateral sternocleidomastoid muscles in group A were[(6.6±1.9)u V] and [(6.5±2.2)u V];the RMS values of the bilateral sternocleidomastoid muscles in group B were respectively [(9.4±4.0)u V] and[(8.8±1.7)u V].During extension,the RMS values of the bilateral sternocleidomastoid muscles in group A were [(7.5±2.6)u V] and[(6.7±2.0)u V];the RMS values of the bilateral sternocleidomastoid muscles in group B were [(9.5±2.9)u V] and [(9.1±3.0)u V].When left flexion,the RMS values of bilateral sternocleidomastoid muscles in group A were [(7.3±2.1)u V]and [(4.7±1.6)u V];the RMS values of bilateral sternocleidomastoid muscles in group B were [(9.1±3.2)u V] and [(6.9±2.4)u V].In the right flexion,the RMS values of the bilateral sternocleidomastoid muscles in group A were[(4.5 ± 1.5)u V] and [(7.7 ± 2.2)u V];the RMS values of the bilateral sternocleidomastoid muscles in group B were [(7.4 ± 2.3)u V] and [(9.7 ±3.2)u V].When rotating to the left,the RMS values of the bilateral sternocleidomastoid muscles in group A were [(5.2 ± 1.7)u V] and [(10.0 ±2.3)u V];the RMS values of the bilateral sternocleidomastoid muscles in group B were [(7.2±1.8)u V] and [(12.5±3.0)u V].When rotating to the right,the RMS values of the bilateral sternocleidomastoid muscles in group A were[(10.0 ± 2.5)u V] and [(4.7 ± 1.9)u V];the RMS values of the bilateral sternocleidomastoid muscles in group B were [(12.3± 3.6)u V] and [(7.2±1.8)u V].The RMS value of the sternocleidomastoid muscle after treatment in the two groups decreased compared with that before treatment,and the difference was statistically significant(P<0.05).In comparison between the groups,the RMS value of the bilateral sternocleidomastoid muscles in the group A was significantly lower than that of group B at rest and exercise,and the difference was statistically significant(P<0.05).Conclusion:1.This study shows that both neck resistance training and shock wave therapy combined with neck resistance training can effectively relieve the pain of patients with chronic non-specific neck pain and improve the abnormal activation pattern of their neck muscles.2.This study shows that the effect of shock wave therapy combined with neck resistance training is better than that of the neck resistance training group,and the combination group has a good long-term effect. |
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