مقایسه تاثیر تمرینات اصلاح وضعیت عمومی و تمرینات تقویت عصبی-عضلانی بر کاهش درد و بهبود عملکرد در مردان میانسال مبتلا به گردن درد غیراختصاصی در شهر تهران

زمینه و هدف: گردن درد یکی از اختلالات اسکلتی_عضلانی است که می‌تواند به ناتوانی شدید در انجام‌دادن فعالیت‌های روزمره و شغلی فرد منجر شود. امروزه تمرین‌درمانی به‌عنوان درمانی موثر برای گردن‌درد، موضوعی پذیرفته شده است. تمرینات تسهیل عصبی عضلانی و نیز تمرینات بازآموزی وضعیتی عمومی دو نوع تمرین هستند که در منزل هم توسط خود فرد قابل انجام هستند. هدف مطالعه حاضر مقایسه تاثیر تمرینات اصلاح وضعیت عمومی و تمرینات تقویت عصبی-عضلانی بر کاهش درد و بهبود عملکرد در مردان میانسال مبتلا به گردن درد غیراختصاصی در شهر تهران بود. روش کار: این تحقیق از لحاظ هدف کاربردی و از لحاظ روش به صورت نیمه تجربی با طرح پیش‌آزمون و پس‌آزمون بود. درد از طریق شاخص بصری درد و ناتوانی عملکردی از طریق پرسشنامه اندازه گیری شدند. 45 آزمودنی باتوجه به ملاک های ورود به مطالعه به روش هدفمند انتخاب شده و به صورت تصادفی به سه گروه شاهد – تمرینات تسهیل عصبی عضلانی و گروه تمرینات بازآموزی وضعیتی عمومی تقسیم شدند و درد و ناتوانی عملکردی آنها اندازه گیری شد و بعد از 6 هفته انجام تمرینات درمنزل (18 جلسه) مجددا مراجعه نموده و پس آزمون از آنها به عمل آمد. از روش آماری کوواریانس برای تجزیه و تحلیل داده ها استفاده شد. یافته‌ها: درد و ناتوانی عملکردی در هردو گروه تمرینی تسهیل عصبی عضلانی و بازاموزی وضعیتی عمومی کاهش معناداری نشان داد. هر دو متغیر وابسته در گروه شاهد تغییر معناداری نشان ندادند. بین دو گروه تمرینی تفاوت معنادار نبود.نتیجه‌گیری: هردو روش تمرینی تقریبا به یک اندازه در بهبود درد و ناتوانی مبتلایان موثر هستند و می توان به عنوان یک برنامه تمرین اصلاحی که در منزل هم قابل انجام هستند به افراد مبتلا توصیه کرد.

comparison of the effects of general postural correction exercises and neuromuscular facilitation exercises on pain reduction and functional improvement in middle-aged men with non-specific neck pain in tehran

background & aims: neck pain is one of the musculoskeletal disorders that causes functional disability in an individual. functional disability means the impairment of performing movements with complete freedom of action and without restriction, caused by factors such as pain, reduced range of motion, and abnormal muscle contractions and poses limitations and difficulties to the individual's normal functioning. this problem affects the individual's daily and professional activities, including personal care, lifting objects, studying, driving, sleeping, recreation, etc. the prevalence of neck pain is increasing with the progress of societies. in recent years, its prevalence has increased due to the development of technology and the use of computers. the second most common musculoskeletal disability after back pain is neck pain, which about 70% of people have experienced at some point in their lives. every year, 30% of adults report neck pain. when the neck is in an awkward position for a long time and mechanical stresses occur during some daily activities, especially using a mobile phone, pressure is placed on the cervical spine. ligaments are overstretched, muscles are tired, and joints and nerves are stressed. one of the vulnerable groups in society is the middle-aged, who are in greater need of health care. approximately 67% of adults experience neck pain at some point in their lives. in most cases, no serious pathophysiological origin is known for this pain and its main cause is multifactorial. the most common cause of chronic neck pain in the elderly is intervertebral disc and facet joint osteoarthritis, which in most cases causes damage to the nerves and spinal cord. the range of motion of the neck is limited to the point that the person's rotational and other movements will be impaired. the present study aimed to compare the effects of general posture correction exercises and neuromuscular strengthening exercises on pain reduction and function improvement in middle-aged men with non-specific neck pain in tehran.methods: this study was applied in terms of purpose and semi-experimental in terms of method with a pre-test and post-test design. pain was measured through the visual index of pain and functional disability through a questionnaire. 45 subjects were selected purposively according to the inclusion criteria and randomly divided into three control groups - neuromuscular facilitation exercises and general postural retraining exercises. their pain and functional disability were measured and after 6 weeks of home exercises (18 sessions) they were referred again and a post-test was performed on them. the covariance statistical method was used to analyze the data. the paired t-test was used to examine the effect of the variables and the analysis of covariance or anova test was used to examine the significance of the research variables. also, the bonferroni post-hoc test was used to compare the groups pairwise.results:  pain and functional disability were significantly reduced in both neuromuscular facilitation and general postural retraining training groups. both dependent variables did not change significantly in the control group. there was no significant difference between the two training groups. it has been hypothesized that clinical symptoms are caused by disruption of the anterior and posterior chains of the spine, and as a result, the person develops neck or back pain. general postural retraining exercises cause the shortened muscles to stretch and lengthen, so that the antagonist muscles, by contracting, apply a corrective force to the chains. the results of our study showed that performing neuromuscular facilitation exercises reduces pain and functional disability in patients with non-specific neck pain in middle-aged men. below, we will review related studies. the results showed that neuromuscular facilitation exercises are useful and effective in reducing pain in people with nonspecific neck pain. exercise therapy in people with nonspecific neck pain strengthens and stretches the neck muscles and corrects poor posture. neuromuscular facilitation exercises improve muscle function by performing movements in the appropriate pattern and stimulating the proprioceptive system. neuromuscular facilitation exercises are an example of a prescribed exercise therapy. these exercises provide effective techniques for treating structural and neuromuscular disorders. several articles have proven that neuromuscular facilitation exercises can reduce pain, and disability, and increase range of motion. neck pain is a musculoskeletal disorder that alters muscle control in such a way that the superficial muscles of the spine will increase in activity and the contraction of the superficial muscles of the spine will also increase. neck pain increases disability and its consequences for workers and imposes costs on businesses and society. risk factors associated with neck pain include genetics, poor mental health, a history of musculoskeletal pain, workplace factors (lifting or lowering heavy objects, repetitive activities, and an unfavorable work environment), low social support, and postural deformities such as forward head and hunchback. whatever the cause of neck pain, postural changes are a common finding in patients with neck pain. poor posture during work and bad postural habits can alter the natural alignment of the spine. gradually, these changes introduce altered forces to body structures including ligaments, bones, and muscles.conclusion:  both exercise methods are almost equally effective in improving pain and disability in sufferers and can be recommended as a corrective exercise program that can be done at home.