Pride Physio Academy

The following exercises (27 trials) were supported by ‘Moderate GRADE’ evidence.

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For chronic NP: 

1) Cervico-Scapulothoracic and Upper Extremity (UE) strengthening for moderate to large pain            

    reduction immediately post treatment (IP) and at Short-Term (ST) follow-up.

2) Scapulo-thoracic and UE endurance training for a small pain reduction (IP/ST).

3) Cervical, shoulder and scapulothoracic strengthening and stretching exercise for a small to large pain     reduction in the long-term (LT) (SMDp −0.45 [95%CI: −0.72 to −0.18]) and function improvement. 

4) Cervico-Scapulothoracic strengthening/stabilisation exercises for pain and function at intermediate-       term (IT) (SMDp −14.90 [95%CI: −22.40 to −7.39]).

5) Mindfulness exercises (Qigong) for minor improved function but not GPE (ST).

For chronic CGH (Cervicogenic Headache): 

Cervico-scapulothoracic strengthening and endurance exercises including pressure biofeedback for small/moderate improvement of pain, function and GPE (IP/LT).

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So, Author concluded it as - Specific strengthening exercises of the neck, scapulothoracic and shoulder for chronic NP and chronic CGH are beneficial. Future research should explore optimal dosage.

Participants receiving physiotherapy reported significant reductions in headache frequency immediately after treatment (mean difference −1.6 days, 95% confidence interval [CI] −2.5 to −0.6), at 6-month follow-up (−1.7 days, 95% CI −2.6 to −0.8), and at 9-month follow-up (−2.4 days, 95% CI −3.2 to −1.5), and significant improvements in all secondary outcomes immediately post treatment and at 6- and 9-month follow-ups, (p<.05 for all). No adverse events were reported.

So, Concluded that Physiotherapy treatment provided benefits over usual care for seniors with recurrent headache associated with neck pain and dysfunction.

On the basis of the patient centred outcomes measured in this randomised trial, orthopaedic physiotherapy specialists are as effective as Post-Fellowship junior staff and clinical assistant orthopaedic surgeons in the initial assessment and management of new referrals to outpatient orthopaedic departments, and generate lower initial direct hospital costs.

Patients are highly satisfied with the care provided by Advanced Practice Physiotherapists (APPs) in follow-up clinics after joint replacement. Evaluation of the patient perspective is essential to any new role involving a shift in traditional practice boundaries.

There is evidence that physiotherapy leads to a prolonged time before patients return to usual activities. This study shows no clear danger from physiotherapy intervention and long term outcomes may be different but given these findings, a best estimate is that introducing physiotherapist assessment will increase costs to the health service and society. Routine care should continue be provided unless there is some reason why it is not feasible to do so and an alternative must be found.