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Effectiveness of Global Postural Re-education in Patients With Chronic Nonspecific Neck Pain: Randomized Controlled Trial

Paolo Pillastrini, Fernanda de Lima e Sá Resende, Federico Banchelli, Anna Burioli, Emanuele Di Ciaccio, Andrew A. Guccione, Jorge Hugo Villafañe, Carla Vanti
DOI: 10.2522/ptj.20150501 Published 1 September 2016
Paolo Pillastrini
P. Pillastrini, PT, MSc, Occupational Medicine Unit, Department of Biomedical and Neurological Sciences, University of Bologna, via P. Palagi 9-40138 Bologna, Italy.
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Fernanda de Lima e Sá Resende
F. de Lima e Sá Resende, PT, PhD, Occupational Medicine Unit, Department of Biomedical and Neurological Sciences, University of Bologna.
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Federico Banchelli
F. Banchelli, PhD, Department of Statistical Sciences Paolo Fortunati, University of Bologna.
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Anna Burioli
A. Burioli, PT, Occupational Medicine Unit, Department of Biomedical and Neurological Sciences, University of Bologna.
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Emanuele Di Ciaccio
E. Di Ciaccio, PT, Occupational Medicine Unit, Department of Biomedical and Neurological Sciences, University of Bologna.
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Andrew A. Guccione
A.A. Guccione, PT, DPT, PhD, FAPTA, Department of Rehabilitation Science, College of Health and Human Services, George Mason University, Fairfax, Virginia.
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Jorge Hugo Villafañe
J.H. Villafañe, PT, PhD, IRCCS Don Gnocchi Foundation, Milan, Italy.
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Carla Vanti
C. Vanti, PT, MSc, Occupational Medicine Unit, Department of Biomedical and Neurological Sciences, University of Bologna.
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Figures

Figure 1.
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Figure 1.

(A) Supine posture with leg extension progression: anterior muscle chain stretching. Starting position. (B) Supine posture with leg extension progression: anterior muscle chain stretching. Final position.

Figure 2.
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Figure 2.

(A) Supine posture with leg flexion progression: posterior muscle chain stretching. Starting position. (B) Supine posture with leg flexion progression: posterior muscle chain stretching. Final position.

Figure 3.
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Figure 3.

Flowchart of participants through the study.

Tables

Table 2.
Table 2.

Mean (SD) for Outcome Measures at All Study Visits for Each Group, Mean (95% CI) Difference Between Groups, and Mean (95% CI) Difference Between Groups Adjusted for Baseline Scorea

  • ↵a GPR=global postural re-education, MT=manual therapy, T1=time 1 (immediately postintervention), T2=time 2 (6 months postintervention), CI=confidence interval, VAS=visual analog scale, NDI-I= Neck Disability Index (Italian version), TSK=Tampa Scale of Kinesiophobia, TSK-1=TSK activity avoidance subscale, TSK-2=TSK harm subscale, ROM=range of motion, *Significantly different between groups (adjusting for baseline score): P<.05 (95% CI).

Table 3.
Table 3.

Mean (95% CI), at Each Study Visit, of Principal Outcomes Difference Between Groups Adjusted for Baseline Score, According to Best-Case and Worst-Case Scenariosa

  • ↵a GPR=global postural re-education group, MT=manual therapy group, T1=time 1 (immediately postintervention), T2=time 2 (6 months postintervention), CI=confidence interval, VAS=visual analog scale, NDI-I=Neck Disability Index (Italian version), *Significantly different between groups (adjusting for baseline score): P<.05 (95% CI).

Table 1.
Table 1.

Characteristics of Participants at Baselinea

  • ↵a GPR=global postural re-education, MT=manual therapy, BMI=body mass index, VAS=visual analog scale, NDI-I=Neck Disability Index (Italian version), TSK=Tampa Scale of Kinesiophobia, TSK-1=TSK activity avoidance subscale, TSK-2=TSK harm subscale, ROM=range of motion. *Significantly different.

Supplementary Data

eAppendixes and eTable

Files in this Data Supplement:

  • eAppendixes and eTable (PDF) (2.11 MB) - This PDF contains the following supplements:
    • eAppendix 1. Global Posture Re-education Group: Home Exercises
    • eAppendix 2. Manual Theory Group: Home Exercises
    • eAppendix 3. Advice for Daily Activities
    • eTable. Descriptive Statistics of GPE and PTPSQ-I(15) Outcome Measures for Each Group

Author Interview Podcast: Paolo Pilliastrini

Click here to listen to the PTJ author interview podcast. In this podcast, Editor in Chief Dr Alan Jette talks with Dr Paolo Pillastrini about his Research Report "Effectiveness of Global Postural Re-education in Patients With Chronic Nonspecific Neck Pain: Randomized Controlled Trial," which was published in the September 2016 issue.

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    Vol 96 Issue 9 Table of Contents
    Physical Therapy: 96 (9)

    Issue highlights

    • Experiences of Physical Therapists Working in the Acute Hospital Setting: Systematic Review
    • Physician Impressions of Physical Therapist Practice in the Emergency Department: Descriptive, Comparative Analysis Over Time
    • Simulated Patients in Physical Therapy Education: Systematic Review and Meta-Analysis
    • Physical Therapists' Perceptions and Use of Exercise in the Management of Subacromial Shoulder Impingement Syndrome: Focus Group Study
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    • Client Perspectives on Reclaiming Participation After a Traumatic Spinal Cord Injury in South Africa
    • Inpatient Rehabilitation Outcomes in Patients With Stroke Aged 85 Years or Older
    • Physical Activity Levels and Their Associations With Postural Control in the First Year After Stroke
    • Patient Perspectives on Participation in Cognitive Functional Therapy for Chronic Low Back Pain
    • Effectiveness of Global Postural Re-education in Patients With Chronic Nonspecific Neck Pain: Randomized Controlled Trial
    • Development and Integration of Professional Core Values Among Practicing Clinicians
    • Translation, Validation, and Reliability of the Dutch Late-Life Function and Disability Instrument Computer Adaptive Test
    • Coactivation During Dynamometry Testing in Adolescents With Spastic Cerebral Palsy
    • Cohort Study Comparing the Berg Balance Scale and the Mini-BESTest in People Who Have Multiple Sclerosis and Are Ambulatory
    • Use of Six-Minute Walk Test to Measure Functional Capacity After Liver Transplantation
    • Feasibility of the Six-Minute Walk Test for Patients Who Have Cystic Fibrosis, Are Ambulatory, and Require Mechanical Ventilation Before Lung Transplantation
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    Effectiveness of Global Postural Re-education in Patients With Chronic Nonspecific Neck Pain: Randomized Controlled Trial
    Paolo Pillastrini, Fernanda de Lima e Sá Resende, Federico Banchelli, Anna Burioli, Emanuele Di Ciaccio, Andrew A. Guccione, Jorge Hugo Villafañe, Carla Vanti
    Physical Therapy Sep 2016, 96 (9) 1408-1416; DOI: 10.2522/ptj.20150501

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    Effectiveness of Global Postural Re-education in Patients With Chronic Nonspecific Neck Pain: Randomized Controlled Trial
    Paolo Pillastrini, Fernanda de Lima e Sá Resende, Federico Banchelli, Anna Burioli, Emanuele Di Ciaccio, Andrew A. Guccione, Jorge Hugo Villafañe, Carla Vanti
    Physical Therapy Sep 2016, 96 (9) 1408-1416; DOI: 10.2522/ptj.20150501
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    Subjects

    • Pain
    • Randomized Controlled Trials
    • Intervention
      • Therapeutic Exercise
      • Manual Therapy
    • Musculoskeletal System/Orthopedic
      • Injuries and Conditions: Neck

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