Neck-Related Physical Function, Self-Efficacy, and Coping Strategies in Patients With Cervical Radiculopathy: A Randomized Clinical Trial of Postoperative Physiotherapy

• Published in: Journal of manipulative and physiological therapeutics Vol. 40; no. 5; pp. 330 - 339
• Main Authors: Wibault, Johanna, PhD, PT, Öberg, Birgitta, PT, Dedering, Åsa, PhD, PT, Löfgren, Håkan, PhD, MD, Zsigmond, Peter, PhD, MD, Persson, Liselott, PhD, PT, Andell, Maria, PT, R. Jonsson, Margareta, MSc, PT, Peolsson, Anneli, PT
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2017
• Subjects: Adult; Cervical Radiculopathy; Cervical Vertebrae - surgery; Coping Skills; Coping strategies; Female; Health Sciences; Humans; Hälsovetenskap; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Middle Aged; Muscle Strength - physiology; Musculoskeletal Manipulations - methods; Physical function; Physical Medicine and Rehabilitation; Physical Therapy Modalities; Physiotherapy; Postoperative Period; Postoperative physiotherapy; Prospective Studies; Radiculopathy - rehabilitation; Radiculopathy - surgery; Randomized Clinical Trial; Range of Motion, Articular; Self Efficacy; Sjukgymnastik; Time Factors; Treatment Outcome; Physical Therapy Modalities; Coping Skills; Postoperative Period; Cervical Radiculopathy; Randomized Clinical Trial
• ISSN: 0161-4754; 1532-6586; 1532-6586
• DOI: 10.1016/j.jmpt.2017.02.012

Abstract Objective The purpose of this study was to compare postoperative rehabilitation with structured physiotherapy to the standard approach in patients with cervical radiculopathy (CR) in a prospective randomized study at 6 months follow-up based on measures of neck-related physical function, self-efficacy, and coping strategies. Methods Patients with persistent CR and scheduled for surgery (N = 202) were randomly assigned to structured postoperative physiotherapy or a standard postoperative approach. Structured postoperative physiotherapy combined neck-specific exercises with a behavioral approach. Baseline, 3-month, and 6-month evaluations included questionnaires and clinical examinations. Neck muscle endurance, active cervical range of motion, self-efficacy, pain catastrophizing (CSQ-CAT), perceived control over pain, and ability to decrease pain were analyzed for between-group differences using complete case and per-protocol approaches. Results No between-group difference was reported at the 6-month follow-up ( P = .05-.99), but all outcomes had improved from baseline ( P < .001). Patients undergoing structured postoperative physiotherapy with ≥50% attendance at treatment sessions had larger improvements in CSQ-CAT ( P = .04) during the rehabilitation period from 3 to 6 months after surgery compared with the patients who received standard postoperative approach. Conclusions No between-group difference was found at 6 months after surgery based on measures of neck-related physical function, self-efficacy, and coping strategies. However, the results confirm that neck-specific exercises are tolerated by patients with CR after surgery and may suggest a benefit from combining surgery with structured postoperative physiotherapy for patients with CR.