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

J Manipulative Physiol Ther. 2017 Jun;40(5):330-339. doi: 10.1016/j.jmpt.2017.02.012. Epub 2017 May 9.

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.

Keywords: Cervical Radiculopathy; Coping Skills; Physical Therapy Modalities; Postoperative Period; Randomized Clinical Trial.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cervical Vertebrae / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Strength / physiology
  • Musculoskeletal Manipulations / methods*
  • Prospective Studies
  • Radiculopathy / rehabilitation*
  • Radiculopathy / surgery
  • Range of Motion, Articular
  • Self Efficacy*
  • Time Factors
  • Treatment Outcome