There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Regular physical exercise is a cornerstone in rehabilitation programs, but adherence to comprehensive exercise remains low. This study determined the effectiveness of small daily amounts of progressive resistance training for relieving neck/shoulder pain in healthy adults with frequent symptoms; 174 women and 24 men working at least 30 h per week and with frequent neck/shoulder pain were randomly assigned to resistance training with elastic tubing for 2 or 12 minutes per day 5 times per week, or weekly information on general health (control group). Primary outcomes were changes in intensity of neck/shoulder pain (scale 0 to 10), examiner-verified tenderness of the neck/shoulder muscles (total tenderness score of 0 to 32), and isometric muscle strength at 10 weeks. Compared with the control group, neck/shoulder pain and tenderness, respectively, decreased 1.4 points (95% confidence interval -2.0 to -0.7, p<0.0001) and 4.2 points (95% confidence interval -5.7 to -2.7, p<0.0001) in the 2-minute group and 1.9 points (95% confidence interval -2.5 to -1.2, p<0.0001) and 4.4 points (95% confidence interval -5.9 to -2.9, p<0.0001) in the 12-minute group. Compared with the control group, muscle strength increased 2.0 Nm (95% confidence interval 0.5 to 3.5Nm, p=0.01) in the 2-minute group and 1.7Nm (95% confidence interval 0.2 to 3.3 Nm, p=0.02) in the 12-minute group. In conclusion, as little as 2 minutes of daily progressive resistance training for 10 weeks results in clinically relevant reductions of pain and tenderness in healthy adults with frequent neck/shoulder symptoms. www.isrctn.org/ISRCTN60264809. In generally healthy adults with frequent neck/shoulder muscle pain, as little as 2 minutes of daily progressive resistance training reduces pain and tenderness. Copyright Â© 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Related collections

Most cited references 21

Record: found
Abstract: found
Article: not found

Evidence for prescribing exercise as therapy in chronic disease.

B K Pedersen, B Saltin (2006)

Considerable knowledge has accumulated in recent decades concerning the significance of physical activity in the treatment of a number of diseases, including diseases that do not primarily manifest as disorders of the locomotive apparatus. In this review we present the evidence for prescribing exercise therapy in the treatment of metabolic syndrome-related disorders (insulin resistance, type 2 diabetes, dyslipidemia, hypertension, obesity), heart and pulmonary diseases (chronic obstructive pulmonary disease, coronary heart disease, chronic heart failure, intermittent claudication), muscle, bone and joint diseases (osteoarthritis, rheumatoid arthritis, osteoporosis, fibromyalgia, chronic fatigue syndrome) and cancer, depression, asthma and type 1 diabetes. For each disease, we review the effect of exercise therapy on disease pathogenesis, on symptoms specific to the diagnosis, on physical fitness or strength and on quality of life. The possible mechanisms of action are briefly examined and the principles for prescribing exercise therapy are discussed, focusing on the type and amount of exercise and possible contraindications.

0 comments Cited 333 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Interpreting the clinical importance of group differences in chronic pain clinical trials: IMMPACT recommendations.

Robert H Dworkin, Dennis C Turk, Michael McDermott … (2009)

An essential component of the interpretation of results of randomized clinical trials of treatments for chronic pain involves the determination of their clinical importance or meaningfulness. This involves two distinct processes--interpreting the clinical importance of individual patient improvements and the clinical importance of group differences--which are frequently misunderstood. In this article, we first describe the essential differences between the interpretation of the clinical importance of patient improvements and of group differences. We then discuss the factors to consider when evaluating the clinical importance of group differences, which include the results of responder analyses of the primary outcome measure, the treatment effect size compared to available therapies, analyses of secondary efficacy endpoints, the safety and tolerability of treatment, the rapidity of onset and durability of the treatment benefit, convenience, cost, limitations of existing treatments, and other factors. The clinical importance of individual patient improvements can be determined by assessing what patients themselves consider meaningful improvement using well-described methods. In contrast, the clinical meaningfulness of group differences must be determined by a multi-factorial evaluation of the benefits and risks of the treatment and of other available treatments for the condition in light of the primary goals of therapy. Such determinations must be conducted on a case-by-case basis, and are ideally informed by patients and their significant others, clinicians, researchers, statisticians, and representatives of society at large.

0 comments Cited 226 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Statistical considerations in the intent-to-treat principle.

John M. Lachin (2000)

This paper describes some of the statistical considerations in the intent-to-treat design and analysis of clinical trials. The pivotal property of a clinical trial is the assignment of treatments to patients at random. Randomization alone, however, is not sufficient to provide an unbiased comparison of therapies. An additional requirement is that the set of patients contributing to an analysis provides an unbiased assessment of treatment effects, or that any missing data are ignorable. A sufficient condition to provide an unbiased comparison is to obtain complete data on all randomized subjects. This can be achieved by an intent-to-treat design wherein all patients are followed until death or the end of the trial, or until the outcome event is reached in a time-to-event trial, irrespective of whether the patient is still receiving or complying with the assigned treatment. The properties of this strategy are contrasted with those of an efficacy subset analysis in which patients and observable patient data are excluded from the analysis on the basis of information obtained postrandomization. I describe the potential bias that can be introduced by such postrandomization exclusions and the pursuant effects on type I error probabilities. Especially in a large study, the inflation in type I error probability can be severe, 0.50 or higher, even when the null hypothesis is true. Standard statistical methods for the analysis of censored or incomplete observations all require the assumption of missing at random to some degree, and none of these methods adjust for the potential bias introduced by post hoc subset selection. Nor is such adjustment possible unless one posits a model that relates the missing observations to other observed information for each subject-models that are inherently untestable. Further, the subset selection bias is confounded with the subset-specific treatment effect, and the two components are not identifiable without additional untestable assumptions. Methods for sensitivity analysis to assess the impact of bias in the efficacy subset analysis are described. It is generally believed that the efficacy subset analysis has greater power than the intent-to-treat analysis. However, even when the efficacy subset analysis is assumed to be unbiased, or have a true type I error probability equal to the desired level alpha, situations are described where the intent-to-treat analysis in fact has greater power than the efficacy subset analysis. The intent-to-treat design, wherein all possible patients continue to be followed, is especially powerful when an effective treatment arrests progression of disease during its administration. Thus, a patient benefits long after the patient becomes noncompliant or the treatment is terminated. In such cases, a landmark analysis using the observations from the last patient evaluation is likely to prove more powerful than life-table or longitudinal analyses. Examples are described.

0 comments Cited 128 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

PubMed ID:: 21177034

DOI:: 10.1016/j.pain.2010.11.016

ScienceOpen disciplines: Chemistry

Keywords: Adult,Exercise Therapy,methods,Female,Humans,Male,Middle Aged,Neck Pain,physiopathology,rehabilitation,Resistance Training,Shoulder Pain

Data availability:

ScienceOpen disciplines: Chemistry

Keywords: Adult, Exercise Therapy, methods, Female, Humans, Male, Middle Aged, Neck Pain, physiopathology, rehabilitation, Resistance Training, Shoulder Pain

Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: randomised controlled trial.

Read this article at

Abstract

Related collections

Methods by AKJournals

Most cited references 21

Evidence for prescribing exercise as therapy in chronic disease.

Interpreting the clinical importance of group differences in chronic pain clinical trials: IMMPACT recommendations.

Statistical considerations in the intent-to-treat principle.

Author and article information

Journal

Comments

Comment on this article

Similar content 85

Cited by 71

Most referenced authors 302