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Evaluations and Treatment of the Cervical Spine, 2nd Edition: Summary
RECOMMENDED INTERVENTIONS BASED ON CPG CLASSIFICATIONS CPG Classification Intervention Neck Pain with Mobility Deficits Acute: ○ Manipulation and mobilization
○ Cervical ROM, stretching, and isometric strengthening ○ Advice to stay active and comply with home exercise program ○ Other therapeutic exercise: upper extremity and endurance ○ General fitness Subacute: ○ Manipulation and mobilization ○ Cervicoscapulothoracic endurance exercise Chronic: ○ Mobilization and manipulation ○ Cervicoscapulaothoracic exercise ○ Therapeutic exercise (e.g., posture, flexibility, endurance, strength)
○ Active lifestyle ○ Dry needling ○ Low-level laser therapy
○ Pulsed or high-power ultrasound ○ Intermittent mechanical traction ○ Electrical stimulation
Neck Pain with Movement Coordination Impairments (WAD)
Acute: ○ Education and advice to stay active; act as usual ○ HEP to include pain-free cervical ROM and postural exercise ○ Minimize cervical collar use Subacute: ○ Education and advice to stay active ○ Therapeutic exercise (i.e., AROM, isometric strengthening, low-load strengthening, posture, coordination, endurance) ○ Modalities for pain (ice, heat, electrical stimulation) Chronic: ○ Education: Prognosis, encouragement, reassurance, pain management ○ Cervical mobilization ○ Therapeutic exercise (i.e., AROM, isometric strengthening, low-load strengthening, posture, coordination, endurance, functional training) ○ Electrical stimulation
Neck Pain with Headache Acute:
○ Exercise: Self-SNAG C1–C2 vertebra Subacute: ○ Manipulation and mobilization ○ Exercise: Self-SNAG C1–C2 vertebra Chronic: ○ Manipulation and mobilization ○ Therapeutic exercise for the scapulothoracic region: Strength, endurance, neuromuscular training, motor control, and stretching ○ Manual therapy/soft tissue mobilization
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