Respiratory dysfunction in patients with chronic neck pain: What is the current evidence?
Respiratory function of patients with neck pain has not been given much consideration in usual clinical practice. The problem has however been highlighted occasionally by renown clinical scientists and recently there is a growing interest in the investigation of respiratory function in this clinical population. The aim of this review is to critically present the emerging evidence and discuss the similarities and differences observed. Although the evidence for some respiratory parameters is conflicting, it seems to be generally agreed that others such as maximal voluntary ventilation, strength of respiratory muscles, chest mechanics and partial pressure of arterial carbon dioxide are affected in patients with chronic neck pain. The effect size of the respiratory dysfunction regarding these respiratory parameters can be approximately described as moderate. These findings not only suggest a more thoughtful drug prescription, but they may lead to consideration of incorporation of respiratory assessment and treatment into routine physiotherapy practice. Indeed preliminary studies exploring the incorporation of such a treatment into usual practice have provided very promising results not only in relation to respiratory function, but also for other parameters of clinical interest. There remains however imminent need for randomized controlled trials to confirm the evidence base for such an approach.
Physiotherapy Department, School of Health and Caring Professions, Technological Education Institute of Sterea Ellada, Lamia, Greece; Physiotherapy Department, School of Health and Caring Professions, Technological Education Institute of Athens, Athens, Greece; Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK. Electronic address: zachariasd@hotmail.com.
Zacharias
Z
Dimitriadis
Physiotherapy Department, School of Health and Caring Professions, Technological Education Institute of Sterea Ellada, Lamia, Greece.
Eleni
E
Kapreli
Physiotherapy Department, School of Health and Caring Professions, Technological Education Institute of Sterea Ellada, Lamia, Greece; Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.
Nikolaos
N
Strimpakos
Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.
Jacqueline
J
Oldham
D001696:Biomechanical Phenomena; D002245:Carbon Dioxide / Q000097:blood; D002574:Cervical Vertebrae / Q000503:physiopathology; D059350:Chronic Pain; D006801:Humans; D026201:Musculoskeletal Manipulations; D019547:Neck Pain / Q000150:complications* / Q000503:physiopathology*; D011187:Posture / Q000502:physiology; D012119:Respiration; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000503:physiopathology; D012140:Respiratory Tract Diseases / Q000209:etiology* / Q000503:physiopathology*
D002245:Carbon Dioxide
Blood gases; Neck pain; Respiratory strength; Spirometry; Ventilation