PROTOCOL OF INTERVENTIONS
The intervention of group 1 (G1) is based on education and selective strengthening exercises for cervical muscles, and involves a protocol that must be performed by the patient for 8 weeks. Halfway through the course (at the end of the fourth week) the physical therapist will carry out a reinforcement session, to monitor the clinical situation, motivate the patient and resolve any doubts (booster session).
In group 2 (G2) the "Pompage" treatment will be added to this intervention.
HOME EXERCISES: CONTENTS
In the first session supervised by a physical therapist, lasting 30 minutes, the patient will be taught all the home exercises that he/she will have to perform and will be given:
1. a hard copy with the exercise reminder;
2. a diary for recording the daily execution of the exercises. The patients will be instructed to perform the exercises on a daily basis, without feeling pain. These exercises focus on strengthening the deep muscles of the neck; cranio-cervical flexor muscles and cervical extensors.
PAIN EDUCATION: CONTENTS
The educational intervention will take place verbally in a 30-minute session (explanation by the physical therapist), and will be supported by images, diagrams and summaries.
During this intervention, the patient will be provided with information on chronic non-specific cervical pain and on "pain neuroscience education". The education session will focus on explaining the mechanisms through which the body perceives and interprets pain. The aim is to make the patient aware that experiencing pain does not necessarily mean that there is a damage on a part of the body. During this educational session, the physical therapist will try to encourage the patient to ask questions.
At the end of this session, the patient will be given an information booklet on pain, with references to the themes just explored. This booklet provides further examples and ideas for elaborating and fixing the concepts learned during the session supervised by the physical therapist.
MANUAL THERAPY: CONTENTS
The treatment of group 2 (G2) combines the previous treatments with eight 30-minutes sessions of passive manual therapy, using the "Pompage" technique, carried out according to the indications shown in the monograph: "Zanella F, Vanti C. Pompage technique. The myofascial release. Piccin, Padua, 2015." The "Pompage" technique includes gradual and progressive soft tissue and fascia mobilization procedures, with the aim to obtain the myofascial release. This procedure is performed without provoking pain or forcing movements beyond the passive physiological range of motion. It consists of an alternation of rhythmic pressure and decompression, located at cervical joints and muscles (e.g. Trapezius Superior, Levator scapulae, Scalenus, Sterno-Cleido-Occipito-Mastoideus, etc.).
