Active or passive physiotherapy for occupational cervicobrachial disorders? A comparison of two treatment methods with a 1-year follow-up.

In this study 169 female office employees were interviewed and examined to determine the occurrence and severity of neck and shoulder symptoms. Forty-seven of those with symptoms who fulfilled the criteria taken as indicating need for treatment were enrolled in a controlled clinical trial and divided into two groups. One group participated in dynamic muscle training of neck and shoulder muscles (active physiotherapy). The other patients were treated by means of surface heat, massage, and stretching (passive physiotherapy). Pain in the neck and shoulder regions disappeared significantly more often just after active treatment as compared to passive treatment. Symptoms returned within three months in both groups. However, after 12 months, the incidence of headache was significantly less in the group that had received active physiotherapy. Maximal isometric muscle strength in relation to cervical lateral flexion and extension and grip strength and endurance force of shoulder muscles improved significantly after active physiotherapy, but only maximal isometric extension force increased significantly after passive physiotherapy. Numbers of tender points in neck and shoulder muscles decreased significantly after both types of physiotherapy. Pressure threshold levels increased but not significantly in both groups during treatment.