New in Research

Footnote: What's New in the Literature

A semi-hard cervical collar and rest for 3 to 6 weeks or physical therapy accompanied by home exercises for 6 weeks reduced neck and arm pain substantially compared with a wait-and-see policy in the early phase of cervical radiculopathy, say authors of an article published October 7 in BMJ. 

This randomized controlled trial was conducted in neurology outpatient clinics in three Dutch hospitals. Participants were 205 patients with symptoms and signs of cervical radiculopathy of less than one month's duration. Interventions included treatment with a semi-hard collar and taking rest for 3 to 6 weeks; 12 twice weekly sessions of physical therapy for 6 weeks; or continuation of daily activities as much as possible without specific treatment (control group).Physical therapy consisted of mobility and stability exercises for the cervical spine and a home exercise program. Time course of changes in pain scores for arm and neck pain on a 100 mm visual analogue scale and in the neck disability index during the first 6 weeks was the main outcome measure. 

In the wait-and-see group, arm pain diminished by 3 mm/week on the visual analogue scale and by 19 mm in total over 6 weeks. Patients who were treated with cervical collar or physical therapy achieved additional pain reduction, resulting in an extra pain reduction compared with the control group of 12 mm after 6 weeks. In the wait-and-see group, neck pain did not decrease significantly in the first 6 weeks. Treatment with the collar resulted in a weekly reduction on the visual analogue scale of 2.8 mm, amounting to 17 mm in 6 weeks, whereas physical therapy gave a weekly reduction of 2.4 mm resulting in a decrease of 14 mm after 6 weeks. Compared with a wait-and-see policy, the neck disability index showed a significant change with the use of the collar and rest and a non-significant effect with physical therapy and home exercises.

Increased Physical Activity, Weight Reduction Linked With Reduction in Type 2 Diabetes    

In a 10-year study, intensive lifestyle changes aimed at modest weight loss reduced the rate of developing type 2 diabetes by 34% compared with placebo in people at high risk for the disease, according researchers at the National Institutes of Health's (NIH) National Institute of Diabetes and Digestive and Kidney Diseases.

Participants randomly assigned to make lifestyle changes also had more favorable cardiovascular risk factors, including lower blood pressure and triglyceride levels, despite taking fewer drugs to control their heart disease risk.

Treatment with the oral diabetes drug metformin reduced the rate of developing diabetes by 18% after 10 years compared with placebo. Results of the Diabetes Prevention Program Outcomes Study (DPPOS), which examines the persistence of the interventions tested in the Diabetes Prevention Program (DPP), were published online in The Lancet on October 29.

Intensive lifestyle changes consisted of lowering fat and calories in the diet and increasing regular physical activity to 150 minutes per week. Participants received training in diet, exercise (most chose walking), and behavior modification skills. In the first year of the DPP, this group lost 15 lbs on average but regained all but about 5 pounds over 10 years. The metformin group has maintained a loss of about 5 pounds, and the placebo group lost less than 2 pounds over the decade.