Effect of therapeutic exercise on pain and disability in the management of chronic nonspecific neck pain: systematic review and meta-analysis of randomized trials
One article on PainSci cites Bertozzi 2013: The Complete Guide to Neck Pain & Cricks
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
BACKGROUND: Given the prevalence of chronic nonspecific neck pain (CNSNP) internationally, attention has increasingly been paid in recent years to evaluating the efficacy of therapeutic exercise (TE) in the management of this condition.
PURPOSE: The purpose of this study was to conduct a current review of randomized controlled trials concerning the effect of TE on pain and disability among people with CNSNP, perform a meta-analysis, and summarize current understanding.
DATA SOURCES: Data were obtained from MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Physiotherapy Evidence Database (PEDro), and Cochrane Central Register of Controlled Trials (CENTRAL) databases from their inception to August 2012. Reference lists of relevant literature reviews also were tracked.
STUDY SELECTION: All published randomized trials without any restriction regarding time of publication or language were considered for inclusion. Study participants had to be symptomatic adults with only CNSNP.
DATA EXTRACTION: Two reviewers independently selected the studies, conducted the quality assessment, and extracted the results. Data were pooled in a meta-analysis using a random-effects model.
DATA SYNTHESIS: Seven studies met the inclusion criteria. Therapeutic exercise proved to have medium and significant short-term and intermediate-term effects on pain (g=-0.53, 95% confidence interval [CI]=-0.86 to -0.20, and g=-0.45, 95% CI=-0.82 to -0.07, respectively) and medium but not significant short-term and intermediate-term effects on disability (g=-0.39, 95% CI=-0.86 to 0.07, and g=-0.46, 95% CI=-1.00 to -0.08, respectively).
LIMITATIONS: Only one study investigated the effect of TE on pain and disability at follow-up longer than 6 months after intervention.
CONCLUSIONS: Consistent with other reviews, the results support the use of TE in the management of CNSNP. In particular, a significant overall effect size was found supporting TE for its effect on pain in both the short and intermediate terms.
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- “Strength training and stretching versus stretching only in the treatment of patients with chronic neck pain: a randomized one-year follow-up study,” Häkkinen et al, Clinical Rehabilitation, 2008.
- “Dose-Response Relationship of Specific Training to Reduce Chronic Neck Pain and Disability,” Nikander et al, Medicine & Science in Sports & Exercise, 2006.
- “Stretching exercises vs manual therapy in treatment of chronic neck pain: a randomized, controlled cross-over trial,” Ylinen et al, Journal of Rehabilitation Medicine, 2007.
- “Effect of neck exercises on cervicogenic headache: a randomized controlled trial,” Ylinen et al, Journal of Rehabilitation Medicine, 2010.
- “Active neck muscle training in the treatment of chronic neck pain in women: a randomized controlled trial,” Ylinen et al, Journal of the American Medical Association, 2003.
- “Effects of neck muscle training in women with chronic neck pain: one-year follow-up study,” Ylinen et al, Journal of Strength & Conditioning Research, 2006.
- “Neck muscle training in the treatment of chronic neck pain: a three-year follow-up study,” Ylinen et al, Europa Medicophysica, 2007.
- “Dose-Response Relationship of Specific Training to Reduce Chronic Neck Pain and Disability,” Nikander et al, Medicine & Science in Sports & Exercise, 2006.
- “Long-term effects of therapeutic exercise on nonspecific chronic neck pain: a literature review,” Cheng et al, J Phys Ther Sci, 2015.
- “Exercises for mechanical neck disorders,” Gross et al, Cochrane Database of Systematic Reviews, 2015.
- “The effects of training and detraining after an 8 month resistance and stretching training program on forward head and protracted shoulder postures in adolescents: Randomised controlled study,” Ruivo et al, Manual Therapy, 2015.
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