Active neck muscle training in the treatment of chronic neck pain in women: a randomized controlled trial

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original abstract
CONTEXT: Active physical training is commonly recommended for patients with chronic neck pain; however, its efficacy has not been demonstrated in randomized studies.
OBJECTIVE: To evaluate the efficacy of intensive isometric neck strength training and lighter endurance training of neck muscles on pain and disability in women with chronic, nonspecific neck pain.
DESIGN: Examiner-blinded randomized controlled trial conducted between February 2000 and March 2002.
SETTING: Participants were recruited from occupational health care systems in southern and eastern Finland.
PATIENTS: A total of 180 female office workers between the ages of 25 and 53 years with chronic, nonspecific neck pain.
INTERVENTIONS: Patients were randomly assigned to either 2 training groups or to a control group, with 60 patients in each group. The endurance training group performed dynamic neck exercises, which included lifting the head up from the supine and prone positions. The strength training group performed high-intensity isometric neck strengthening and stabilization exercises with an elastic band. Both training groups performed dynamic exercises for the shoulders and upper extremities with dumbbells. All groups were advised to do aerobic and stretching exercises regularly 3 times a week.
MAIN OUTCOME MEASURES: Neck pain and disability were assessed by a visual analog scale, the neck and shoulder pain and disability index, and the Vernon neck disability index. Intermediate outcome measures included mood assessed by a short depression inventory and by maximal isometric neck strength and range of motion measures.
RESULTS: At the 12-month follow-up visit, both neck pain and disability had decreased in both training groups compared with the control group (P<.001). Maximal isometric neck strength had improved flexion by 110%, rotation by 76%, and extension by 69% in the strength training group. The respective improvements in the endurance training group were 28%, 29%, and 16% and in the control group were 10%, 10%, and 7%. Range of motion had also improved statistically significantly in both training groups compared with the control group in rotation, but only the strength training group had statistically significant improvements in lateral flexion and in flexion and extension.
CONCLUSIONS: Both strength and endurance training for 12 months were effective methods for decreasing pain and disability in women with chronic, nonspecific neck pain. Stretching and fitness training are commonly advised for patients with chronic neck pain, but stretching and aerobic exercising alone proved to be a much less effective form of training than strength training.
related content
- “Strength training and stretching versus stretching only in the treatment of patients with chronic neck pain: a randomized one-year follow-up study,” an article in Clinical Rehabilitation, 2008.
- “Dose-Response Relationship of Specific Training to Reduce Chronic Neck Pain and Disability,” an article in Medicine & Science in Sports & Exercise, 2006.
- “Stretching exercises vs manual therapy in treatment of chronic neck pain: a randomized, controlled cross-over trial,” an article in Journal of Rehabilitation Medicine, 2007.
- “Effect of neck exercises on cervicogenic headache: a randomized controlled trial,” an article in Journal of Rehabilitation Medicine, 2010.
- “Effects of neck muscle training in women with chronic neck pain: one-year follow-up study,” an article in Journal of Strength & Conditioning Research, 2006.
- “Neck muscle training in the treatment of chronic neck pain: a three-year follow-up study,” an article in Europa Medicophysica, 2007.
- “Dose-Response Relationship of Specific Training to Reduce Chronic Neck Pain and Disability,” an article in Medicine & Science in Sports & Exercise, 2006.
- “Effect of therapeutic exercise on pain and disability in the management of chronic nonspecific neck pain: systematic review and meta-analysis of randomized trials,” an article in Physical Therapy, 2013.
- “Long-term effects of therapeutic exercise on nonspecific chronic neck pain: a literature review,” an article in J Phys Ther Sci, 2015.
- “Exercises for mechanical neck disorders,” an article in Cochrane Database of Systematic Reviews, 2012.
- “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,” an article in Manual Therapy, 2015.
One article on PainScience.com cites Ylinen 2003 as a source:
- PS Save Yourself from Neck Pain! — All your treatment and self-help options for a crick in the neck explained and reviewed