Objective: To compare the effectiveness of a 12-month home-based combined strength training and stretching programme against stretching alone in the treatment of chronic neck pain.
Design: A randomized follow-up study.
Participants: One hundred and one patients with chronic non-specific neck pain were randomized in two groups.
Intervention: The strength training and stretching group was supported by 10 group training sessions and the stretching group was instructed to perform stretching exercises only as instructed in one group session.
Main outcome measurements: Neck pain, disability, neck muscle strength and mobility of cervical spine were measured before and after the intervention.
Results: No significant differences in improvement in neck pain and disability were found between the two training groups. Mean (SD) pain decreased from 64 (17) mm by 37 (95% confidence interval (CI) 44 to 30) mm in the strength training and stretching group, and from 60 (17) mm by 32 (39 to 25) mm in the stretching group. The improvements in disability were significant in both groups (P<0.001), while the changes in neck strength and mobility were minor. Training adherence decreased over time from the targeted three sessions a week, ending up at 1.1 (0.7) times a week for strength training and stretching group and 1.4 (0.8) times a week for stretching group.
Conclusions: No statistically significant differences in neck pain and disability were observed between the two home-based training regimens. Combined strength training and stretching or stretching only were probably as effective in achieving a long-term improvement although the training adherence was rather low most of the time.
Get full access to this article
View all access options for this article.
References
1.
Ariëns GAM , van Mechelen W. , Bongers PM , Bouter LM , van der Wal G.Physical risk factors for neck pain . Scand J Work Environ Health2000; 26: 7-19.
2.
Aromaa A , Koskinen S (eds). Health and functional capacity in Finland. Baseline results of the 2000 health examination survey. Publications of the National Public Health Institute B3/2002. Helsinki , 2002.
3.
Webb R. , Brammah T. , Lunt M. , Urwin M. , Allison T. , Symmons D.Prevalence and predictors of intense, chronic, and disabling neck and back pain in the UK general population . Spine2003 ; 28: 1195-202.
4.
Borghouts JA , Koes BW , Vondeling H. , Bouter LMCost-of-illness of neck pain in The Netherlands in 1996 . Pain1999; 80: 629-36.
5.
Mäntyselkä PTPatient pain in general practice. Kuopio University Publications D. Med. Sci. 165. Kuopio1998.
6.
Gross AR , Aker PD , Goldsmith CH , Peloso P.Physical medicine modalities for mechanical neck disorders (Cochrane Review) . In The Cochrane Library, Issue 1, 2002. Update Software .
7.
Kay TM , Gross A. , Goldsmith C. , Santaguida PL , Hoving J. , Bronfort G. , Cervical Overview Group. Exercises for mechanical neck disorders (Review) . In The Cochrane Library , Issue3, 2006.
8.
Levoska S. , Keinänen-Kiukaanniemi S.Active or passive physiotherapy for occupational cervicobrachial disorders? A comparison of two treatment methods with a 1-year follow-up . Arch Phys Med Rehabil1993; 74: 425-30.
9.
Taimela S. , Takala E-P. , Asklöf T. , Seppälä K. , Parviainen S.Active treatment of chronic neck pain. A prospective randomized intervention . Spine2000; 25: 1021-27.
10.
Ylinen J. , Takala EP , Nykänen M. et al. Active neck muscle training in the treatment of chronic neck pain in women: a randomized controlled trial . JAMA2003; 289: 2509-16.
11.
Dixon JS , Bird HAReproducibility along a 10-cm vertical visual analogue scale . Ann Rheum Dis1981; 40: 87-89.
12.
Viikari-Juntura E. , Takala E-P. , Alaranta H.Neck and shoulder pain and disability . Scand J Rehabil Med1988; 20: 167-73.
13.
Vernon H. , Mior S.The neck disability index: a study of reliability and validity . J Manipulative Physiol Ther1991; 14: 409-15.
14.
Ylinen J. , Salo P. , Nykänen M. , Kautiainen H. , Häkkinen A.Decreased isometric neck strength in women with chronic neck pain and the repeatability of neck strength measurements . Arch Phys Rehabil Med2004; 85: 1303-308.
15.
Peolsson A. , Hedlund R. , Ertzgaard S. , Oberg B.Intra- and inter-tester reliability and range of motion of the neck . Physiother Can2000 ; 52: 233-45.
16.
Cohen J.Statistical power analysis for the behavioural sciences, revised edition . Academic Press , 1988.
17.
Farrar JT , Portenoy RK , Berlin JA , Kinman JL , Strom BLDefining the clinically important difference in pain outcome measures . Pain2000; 88: 287-94.
18.
Bronfort G. , Evans R. , Nelson B. , Aker P. , Goldsmith CH , Vernon H.A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain . Spine2001; 26: 788-99.
19.
Chiu TT , Lam TH , Hedley AJA randomized controlled trial on the efficacy of exercise for patients with chronic neck pain . Spine2005; 30: E1-7.
20.
Viljanen M. , Malmivaara A. , Uitti J. , Rinne M. , Palmroos P. , Laippala P.Effectiveness of dynamic muscle training, relaxation training, or ordinary activity for chronic neck pain: randomised controlled trial . BMJ2003; 327: 475-79.
21.
Larsson SE , Bengtsson A. , Bodegard L. , Henriksson KG , Larsson J.Muscle changes in work-related chronic myalgia . Acta Orthop Scand1988; 59: 552-56.
22.
McPartland JM , Brodeur RR , Hallgren RCChronic neck pain, standing balance, and suboccipital muscle atrophy - a pilot study . J Manipulative Physiol Ther1997; 20: 24-29.
23.
Ylinen J. , Takala E-P. , Nykänen M. et al. Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain . Eur J Pain2004; 8: 473-78.
24.
Simoneau GG , Bereda SM , Sobush DC , Starsky AJBiomechanics of elastic resistance in therapeutic exercise programs . J Orthop Sports Phys Ther2001; 31: 16-24.
