Svedmark Å1, Häger CK1, Björklund M1
1Physiotherapy, Community Medicine and Rehabilitation, Umeå, Sweden
Background: Non-specific neck pain has a multifaceted symptom picture and the relationship is obscure between individual improvement on physical function and the neck patient's self-rated status.
Purpose: The present aim was to determine the associations between physical test outcomes involving the neck and shoulder region, and self-reported neck symptoms before and after a treatment intervention in women with non-specific neck pain.
Methods: Data were obtained for 120 women (aged 20-65) who had participated in a previous randomized controlled trial. Data were used from all participants at baseline for cross-sectional analysis and from 69 women for longitudinal analysis (Change-scores). Associations between self-reported neck problems (pain, disability and symptoms from the neck) and physical test outcomes (Neck-Strength, Cervical Axial-Range of Motion and Peak-Speed of cervical rotation) were estimated with linear regression analyses.
Results: Self-rated neck pain was only significantly associated to the physical outcome measure Peak-Speed of cervical rotation, i.e., increased pain related to lower speed. This was true at baseline and for Change-scores at 9 months. Increased neck disability and frequency of symptoms were associated to lower Neck Strength and reduced Peak-Speed at baseline, and to reduced Peak-Speed and Cervical Axial-Range of Motion at 3 and 9 months, respectively. Peak-Speed and Cervical Axial-ROM were thus the physical test outcomes with associations to self-rated changes in neck symptoms. At the 9-month follow-up, 26% of the variance of frequency of symptom changes was explained by changes in Cervical Axial-ROM and Peak-Speed, which were also inter-correlated (r=0.55).
Conclusion(s): The results indicate that changes in physical functioning, tested as cervical mobility and strength, have only a modest relation to the course of self-rated condition in neck disorders.
Implications: The present study calls for reconsideration regarding acting mechanisms behind the apparent effect of, e.g., strength training on neck pain disorders. The specificity and usefulness of various assessments for decision-making, treatment and evaluation might be questioned.
Keywords: Neck pain, Neck strength, Range of motion
Funding acknowledgements: Swedish Council for Working Life and Social Research (2009-1403), AFA Insurance (090288), The Centre for Environmental Research (1152383).
Purpose: The present aim was to determine the associations between physical test outcomes involving the neck and shoulder region, and self-reported neck symptoms before and after a treatment intervention in women with non-specific neck pain.
Methods: Data were obtained for 120 women (aged 20-65) who had participated in a previous randomized controlled trial. Data were used from all participants at baseline for cross-sectional analysis and from 69 women for longitudinal analysis (Change-scores). Associations between self-reported neck problems (pain, disability and symptoms from the neck) and physical test outcomes (Neck-Strength, Cervical Axial-Range of Motion and Peak-Speed of cervical rotation) were estimated with linear regression analyses.
Results: Self-rated neck pain was only significantly associated to the physical outcome measure Peak-Speed of cervical rotation, i.e., increased pain related to lower speed. This was true at baseline and for Change-scores at 9 months. Increased neck disability and frequency of symptoms were associated to lower Neck Strength and reduced Peak-Speed at baseline, and to reduced Peak-Speed and Cervical Axial-Range of Motion at 3 and 9 months, respectively. Peak-Speed and Cervical Axial-ROM were thus the physical test outcomes with associations to self-rated changes in neck symptoms. At the 9-month follow-up, 26% of the variance of frequency of symptom changes was explained by changes in Cervical Axial-ROM and Peak-Speed, which were also inter-correlated (r=0.55).
Conclusion(s): The results indicate that changes in physical functioning, tested as cervical mobility and strength, have only a modest relation to the course of self-rated condition in neck disorders.
Implications: The present study calls for reconsideration regarding acting mechanisms behind the apparent effect of, e.g., strength training on neck pain disorders. The specificity and usefulness of various assessments for decision-making, treatment and evaluation might be questioned.
Keywords: Neck pain, Neck strength, Range of motion
Funding acknowledgements: Swedish Council for Working Life and Social Research (2009-1403), AFA Insurance (090288), The Centre for Environmental Research (1152383).
Topic: Musculoskeletal: spine; Musculoskeletal: upper limb; Disability & rehabilitation
Ethics approval required: Yes
Institution: Regional ethical review board in Uppsala Sweden
Ethics committee: Regional ethical review board in Uppsala Sweden
Ethics number: No 2011/081
All authors, affiliations and abstracts have been published as submitted.
