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L. Rahnama1, M.D. Geil1, P. Kashfi2, M. Rahnama3, N. Karimi2, A. Peolsson4
1Kennesaw State University, Department of Exercise Science & Sport Management, Kennesaw, United States, 2University of Social Welfare and Rehabilitation Sciences, Department of Physiotherapy, Tehran, Iran, 3Shiraz University of Medical Sciences, Department of Radiology, Shiraz, Iran, 4Linköping University, Department of Health, Medicine and Caring Sciences (HMV), Linköping, Sweden
Background: Chronic non-specific neck pain (CNNP) is one of the most common musculoskeletal disorders that might lead to disability and reduced quality of life. Exercise therapy is the most accepted treatment strategy for CNNP. However, the variety of recommended exercises made clinicians and patients confused about their choice of exercise program. Two main groups of exercise programs are general neck exercises (GNE) and specific neck exercises (SNE). Generally, the GNE is simpler to be supervised and performed than SNE. But SNEs are more task-oriented and purposeful than GNEs.
Purpose: The purpose of the current research study was to investigate the efficacy of GNE and SNE on health status in patients with CNNP.
Methods: We recruited 64 patients with CNNP to this randomized clinical trial. Then we assigned them randomly to either the GNE or the SNE group. The GNE program included neck and shoulder active range of motion (ROM), shoulder shrug, and seated push up. The SNE program included up and downward eye movements, supine chin tucks, supine occiput isometric contractions, and mild resistive head flexion and extension. Participants have performed exercises for eight weeks, three days a week, twice per day, one supervised and one non-supervised. Prior to the intervention program and on the last day of the interventions, all outcome measures were assessed. Outcome measures included pain using the Visual Analogue Scale (VAS), disability using Neck Disability Index (NDI), neck flexor, and extensor muscle thicknesses and strength. A linear 45mm probe with two output frequencies of 6.6 and 12 MHz was used to measure the neck extensor and flexor muscle thicknesses, respectively. The neck extensor and flexor strength were measured, using a tensiometer. A mixed model, two-way ANOVA was used for data analysis.
Results: Thirty-two subjects were assigned to each group. The GNE and SNE mean ages were 31.40 (8.92) and 29.28 (7.56), respectively. Both groups showed significant improvement in pain (F=217.36, p=0.0001) and disability (F=39.48, p=0.0001) by the end of exercise programs. However, no group differences were observed neither for pain (F=1.50, p=0.22) nor for disability (F=0.33, p=0.56). Both neck extensors (F=18.41, p=0.0001) and flexor muscles (F=12.34, p=0.001) showed significant increases in muscle thicknesses, with no between-group differences. Neck extensor (F=44.56, p=0.0001) and flexor (F=48.27, p=0.0001) muscle strength improved significantly in both groups. However, extensor muscles showed more remarkable strength improvement (F=4.45, p=0.039) in the GNE group compare to the SNE group.
Conclusion(s): Despite the general belief of the superiority of SNE and task-oriented exercises in improving the health status of patients with CNNP, both the GNE and SNE were successful in improving patients’ conditions. However, there is still a superiority for the GNE program in terms of muscle strength improvement.
Implications: According to our results, we recommend clinicians to prescribe the exercise program for patients with CNNP, based on their skills and patients’ ease, comfort, and adaptability to either the GNE or SNE programs.
Funding, acknowledgements: This study has not received any specific funding.
Keywords: Chronic neck pain, Neck exercise, Disability
Topic: Musculoskeletal: spine
Did this work require ethics approval? Yes
Institution: University of Social Welfare and Rehabilitation Sciences
Committee: Research Ethics Committee
Ethics number: IR.USWR.REC.1396.194
All authors, affiliations and abstracts have been published as submitted.
