Effects of Neck Muscle Training in Women With Chronic Neck Pain: One-Year Follow-up Study

Abstract

Exercises are commonly recommended for chronic neck pain, but evidence-based guidelines do not explain what types of exercise. The aim of this randomized study was to evaluate the rate of change in neck strength following high- and low-intensity neck muscle training and their effects on pain and disability. One hundred eighty women with chronic neck pain were randomized into a high-intensity strength training group (STG), local muscle endurance training group (ETG), or control group (CG). The neck training consisted of isometric exercises in the STG and dynamic exercises in the ETG. Both groups performed dynamic exercises for the upper extremities. Strength tests, neck pain, and disability indices were evaluated at the baseline, at the follow-ups after 2 and 6 months in the training groups, and after 12 months in all groups. In both groups the greatest gains in neck strength, as well as decrease in neck pain and disability, were achieved during the first 2 months. However, the improvements continued up to 12 months. The STG achieved the greatest strength gains at all follow-ups. The CG showed only minor changes, and significant differences were found in favor of the training groups in all measures. The change in neck pain and disability indices correlated with the isometric neck strength (r = -0.22 [-0.36 to - 0.08] to -0.36 [-0.49 to -0.23]). Neck and shoulder muscle training was shown to be an effective therapy for chronic neck pain, resulting in early improvement in both the strength tests and subjective measures. The results can be maintained and even improved with long-term training.

Lower Trapezius Muscle Strength in Individuals With Unilateral Neck Pain

“…1,17,36 Methods for neck muscle strengthening have been described in the literature, 11 and, although there is no consensus on which strengthening exercises provide the best outcomes, neck strengthening exercises have been observed to have positive effects in individuals with neck pain and whiplash-associated disorders. 13,16,30,37,38 Neck strengthening exercises have been shown to be effective in alleviating pain, increasing cervical muscle strength, increasing cervical range of motion, and decreasing both short-term and longterm disability in individuals with neck pain. 13,16,30,37,38 Although neck muscle strength impairments have been found in individuals with neck pain, no studies to date have examined lower trapezius muscle strength in this population.…”

“…13,16,30,37,38 Neck strengthening exercises have been shown to be effective in alleviating pain, increasing cervical muscle strength, increasing cervical range of motion, and decreasing both short-term and longterm disability in individuals with neck pain. 13,16,30,37,38 Although neck muscle strength impairments have been found in individuals with neck pain, no studies to date have examined lower trapezius muscle strength in this population. The purpose of this study was to examine lower trapezius muscle strength in individuals with unilateral neck pain, as an initial step in determining if impairments need to be assessed and addressed in this population.…”

One-year randomized controlled trial with different physical-activity programs to reduce musculoskeletal symptoms in the neck and shoulders among office workers

“…In particular, evidence-based guidelines are still lacking on the type of physical exercise intervention that is most efficient in relieving musculoskeletal symptoms (11,12). Only a few studies have compared different exercise programs.…”

Neck-specific exercise with or without a behavioural approach, or prescription of physical activity in chronic whiplash associated disorders

“…One reason might be the included discussion of strategies to handle relapse/periods of worsening in the NSEB group. It may also indicate that choice of exercise intervention is important even after 2 years, even when continuous adherence is not optimal, which has also been reported in chronic neck pain by Ylinen et al Improvements achieved through long-term training were maintained over time despite faltering adherence (163).…”