For workers with persistent neck and shoulder pain , evidence supports mixed supervised and unsupervised high-intensity strength training or advice alone ( grade s I-III NAD ) .
A multimodal approach including manual therapy , self-management advice , and exercise is an effective treatment strategy for both recent-onset and persistent neck pain
OBJECTIVE The objective was to develop a clinical practice guideline on the management of neck pain-associated disorders ( NADs ) and whiplash-associated disorders ( WADs ) .
This guideline replaces 2 prior chiropractic guidelines on NADs and WADs .
Effect of strength training in addition to general exercise in the rehabilitation of patients with non-specific neck pain. A randomized clinical trial.
BACKGROUND The optimal type of exercise protocol in the physical rehabilitation of non-specific neck pain has not yet been established . Furthermore , the role of fear-avoidance belief in the maintenance of pain and disability has been highlighted . Research indicates that exercise may be a means to reduce fear-avoidance belief , but evidence is scarce . AIM To compare the effect of two different exercise programs on pain , strength and fear-avoidance belief . DESIGN R and omized clinical trial . SETTING A specialized outpatient hospital clinic in Denmark . POPULATION Twenty-three men and 60 women on sick leave due to non-specific neck pain . METHODS Participants were r and omized to either general physical activity ( GPA group ) or GPA and additional strength training of the neck and shoulder ( SST group ) . The primary outcome was pain intensity . Secondary outcomes were muscle strength of the neck and shoulder and fear-avoidance belief . RESULTS Pain was significantly reduced within groups with a median of -1 ( IQR : -3 to 0 , P<0.001 ) in the SST group and -1 ( IQR : -4 to 1 , P=0.046 ) in the GPA group . The difference between groups was not significant . Changes in strength did not differ between groups . Both groups experienced significant increases in neck flexion strength of 14.7 N ( IQR : -1 to 28.4 , P=0 . 001 ) in the SST group and 6.9 N ( IQR : -4.9 to18.6 , P=0.014 ) in the GPA group . Furthermore , the SST group achieved an increase of 18.6 N ( IQR : -2.6 to 69.7 , P=0.005 ) in neck extension . Fear-avoidance beliefs improved with 6 ( IQR : 3 to 12 , P<0.001 ) in the SST group , while the GPA group improved with 3 ( IQR : 0 to 8 , P=0.004 ) . This between-group difference was significant ( P=0.046 ) . CONCLUSION AND REHABILITATION IMPACT This study indicates that in rehabilitation of subjects severely disabled by non-specific neck pain , there is no additional improvement on pain or muscle strength when neck exercises are given as a home-based program with a minimum of supervision . However , strength training of the painful muscles seems to be effective in decreasing fear-avoidance beliefs
For workers with persistent neck and shoulder pain , evidence supports mixed supervised and unsupervised high-intensity strength training or advice alone ( grade s I-III NAD ) .
A multimodal approach including manual therapy , self-management advice , and exercise is an effective treatment strategy for both recent-onset and persistent neck pain
OBJECTIVE The objective was to develop a clinical practice guideline on the management of neck pain-associated disorders ( NADs ) and whiplash-associated disorders ( WADs ) .
This guideline replaces 2 prior chiropractic guidelines on NADs and WADs .