Exercises for mechanical neck disorders: A Cochrane review update

Area of Science:

• Physical Therapy
• Rehabilitation Medicine
• Musculoskeletal Disorders

Background:

• Neck pain (NP) is a prevalent and disabling condition with significant economic impact.
• Exercise interventions are widely explored for managing NP and related conditions.

Purpose of the Study:

• To systematically evaluate the efficacy of exercise interventions for improving pain, disability, function, patient satisfaction, quality of life (QoL), and global perceived effect (GPE) in adults experiencing NP.
• To assess exercise effectiveness for NP, with or without cervicogenic headache (CGH) or radiculopathy.

Main Methods:

• A comprehensive literature search was conducted for randomized controlled trials (RCTs) up to May 2014.
• Meta-analyses were performed to pool data and calculate standardized mean differences (SMDp).
• The GRADE (Grade of Recommendation, Assessment, Development and Evaluation) system was utilized to assess the quality of evidence.

Main Results:

• Moderate GRADE evidence supports cervico-scapulothoracic and upper extremity (UE) strengthening for significant pain reduction in chronic NP.
• Cervical, shoulder, and scapulothoracic strengthening and stretching exercises demonstrated small to large pain reduction and function improvement in the long-term.
• Strengthening and endurance exercises, including those with pressure biofeedback, showed small to moderate improvements in pain, function, and GPE for chronic CGH.

Conclusions:

• Targeted strengthening exercises for the neck, scapulothoracic region, and shoulders are effective for managing chronic NP and CGH.
• Mindfulness exercises (Qigong) showed minor functional improvements but did not significantly impact GPE.
• Further research is recommended to optimize exercise parameters, such as dosage, for clinical application.