Exercise modalities associated with reduced functional disability in nonspecific neck pain: a network meta-analysis...

Area of Science:

• Musculoskeletal Rehabilitation
• Exercise Science
• Clinical Epidemiology

Background:

• Nonspecific neck pain (NSNP) is a prevalent condition causing significant functional impairment and reduced quality of life.
• Exercise therapy is a cornerstone in NSNP management, yet optimal modalities and exercise dosing remain unclear.

Purpose of the Study:

• To systematically compare the effectiveness of various exercise modalities for NSNP.
• To investigate the dose-response relationship between exercise parameters and functional disability in NSNP patients.

Main Methods:

• A systematic review and network meta-analysis (NMA) of 51 randomized controlled trials (RCTs) involving 4,140 participants.
• Bayesian random-effects NMA was used to compare exercise interventions, with functional disability as the primary outcome.
• Study-level dose-response analysis explored the association between exercise dose (MET-min) and outcomes.

Main Results:

• Mind-body exercise showed the greatest reduction in functional disability (SMD -0.363; 95% CrI [-0.516 to -0.151]) compared to control.
• Resistance training (SMD -0.359), flexibility training (SMD -0.352), and coordination training (SMD -0.328) also demonstrated significant reductions in functional disability.
• Dose-response analysis indicated potential benefits starting around 100 MET-min per session, with larger effects observed at 300-400 MET-min per session.

Conclusions:

• Mind-body, resistance, flexibility, and coordination exercises are favorable for reducing NSNP-related functional disability.
• Exercise dose-response findings require cautious interpretation due to intervention heterogeneity and data limitations.