Strength Training with Chronic Neck Pain Improves Quality of Life

Effect of neck strength training on health-related quality of life in females with chronic neck pain: a randomized controlled 1-year follow-up study. Health Qual Life Outcomes. 2010 May 14;8:48. Salo PK, Häkkinen AH, Kautiainen H, Ylinen JJ.

Abstract BACKGROUND: Chronic neck pain is a common condition associated not only with a decrease in neck muscle strength, but also with decrease in health-related quality of life (HRQoL). While neck strength training has been shown to be effective in improving neck muscle strength and reducing neck pain, HRQoL among patients with neck pain has been reported as an outcome in only two short-term exercise intervention studies. Thus, reports on the influence of a long-term neck strength training intervention on HRQoL among patients with chronic neck pain have been lacking. This study reports the effect of one-year neck strength training on HRQoL in females with chronic neck pain. METHODS: One hundred eighty female office workers, 25 to 53 years of age, with chronic neck pain were randomized to a strength training group (STG, n = 60), endurance training group (ETG, n = 60) or control group (CG, n = 60). The STG performed high-intensity isometric neck strengthening exercises with an elastic band while the ETG performed lighter dynamic neck muscle training. The CG received a single session of guidance on stretching exercises. HRQoL was assessed using the generic 15D questionnaire at baseline and after 12 months. Statistical comparisons among the groups were performed using bootstrap-type analysis of covariance (ANCOVA) with baseline values as covariates. Effect sizes were calculated using the Cohen method for paired samples. RESULTS: Training led to statistically significant improvement in the 15D total scores for both training groups, whereas no changes occurred for the control group (P = 0.012, between groups). The STG improved significantly in five of 15 dimensions, while the ETG improved significantly in two dimensions. Effect size (and 95% confidence intervals) for the 15D total score was 0.39 (0.13 to 0.72) for the STG, 0.37 (0.08 to 0.67) for the ETG, and -0.06 (-0.25 to 0.15) for the CG. CONCLUSIONS: One year of either strength or endurance training seemed to moderately enhance the HRQoL. Neck and upper body training can be recommended to improve HRQoL of females with neck pain if they are motivated for long-term regular exercise.

My comments: This is further confirmation that strength training for women with chronic neck pain is beneficial. Subjects in the strength training group did a single set of 15 reps at 80% of their maximum isometric strength level in 4 directions, forward, backward, right and left.  Max isometric strength was updated at 2 and 6 months.  The neck was kept neutral as they moved against the band with the hips and a force device was attached to ensure 80% force.  The time each repetition was held was not given.  In addition they did one set each of basic upper body free weights exercises including shrugs, presses, curls, bent over flys, and pullovers for 15 reps with the highest weight possible, increasing the weight when they could get 20 reps. While this is another study showing that strengthening is more effective than stretch for the treatment of chronic neck pain, the improvements were significant but not exceptional. The reason is that with spine injuries in particular, exercise while beneficial is not the entire answer. Motor control, ergonomics and postural alignment are all part of recovery, and part of my physical therapy programs for neck pain. In addition I find electric muscle stimulation very effective at acutely decreasing pain while further increasing muscle strength and endurance just as well as it does with low back pain, thus complementing the active exercise, motor control and postural improvements.

As always, if you have any further questions or need for clarifications, please don’t hesitate to ask. Being aware that some of my blog ideas are contentious and occasionally a bit out of the field of my expertise, I encourage my readers to come forth with any questions/comments that are of interest or concern. Your comments are valued and welcomed.

Chad Reilly is a licensed physical therapist, located in North Phoenix, practicing science based medicine with treatment protocols unique and effective enough to proudly serve patients from Phoenix, Scottsdale, Mesa, Chandler, Tempe, Peoria, and Glendale.

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