Table 5.
Characteristics of included studies
| Study | Population | Intervention | Comparison | Reported outcomes |
|---|---|---|---|---|
| Andersen et al.16 RCT | 198 participants (174 women, 24 men) | HEP only: shoulder abduction (lateral raise), exercise to target perceived, ‘relevant neck and shoulder muscles’ 5 times per week During weeks 1–2, participants used moderate resistance training with elastic tubing. During weeks 2–4, participants progressed to higher level of resistance | Control group=weekly educational emails containing information including general health and physical activity. Internet links regarding this information were also provided | Clinically relevant reductions in pain and tenderness as well as muscle strength increases were found in approximately half of the participants of the training groups As little as 2 minutes of daily progressive resistance training for 10 weeks results in clinically relevant reductions of pain and tenderness and increased muscles strength in adults with frequent neck/shoulder symptoms |
| Mean age: | 12-minute group: | |||
| 2-minute group: 44 (±11) | Weeks 1–2=5–6 sets of 8–12 repetitions | |||
| 12 minute group: 42 (±11) control group: 43 (±10) | Weeks 2–4=6 sets of 12 repetitions 2-minute group: | |||
| Chronic neck pain with/or without shoulder pain for the previous 3 months lasting at least 30 days within 1 year28,29 | Weeks 1–2=single set until failure or until 2 minutes | |||
| Weeks 2–4=increased resistance band | ||||
| Bronfort et al.17 RCT | 272 patients; aged 18–65 years old | Within clinic treatment of spinal thrust/ non-thrust decided by the provider group lasting 15–20 minutes | Home exercise with advice (HEA): instructional 1-hour sessions (×2) | SMT had statistically significant advantage over medication at 26 weeks. No important differences in pain were found between SMT and HEA at any time point |
| Mean age: | ||||
| SMT group: 48.3 (±15.2) | placed 1–2 weeks apart for home exercise of ‘self-mobilization’ of gentle controlled general movements of neck retraction, extension, flexion, rotation, lateral bending motions, and scapular retraction (with no resistance) | |||
| Med group: 46.8 (±12.2) | 5–10 repetitions of each exercise up to 6–8 times per day | |||
| HEA group: 48.6 (±12.5) | Medication group: | |||
| Sub-acute non-specific neck pain for 2–12 weeks28,29 | visits lasted 15–20 minutes. Non-steroidal anti-inflammatory drugs, acetaminophen, or both. Participants who did not respond to or could not tolerate drugs received narcotic medications or muscle relaxants | |||
| Hall et al.18 RCT | 32 subjects, mean±SD age, 36±3 years Chronic cervicogenic headache (CHA) for past 3 months28,29 | HEP only: | The control group was involved in a sham self-mobilization at C1–C2 using the cervical self-SNAG strap | C1–C2 self-SNAG reduced cervicogenic headache symptoms on the headache severity index over 1 year compared to the control group |
| The experimental group: C1–C2 self-SNAG. Position held for 3 seconds, 2 repetitions of the exercise, twice daily for 12 months | The strap was positioned in the same way at the experimental group, but the subject did not turn their head when they applied the 3-second sustained forward pressure at C1 | |||
| Kuijper et al.19 RCT | 205 patients, ages 18–75 years | Cervical collar group: | Control group: patients were advised to continue daily activities and document their normal routine | Treatment with a cervical collar plus rest or PT plus home exercises resulted in a statistically significant reduction of arm and neck pain compared to the control group |
| Mean age: collar group: 47 (±9.1) |
semi-hard collar throughout the day for 3 weeks | With the control group, disability index score improved by 9 points on the neck disability | ||
| PT: 46.7 (±10.9) | Weeks 3–6=patients were weaned from the collar until week 6 where they were advised to terminate the use of the collar Physiotherapy with HEP | Both the cervical collar and the PT groups disability index score improved by 14 points | ||
| control: 47.7 (±10.6) | Physiotherapy group: | |||
| Acute/sub-acute cervical radiculopathy, <1 month in duration28,29 | clinical treatment of deep and | |||
| superficial neck muscle exercises twice | ||||
| a week for 6 weeks in duration | ||||
| HEP: isometric and chin retraction exercises, 2 sets of 10 repetitions | ||||
| Mongini et al.20 RCT | 1040 participants between 43 and 52 | HEP only | Control group: one-month diary for daily recording of the presences, severity of their headache and neck/shoulder pain, and their intake of analgesics (by type) | Intervention group showed a higher respondent rate for headache and for neck/shoulder pain, and a larger reduction in the days per month with headache |
| Mean age: | Intervention group: | |||
| intervention group: 48 control group: 47 |
relaxation exercises: concentrated craniofacial-cervical facial relaxation for 1 repetition 2 times daily | |||
| Chronic headache, neck/shoulder pain28,29 | posture retraining of upright standing, horizontal forward and backward head movements, and isometric extension (counter-pressure): 8–10 repetitions, every 2–3 hours | |||
| Nikander et al.11 RCT | 180 female office workers aged 25–53 years | All three groups were encouraged to perform aerobic exercise 3 times/week for 30 minutes | The control group received written information with the same stretching exercises as the training groups to complete three times/week for 20 minutes | One MET-hour of training per week accounted for an 0.8-mm decrease of neck pain on the Visual Analog Scale (VAS) and a 0.5-mm decrease on the Disability Index; a training dose of 20 MET(hour) per month represented a 16-mm decline in the VAS |
| Mean Age: | ||||
| strength group: 45 (±6) | Both training groups exercised 3 times/ week and also completed a single series of squats, sit-ups, and back extensor | |||
| endurance group: 45 (±6) | exercises as well as 20 minutes of stretching | |||
| control group: 46 (±5) | HEP only: | |||
| Constant or frequent chronic neck pain and disability occurring.6 months28,29 | Both groups attended a 12-day rehabilitation period to learn exercises followed by performing exercises for 12 months at home | The effective dose of the specific training program to decrease chronic neck pain was 8.75 MET(hour) per week on a scale of 1.5 (light work) to 10 (extremely heavy work) | ||
| Strength training group targeted neck muscles with rubber band 1 set of 15 repetitions 3 times/week at a resistance level of 80% patient’s maximum isometric strength from baseline |
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| upper body exercises 1 set of 15 repetitions (4–13 kg gradually increasing the load) with dumbbell including dumbbell shrugs, presses, curls, bent-over rows, flies, and pullovers Endurance-training group: | ||||
| trained neck muscles in supine position by lifting up head in 3 sets of 20 repetitions 3 times/week | ||||
| same upper body exercises as the strength training group with 2 kg dumbbells with 3 sets of 20 repetitions | ||||
| Salo et al.21 RCT | 180 female office workers, ages 25–53 years | HEP only: | The control group received written information with the same stretching exercises as the training groups to complete three times/week for 20 minutes | Both training groups had statistically significant score improvements as shown with the HRQoL 15D measurement tool. There was no change in the control group (P=0.012). The strength training group improved in 5 of 15 dimensions and the endurance-training group improved in 2 dimensions. 12-month follow-up: both the strength or endurance training seemed to moderately enhance the HRQoL of female patients with chronic neck pain |
| Mean age: | Both groups attended a 12-day rehabilitation period to learn exercises followed by performing exercises for 12 months at home | |||
| strength group: 45 (±6) | Strength training group: | |||
| endurance group: 45 (±6) | trained neck muscles with rubber band 1 set of 15 repetitions 3 times/week at a resistance | |||
| control group: 46 (±5) | level of 80% patient’s maximum isometric strength from baseline | |||
| Constant or frequent chronic neck pain and disability occurring >6 months28,29 | upper body exercises 1 set of 15 repetitions (4–13 kg gradually increasing the load) with dumbbell including dumbbell shrugs, presses, curls, bent-over rows, flies, and pullovers | |||
| Endurance-training group: | ||||
| trained neck muscles in supine position by lifting up head in 3 sets of 20 repetitions 3 times/week | ||||
| same upper body exercises as the strength training group with 2 kg dumbbells with 3 sets of 20 repetitions |