TY - JOUR
T1 - Stretching and muscle-performance exercises for chronic nonspecific neck pain
T2 - who may benefit most?
AU - Daher, Amira
AU - Dar, Gali
N1 - Funding Information: The authors would like to thank all the patients who participated in the study, as well as our colleagues from the Clalit Health Services Physical Therapy Outpatient Units of the Northern District, Haifa, and Western Galilee for their support throughout this study. This work was supported by National Insurance Institute of Israel [grant number: 12/2018]; Israel Physiotherapy Society [grant number: 06/2015]; and University of Haifa [grant number: 2015]. Publisher Copyright: © 2023 Taylor & Francis Group, LLC.
PY - 2023
Y1 - 2023
N2 - Background: Although exercise is the mainstay of treatment for neck pain (NP), uncertainty remains over optimal decision-making concerning who may benefit most from such, particularly in the long term. Objective: To identify the subgroup of patients with nonspecific NP most likely to benefit from stretching and muscle-performance exercises. Methods: This was a secondary analysis of treatment outcomes of 70 patients (10 of whom dropped out) with a primary complaint of nonspecific NP in one treatment arm of a prospective, randomized, controlled trial. All patients performed the exercises, twice weekly for 6 weeks, and a home exercise program. Blinded outcome measurements were collected at baseline, after the 6-week program, and at a 6-month follow-up. Patients rated their perceived recovery on a 15-point global rating of change scale; a rating of “quite a bit better” (+5) or higher was defined as a successful outcome. Clinical predictor variables were developed via logistic regression analysis to classify patients with NP that may benefit from exercise-based treatment. Results: NP duration since onset≤6 months, no cervicogenic headache, and shoulder protraction were independent predictor variables. The pretest probability of success was 47% after the 6-week intervention and 40% at the 6-month follow-up. The corresponding posttest probabilities of success for participants with all three variables were 86% and 71%, respectively; such participants were likely to recover. Conclusion: The clinical predictor variables developed in this study may identify patients with nonspecific NP likely to benefit most from stretching and muscle-performance exercises in the short and long terms.
AB - Background: Although exercise is the mainstay of treatment for neck pain (NP), uncertainty remains over optimal decision-making concerning who may benefit most from such, particularly in the long term. Objective: To identify the subgroup of patients with nonspecific NP most likely to benefit from stretching and muscle-performance exercises. Methods: This was a secondary analysis of treatment outcomes of 70 patients (10 of whom dropped out) with a primary complaint of nonspecific NP in one treatment arm of a prospective, randomized, controlled trial. All patients performed the exercises, twice weekly for 6 weeks, and a home exercise program. Blinded outcome measurements were collected at baseline, after the 6-week program, and at a 6-month follow-up. Patients rated their perceived recovery on a 15-point global rating of change scale; a rating of “quite a bit better” (+5) or higher was defined as a successful outcome. Clinical predictor variables were developed via logistic regression analysis to classify patients with NP that may benefit from exercise-based treatment. Results: NP duration since onset≤6 months, no cervicogenic headache, and shoulder protraction were independent predictor variables. The pretest probability of success was 47% after the 6-week intervention and 40% at the 6-month follow-up. The corresponding posttest probabilities of success for participants with all three variables were 86% and 71%, respectively; such participants were likely to recover. Conclusion: The clinical predictor variables developed in this study may identify patients with nonspecific NP likely to benefit most from stretching and muscle-performance exercises in the short and long terms.
KW - Clinical prediction rules
KW - cervicogenic headache
KW - chronic nonspecific neck pain
KW - muscle performance exercise
KW - stretching exercise
UR - http://www.scopus.com/inward/record.url?scp=85158860043&partnerID=8YFLogxK
U2 - https://doi.org/10.1080/09593985.2023.2207103
DO - https://doi.org/10.1080/09593985.2023.2207103
M3 - Article
SN - 0959-3985
JO - Physiotherapy Theory and Practice
JF - Physiotherapy Theory and Practice
ER -