Time-Wise Change in Neck Pain in Response to Rehabilitation with Specific Resistance Training: Implications for Exercise Prescription

Mette K Zebis,Gisela Sjøgaard,Mogens T Pedersen,Christoffer H Andersen,Lars L Andersen,Emil Sundstrup

doi:10.1371/journal.pone.0093867

Abstract

PurposeTo determine the time-wise effect of specific resistance training on neck pain among industrial technicians with frequent neck pain symptoms.MethodsSecondary analysis of a parallel-group cluster randomized controlled trial of 20 weeks performed at two large industrial production units in Copenhagen, Denmark. Women with neck pain >30 mm VAS (N = 131) were included in the present analysis. The training group (N = 77) performed specific resistance training for the neck/shoulder muscles three times a week, and the control group (N = 54) received advice to stay active. Participants of both groups registered neck pain intensity (0–100 mm VAS) once a week.ResultsNeck pain intensity was 55 mm (SD 23) at baseline. There was a significant group by time interaction for neck pain (F-value 2.61, P<0.001, DF = 19). Between-group differences in neck pain reached significance after 4 weeks (11 mm, 95% CI 2 to 20). The time-wise change in pain showed three phases; a rapid decrease in the training group compared with the control group during the initial 7 weeks, a slower decrease in pain during the following weeks (week 8–15), and a plateau during the last weeks (week 16–20). Adherence to training followed a two-phase pattern, i.e. weekly participation rate was between 70–86% during the initial 7 weeks, dropping towards 55–63% during the latter half of the training period.ConclusionFour weeks of specific resistance training reduced neck pain significantly, but 15 weeks is required to achieve maximal pain reduction. The time-wise change in pain followed a three-phase pattern with a rapid effect during the initial 7 weeks followed by a slower but still positive effect, and finally a plateau from week 15 and onwards. Decreased participation rate may explain the decreased efficacy during the latter phase of the intervention.

Highlights

Neck and shoulder pain is one of the most frequent health complaints among adults [1,2]
A Danish study among more than 5000 representative employees showed that approximately one third of adult workers suffer from moderate to severe neck pain [4,5].The seriousness is emphasized by the fact that socioeconomic consequences of chronic disorders in the neck and shoulders in terms of disability, sick leave, and early retirement are considerable [4,6,7]
In respect to economical and personal barriers to exercise, one effective way to introduce physical activity to relieve neck pain at the workplace may be by prescribing an ‘exercise dose’, The perspective would be that an effective worksite ‘exercise dose’ could be implemented whenever needed in response to work related neck/shoulder pain

Summary

Introduction

Neck and shoulder pain is one of the most frequent health complaints among adults [1,2]. Different types of physical exercise have been evaluated as treatment of neck and shoulder pain [8,9,10,11], and there is strong evidence that strength training reduces neck pain [12,13,14]. It has been shown that strength training implemented at the workplace is very effective in reducing neck pain [16,17]. In respect to economical and personal barriers to exercise, one effective way to introduce physical activity to relieve neck pain at the workplace may be by prescribing an ‘exercise dose’, The perspective would be that an effective worksite ‘exercise dose’ could be implemented whenever needed in response to work related neck/shoulder pain

Methods

Results

Conclusion