Nonspecific Neck Pain Patients Research Articles

Association between joint position sense, range of motion, pain-related anxiety, disability and deep neck muscles thickness in non-specific chronic neck pain patients with high and low levels of fear of pain: a cross-sectional study

Association between joint position sense, range of motion, pain-related anxiety, disability and deep neck muscles thickness in non-specific chronic neck pain patients with high and low levels of fear of pain: a cross-sectional study

The Effects of Deep Neck Muscle Exercises on Chronic Non-Specific Neck Pain

Introduction: The study aimed to investigate the effects of deep neck flexor (DNF) and deep neck extensor (DNE) muscle exercises on pain, passive range of motion (PROM), craniovertebral angle (CVA), neck flexor endurance (NFE), neck extensor endurance (NEE), and the number of weekly painkiller usage (NWPKU) in chronic non-specific neck pain (CNNP) patients. Materials and Methods: A total of 27 CNNP patients, incuding intervention group (n=15) and control group (n=12), were recruited for this study. Patients in the intervention group participated in 6 weeks of DNF and DNE exercises plus traditional physiotherapy. After 10 sessions (3 weeks), the exercise protocol was followed for 3 weeks of the home-based exercise form. Control group patients received traditional physiotherapy alone. The numeric pain rating scale (NPRS), PROM, CVA, NFE, NEE, and NWPKU were examined and compared between groups, at the baseline and after six weeks. Results: Numeric pain rating scale, PROM, CVA, NFE, NEE, and NWPKU improved significantly in both groups after treatment (P<0.001). The NPRS, passive flexion, passive extension, passive right-side bending, passive left rotation, CVA, NFE, NEE, and NWPKU differences were significant (P<0.05). Conclusion: The study supports the positive effects of combination therapy (DNF and DNE exercises plus traditional physiotherapy) on pain, passive neck range of motion, neck lordosis posture, and neck muscle endurance in CNNP patients.

Sensory-motor training with virtual reality as a complementary intervention to manual therapy for persistent non-specific neck pain: a randomized controlled trial.

Persistent non-specific neck pain (NP) is a widespread condition described as a complex biopsychosocial disorder, characterized by physical and psychological symptoms. Virtual reality (VR) shows promise in NP treatment, potentially reducing pain, kinesiophobia, and improving range of motion (ROM) and motor control. The primary aim of the study was to assess the effectiveness of VR sensorimotor training, combined with manual therapy, in reducing the level of disability in persistent non-specific NP individuals. The secondary aim was to determine if this VR-enhanced approach also contributes to improvement in overall function, pain perception and kinesiophobia. Monocentric, single-blind, randomized controlled trial. We conducted this trial at San Raffaele Scientific Institute, Department of Rehabilitation and Functional Recovery, Milan, Italy. Forty NP participants were enrolled in the study and randomly allocated into two groups. The study involved a 6-week rehabilitation program, comprising 12 sessions of 45 minutes each, twice weekly. Both intervention groups underwent manual therapy as a consistent component of their treatment. The Experimental Group (VRT) was additionally engaged in sensorimotor rehabilitation exercises using Virtual Reality, whereas the Control Group (CT) performed the same exercises without VR. We assessed subjects at baseline (T0) and after six weeks of rehabilitation (T1). The primary outcome was the disability (Neck Disability Index) while the secondary outcomes were: pain perception (Numeric Rating Scale, NP and Disability Scale, Central Sensitization Inventory) function (Cervical Kinematics) and kinesiophobia (Tampa Scale of Kinesiophobia). Both groups demonstrated significant reduction in level of disability, pain perception, and kinesiophobia. Significant advancements in kinematics were observed: VRT group showed enhanced ROM during craniocervical rotation (P=0.039), lateral bending (P=0.001), flexion-extension (P=0.009), and mean velocity across movements (P<0.001), whereas CT group improved in maximal ROM during lateral bending rotation (P=0.001). Between-group analysis, after Bonferroni's correction for multiple comparisons, revealed that VRT group had significantly better outcomes in ROM during rotation (P=0.040), ratio of the primary over the secondary movement while performing rotation (P=0.021), and mean velocity during lateral bending (P=0.031). Sensorimotor training, combined with manual therapy, could enhance kinematic outcomes for NP patients, supporting the potential of VR in rehabilitation. This study highlighted that both groups demonstrated significant reduction in level of disability, pain perception, and kinesiophobia after sensorimotor training combined with manual therapy. It is important to underscore that in terms of reducing the level of neck disability, both interventions proved to be equally effective. This parity in efficacy is a critical finding, reaffirming the robustness of our therapeutic approaches for this specific outcome.

Utilizing machine learning to predict post-treatment outcomes in chronic non-specific neck pain patients undergoing cervical extension traction

This study explored the application of machine learning in predicting post-treatment outcomes for chronic neck pain patients undergoing a multimodal program featuring cervical extension traction (CET). Pre-treatment demographic and clinical variables were used to develop predictive models capable of anticipating modifications in cervical lordotic angle (CLA), pain and disability of 570 patients treated between 2014 and 2020. Linear regression models used pre-treatment variables of age, body mass index, CLA, anterior head translation, disability index, pain score, treatment frequency, duration and compliance. These models used the sci-kit-learn machine learning library within Python for implementing linear regression algorithms. The linear regression models demonstrated high precision and accuracy, and effectively explained 30–55% of the variability in post-treatment outcomes, the highest for the CLA. This pioneering study integrates machine learning into spinal rehabilitation. The developed models offer valuable information to customize interventions, set realistic expectations, and optimize treatment strategies based on individual patient characteristics as treated conservatively with rehabilitation programs using CET as part of multimodal care.

Efficacy of Static and Dynamic Exercise Interventional Protocol in Patients with Non-Specific Neck Pain

Aim: To see the efficacy of dynamic and static neck exercise interventional protocol in patients with nonspecific neck pain. Objectives: To evaluate the efficacy of static and dynamic exercises in patients with nonspecific neck pain and compare the efficacy of dynamic and static neck exercise interventional protocol when given alone or in combination. Methods: 30 Subjects were selected for the study. Sampling was done by random selection method and then groups of 10 subjects were assigned to each group by chit-chat method. Each subject was given an Ultrasound for 5 min before exercises in each group. It was a 5-week (6 days a week) intervention study. Conclusion: Dynamic and static exercise protocols effectively improve the range of motion and functional activities in nonspecific neck pain patients. However, a significant difference has not been found when these exercises are combined or alone.

Effects of Spinal Stabilization Exercises Delivered Using Telerehabilitation on Outcomes in Patients with Chronic Neck Pain: A Randomized Controlled Trial

Background When spinal stabilization exercises (SSE) are performed regularly, they may provide benefits on outcome measures in chronic nonspecific neck pain (CNNP) patients. The pandemic has made it difficult for CNNP patients to access regular physiotherapy-exercise services. This study aims to compare telerehabilitation (TR) with face-to-face rehabilitation in CNNP patients. Methods Neck Functional Capacity Evaluation Test (NFCET) results were the primary outcomes. Pain intensity (PI), disability, awareness, the architecture of the neck muscles, and exercise satisfaction were the secondary outcomes. Patients were randomized into the TR group (TRG) (n=15) and the control group (CG) (n=16). All patients performed SSE 3 days a week, for 8 weeks. The TRG was instructed remotely while the CG was instructed in the clinic. Results After 8 weeks, NFCET values increased (p<0.05). In both groups, PI and disability decreased and neck awareness increased (p<0.05). Muscle architecture parameters improved in both groups (p<0.05), except for the Right Sternocleidomastoideus in both groups and the Right Upper-Trapezius in TRG (p>0.05). There was no difference between the groups for all variables and exercise satisfaction after 8 weeks (p>0.05). Conclusion SSE for neck pain, whether supervised by a therapist in the clinic or by telerehabilitation, was equally effective.

Characteristics of Surface Electromyograph Activity of Cervical Extensors and Flexors in Nonspecific Neck Pain Patients: A Cross-Sectional Study.

Background and Objectives: We identified typical surface electromyogram (sEMG) activities of the cervical extensors and flexors during motions in the three anatomical planes in healthy adults. The aim of this study was to explore characteristics of sEMG activities of these cervical muscles in nonspecific neck pain (NSNP) patients based on healthy adults. Materials and Methods: Participants were 24 NSNP patients (NSNP group, mean ± SD of age, 47.5 ± 15.5) and 24 healthy adults (control group, 20.5 ± 1.4). For each participant, sEMG of the cervical extensors and flexors was recorded during neck flexion, extension, bilateral lateral flexion, bilateral rotation, and at the neutral position in Phase I (the neck from the neutral position to the maximum range of motion), Phase II (at the maximum range of motion), and Phase III (from the maximum range of motion to the neutral position), yielding a total of 42 phases. A percentage of maximum voluntary contraction to normalize muscle activity in each phase was calculated to obtain the ratio of muscle activities in the extensors and flexors in each of 36 phases of the motions to the neutral position and ratio of the flexors to extensors in activity for 21 phases. Results: In 28 of 36 phases of the motions, the ratios of muscle activities in the extensors and flexors to the neutral position in the NSNP group were significantly larger than the control group (p < 0.05). In 6 of 21 phases, the ratios of the flexors to extensors in activity in the NSNP group were significantly larger than in the control group (p < 0.05). Conclusions: In NSNP patients, the activity of the cervical extensors and flexors associated with neck motion increased with an imbalance in activity between these muscles compared to their activity in healthy adults. The results of this study will be useful in understanding the pathogenesis of NSNP and in constructing an objective evaluation of the treatment efficacy on NSNP patients.

Comparison of the efficacy of mud-pack and hot-pack treatments in chronic non-specific neck pain: A single-blind, randomized-controlled study.

This study aims to compare the short-term efficacy of mud-pack (MP) and hot-pack (HP) treatments with the same temperature and duration on sleep, function, depression, and quality of life for chronic non-specific neck pain (CNNP) patients. Between December 2018 and September 2019, a total of 70 patients with CNNP diagnosis (12 males, 58 females; mean age: 50.2±9.4 years; range, 24 to 65 years) were included. The patients were divided into two groups. The MP group (n=35) had a total of 15 sessions of MP for 20 min + transcutaneous electrical nerve stimulation (TENS) for 20 min + home exercise (HE) on five days per week for three weeks. The HP group (n=35) had 15 similar sessions of HP for 20 min + TENS for 20 min + HE. The patients were assessed with the Visual Analog Scale (VAS-pain), VAS physician's and patient's global assessments, modified Neck Disability Index (mNDI), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and Short Form-36 (SF-36) measures before treatment, at the end of post-treatment third week and one month later. In the MP group, there were statistically significant improvements in all parameters at the end of treatment three-week and one-month follow-up (p<0.05), apart from SF-36 Vitality/Energy (SF-36V/E) at the end of treatment and SF-36 General Health (SF-36GH) at one month. In the HP group, there were statistically significant improvements observed for all parameters (p<0.05), apart from the SF-36 Physical Role and SF-36GH at the end of treatment third week and SF-36V/E at the first-month assessment. The VAS-pain(p<0.001), mNDI (p=0.019), BDI (p=0.002), SF-36GH (p<0.001), SF-36V/E (p<0.001) and SF-36 mental health (p<0.001) showed statistically significantly superior improvements in the MP group (p<0.05). In CNNP patients, both MP and HP treatments are effective. However, MP therapy has more positive effects on pain, function, depression, and quality of life parameters. The MP treatment may be used in addition to TENS treatment for CNNP patients.

Efficacy of physiotherapy intervention on craniovertebral and craniohorizontal angle using on protractor mobile app and neck muscle strength in chronic nonspecific neck pain

Introduction and Aim: The chronic nonspecific neck pain is common in all age groups since it is non-specific it may be due to any reasons right from school children to elderly. Factors like muscle strain, worn joints, nerve compression, poor posture, neck pain are found to reduce the cervical angle. The aim of the study is to find the efficacy of physiotherapy intervention on craniovertebral angle, craniohorizontal angle, neck muscle strength and hand grip in subjects with chronic nonspecific neck pain. Materials and Methods: The subjects with chronic nonspecific neck pain (n=30) were selected randomly from the physiotherapy outpatient department of ACS medical college and hospital as per inclusion criteria and divided into two groups. The pre-test and post-test measurements of craniovertebral and craniohorizontal angles, craniovertebral angle were measured using on protractor mobile app. The neck muscle strength was measured using modified dial sphygmomanometer and hand grip was measured using hand held dynamometer. Group A received craniocervical flexion exercise and group B received stretching and strengthening for a period of 12 weeks. Post test was conducted after 12 weeks. Results: The comparison within Group A and Group B pre- and post-test values in both groups showed highly significant difference in mean values at P ? 0.001, but group A which has a higher mean value is more effective in craniovertebral angle, craniohorizontal angle, neck muscle strength (Flexor and Extensor) and hand grip. Conclusion: The craniocervical flexion exercise given to chronic nonspecific neck pain patients was found to reduce neck pain by improving the neck muscle strength, hand grip strength and by correcting the craniocervical and craniohorizontal angles.

The effectiveness of telerehabilitation-based structured exercise therapy for chronic nonspecific neck pain: A randomized controlled trial

Introduction The aim of this research was to investigate the effects of telerehabilitation-based remote supervised or unsupervised structured exercise therapy on pain, disability, and quality of life related to chronic nonspecific neck pain. Method The study was designed as a single-blinded randomized controlled trial. Sixty-six eligible chronic nonspecific neck pain patients were randomized across three groups: remote supervised group (RSG, n = 22), unsupervised group (UG, n = 22), and waitlist control group (CG, n = 22). Progressive structured exercise therapy program was delivered weekly to patients in remote supervised group and unsupervised group to perform four days a week for four weeks. Remote supervised group was supervised by videoconference and text message. Pain, disability, and quality of life of participants were assessed at baseline, week 2, and post-therapy. Results Post-therapy pain and disability total change scores were −3.64 (95% CI −4.85 to −2.42) and −7.27 (95% CI −11.05 to −3.50) for remote supervised group compared with a change of −2.44 (95% CI −3.46 to −1.43) and −5.77 (95% CI −8.54 to −3.01) for unsupervised group, respectively. Post-therapy, quality of life improvements were greater for remote supervised group than unsupervised group overall (general health; remote supervised group: 19.01 (95% CI 6.86 to 31.16), unsupervised group: 12.50 (95% CI 4.79 to 20.21), and physical health; remote supervised group: 18.35 (95% CI 10.35 to 26.35), unsupervised group: 7.31 (95% CI 0.01 to 14.60)). Significant improvements in psychological health and environment-telerehabilitation for remote supervised group were not seen for unsupervised group and outcomes differences did not reach significance for control group (p > 0.05) post-therapy, except environment-telerehabilitation. Discussion Structured exercise therapy can improve chronic nonspecific neck pain outcomes when remotely supervised or unsupervised. Structured exercise therapy content and frequent communication are important for remote chronic nonspecific neck pain management.

The changes after physical therapy in non-specific neck pain patients

Non-specific neck pain is one of the most common pain after low back pain. Physiotherapy interventions are used as a treatment to reduce pain and functional status in such patients. This study aims to see the changes after physiotherapy in non-specific neck pain. To see the changes after physiotherapy in non-specific neck pain. A case series was performed on 35 patients in Dhiraj General Hospital at physiotherapy department. Physiotherapy interventions including electro therapeutic modalities (like moist pack, ultrasound) along with stretching and strengthening exercise, massage to neck musculature was given for 3 days to patients with non-specific neck pain who were referred for physiotherapy. Outcome measure was taken in form of NPRS &amp; NDI. A Decrease in NPRS and improvement in NDI was noted after the treatment sessions for 3 consecutive days. It is concluded that physiotherapy intervention is effective in reducing pain and improving functional status in patients with nonspecific neck pain.

Head Pitch Angular Velocity Discriminates (Sub-)Acute Neck Pain Patients and Controls Assessed with the DidRen Laser Test.

Understanding neck pain is an important societal issue. Kinematic data from sensors may help to gain insight into the pathophysiological mechanisms associated with neck pain through a quantitative sensorimotor assessment of one patient. The objective of this study was to evaluate the potential usefulness of artificial intelligence with several machine learning (ML) algorithms in assessing neck sensorimotor performance. Angular velocity and acceleration measured by an inertial sensor placed on the forehead during the DidRen laser test in thirty-eight acute and subacute non-specific neck pain (ANSP) patients were compared to forty-two healthy control participants (HCP). Seven supervised ML algorithms were chosen for the predictions. The most informative kinematic features were computed using Sequential Feature Selection methods. The best performing algorithm is the Linear Support Vector Machine with an accuracy of 82% and Area Under Curve of 84%. The best discriminative kinematic feature between ANSP patients and HCP is the first quartile of head pitch angular velocity. This study has shown that supervised ML algorithms could be used to classify ANSP patients and identify discriminatory kinematic features potentially useful for clinicians in the assessment and monitoring of the neck sensorimotor performance in ANSP patients.

Psychometric properties of the Persian version of the pain anxiety symptom scale (PASS-20) in chronic non-specific neck pain patients.

Pain-related anxiety has been linked to avoidance behaviour, maintenance of pain and disability. A valid and reliable tool is required to evaluate pain-related anxiety among Persian speaking adults with chronic non-specific neck pain (CNSNP). This study aimed to evaluate psychometric properties of the Persian pain anxiety symptom scale-20 (PASS-20) according to the consensus-based standards for the selection of health measurement instruments (COSMIN) checklist in Iranian adults with CNSNP. 198 individuals with CNSNP completed the PASS-20. The factorial structure (confirmatory factor analysis (CFA), exploratory factor analysis (EFA)), test-retest reliability (intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC)), internal consistency (Cronbach's alpha), and construct validity (convergent and known-group validity) were assessed. The correlation between PASS-20 with pain catastrophizing scale (PCS), Tampa Scale for Kinesiophobia (TSK), neck disability index (NDI), Beck Depression Inventory (BDI), visual analog scale (VAS) (Spearman's rank correlation) were examined. Known-group validity of PASS-20 was evaluated by comparing the difference between the PASS-20 scores of the known groups based on level of disability, pain intensity and gender using non-parametric tests. The CFA showed almost the best fit with the original version. The subscales and total score demonstrated good internal consistency (Cronbach's α: 0.70-0.92) and high test-retest reliability (ICC: 0.94-0.97). PASS-20 had significant moderate correlations with PCS, TSK, NDI, VAS and a significant low correlation with BDI. Regarding known-group validity, the total score of Persian PASS-20 was higher in CNSNP with higher levels of pain and disability and in the female gender. The Persian PASS-20 has acceptable psychometric properties in adults with CNSNP. The results of the factor analysis supported the four-factor structure comparable to the original version. 921672004.

Near-Infrared Spectroscopy for Monitoring Sternocleidomastoid Muscular Oxygenation during Isometric Flexion for Patients with Mild Nonspecific Neck Pain: A Pilot Study.

Since there is merit in noninvasive monitoring of muscular oxidative metabolism for near-infrared spectroscopy in a wide range of clinical scenarios, the present study attempted to evaluate the clinical usability for featuring the modulatory strategies of sternocleidomastoid muscular oxygenation using near-infrared spectroscopy in mild nonspecific neck pain patients. The muscular oxygenation variables of the dominant or affected sternocleidomastoid muscles of interest were extracted at 25% of the maximum voluntary isometric contraction from ten patients (5 males and 5 females, 23.6 ± 4.2 years) and asymptomatic individuals (6 males and 4 females, 24.0 ± 5.1 years) using near-infrared spectroscopy. Only a shorter half-deoxygenation time of oxygen saturation during a sternocleidomastoid isometric contraction was noted in patients compared to asymptomatic individuals (10.43 ± 1.79 s vs. 13.82 ± 1.42 s, p < 0.001). Even though the lack of statically significant differences in most of the muscular oxygenation variables failed to refine the definite pathogenic mechanisms underlying nonspecific neck pain, the findings of modulatory strategies of faster deoxygenation implied that near-infrared spectroscopy appears to have practical potential to provide relevant physiological information regarding muscular oxidative metabolism and constituted convincing preliminary evidences of the adaptive manipulations rather than pathological responses of oxidative metabolism capacity of sternocleidomastoid muscles in nonspecific neck patients with mild disability.

Is Cervical Traction Effective in Chronic Nonspecific Neck Pain Patients With Unsatisfactory NSAID Control? A Nomogram to Predict Effectiveness

In this retrospective study, our objective was to establish a nomogram to predict the effectiveness of cervical traction in young and middle-aged chronic nonspecific neck pain (CNNP) patients with unsatisfactory nonsteroidal anti-inflammatory drug (NSAID) control. For CNNP patients with unsatisfactory NSAID control, the effectiveness of cervical traction varies. Neck muscle fat infiltration and clinical features may associate with the effectiveness. A total of 186 suitable patients were classified into a training data set (from August 2015 to July 2018, n= 118) and a validation data set (from August 2018 to June 2019, n= 68) with time sequence. All patients were included to receive magnetic resonance imaging scan to calculate posterior cervical fat and muscle features, then undergoing unified cervical traction in an outpatient clinic. The least absolute shrinkage and selection operator (LASSO) regression model was used to select potentially relevant features to predict effectiveness possibility of cervical traction. Multivariable logistic regression analysis was used to develop the predicting model, presenting with a nomogram. The performance of the nomogram was assessed based on its calibration, discrimination, and clinical utility. Through the LASSO regression model, we identified 4 predictors including sex, good exercise compliance, the ratio of the cross-sectional area (CSA) between fat and muscle on C5 level (C5 fat CSA/muscle CSA), the ratio of CSA between fat and centrum on C5 level (C5 fat CSA/centrum muscle CSA). The nomogram provided good calibration and discrimination in the training cohort, showing an area under the curve (AUC) of 0.704 (95% CI, 0.608-0.799) and good concordance between the predicted and actual probabilities with Spiegelhalter's Z-test (P= 0.835). Discrimination of the model in the validation data set was acceptable, with AUC of 0.691 (95% CI, 0.564-0.817). Decision curve analysis revealed the nomogram to be clinically useful. Male sex, good exercise compliance, lower C5 fat CSA/centrum CSA, and and lower C5 fat CSA/muscle CSA could be favorable features to predict the effectiveness of cervical traction in CNNP patients with unsatisfactory NSAID control.

Comparison between myofascial release technique (MRT) and Transcutaneous electrical nerve stimulation (TENS) toward pain level in non-specific neck pain patients

Non-specific neck pain is neck pain that does not spread to upper limbs, pain located in the neck of the occipital area to the back shoulders. Non-specific neck pain is caused by several factors such as incorrect posture, anxiety, stress and excessive movement. The rigid and pain in the neck muscles also occurs headaches and migraines. The study aims to determine myofascial release technique (MRT) and Transcutaneous Electrical Nerve Stimulation (TENS) toward the pain level in the non-specific neck pain patients. The study was quasi experimental methods with one group pre-test and post-test design. The study was conducted in Anuntaloko Parigi Hospital on March until April 2017. The samples were 20 respondents who met the inclusion criteria. The result obtained different before and after intervention MRT was 23.2 with p=0.000. These results indicated significant decrease or change in the pain level. Meanwhile, independent t-test obtained the difference of probability before and after intervention was 0.286>0.05 which concluded there was no significant difference in the intervention MRT and TENS toward pain levels in the non-specific neck pain patients.

The Effect of Slump Technique Method against Pain Changes with Patient in Non-Specific Neck Pain

Non-specific neck pain is common cause of neck pain due to poor posture and mechanical disorder included pain following whiplash injury that not includes bone injury and neurological deficit. The study aims to determine the effectiveness of nerve mobilization by slump technique toward changes in the non-specific neck pain patients. The study was used quasi-experimental with time-series experimental design. The samples were 20 patients who met the inclusion criteria were patients seeking treatment at Blora and Cepu hospitals with neck pain and positive pain by slump technique with Visual Analogue Scale (VAS). The result showed 3 times of slump technique was not significant influence toward non-specific neck pain patients, p=0.025, while there was significant influence of 6 times of slump technique toward non-specific neck pain patients, p=0.000. No patient has improved condition or persistent pain after neural mobilization by slump technique method. These results indicated there was an effect of giving slump technique toward the non-specific neck patients’ pain level.

An observational pilot study to compare the strength and endurance of neck muscles of chronic neck pain patients as compared to age- and gender-matched controls using a handheld dynamometer

Context: Neck pain is a common musculoskeletal disorder. Strength and endurance measurements of neck muscles can be of substantial help to evaluate the basic condition and examine whether the rehabilitation protocol has been beneficial or not. Aims: The aim was to propose a technique to use handheld dynamometer for measurement of strength of neck muscles and study the strength and endurance of neck muscles in chronic nonspecific neck pain patients as compared to age- and gender-matched controls. Settings and Design: It is a cross-sectional observational study. Materials and Methodology: Neck muscle strength and endurance was measured in patients with neck pain (n = 30) and without neck pain (n = 30). Statistical Analysis Used: Test–retest reliability, Man–Whitney U-test, and ratio analysis were used for statistical analysis. Results: Inter-rater and intra-rater reliability for the technique used to measure neck muscle strength was found reliable and valid. The mean of neck flexor and extensor strength in neck pain patients was 2.97 ± 1.09 kg and 4.70 ± 0.87 kg (P Conclusions: Handheld dynamometer is a reliable tool to measure the strength of neck muscles. Strength and endurance of neck muscles chronic neck pain patients is significantly lower as compared to age- and gender-matched controls.

Optimal Duration of Stretching Exercises for Chronic Non-specific Neck Pain Patients

Optimal Duration of Stretching Exercises for Chronic Non-specific Neck Pain Patients

Strength and Range of Motion in the Contralateral Side to Pain and Pain-Free Regions in Unilateral Chronic Nonspecific Neck Pain Patients.

The aim of the study was to determine whether strength and range of motion deficits are present in patients with unilateral chronic neck pain at contralateral side to pain and at other regions. Forty-nine patients with unilateral chronic neck pain and 98 asymptomatic subjects participated in this case-control study. Range of motion and muscle strength of the cervical, shoulder, trunk, and hip regions were assessed bilaterally using inclinometer and dynamometer, respectively. Chronic neck pain patients demonstrated reduced cervical, shoulder, and trunk range of motion in their ipsilateral side to pain comparing the asymptomatic participants (P < 0.05). The ipsilateral side to pain cervical and shoulder range of motion were also significantly lower than the contralateral side to pain (P < 0.05). Significant differences were also observable in the contralateral side to pain comparing the asymptomatic group (P < 0.05). Cervical, shoulder, and scapulothoracic muscles were found weaker both in the ipsilateral side to pain and contralateral side to pain comparing the asymptomatic group (P < 0.05). Ipsilateral side to pain and contralateral side to pain in hip flexors were also found to be significantly weaker than the asymptomatic group (P < 0.01). The results revealed range of motion and strength deficits in the pain-free regions of the body in unilateral chronic neck pain patients. Findings support the regional interdependence theory and emphasize the need for managing seemingly intact neighboring and more remote regions in unilateral chronic neck pain patients.