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CATHRIN GRIFFITHS, KRYSIA DZIEDZIC, JACKIE WATERFIELD, and JULIUS SIM ABSTRACT. Objective. In a cohort of primary care patients with chronic neck pain, to determine whether specific neck stabilization exercises, in addition to general neck advice and exercise, provide better clinical outcome at 6 weeks than general neck advice and exercise alone. Methods. This was a multicenter randomized controlled trial in 4 physical therapy departments. Seventy-four participants (mean age 51.3 yrs) were randomized to specific neck stabilization exercises with a general neck advice and exercise program (n = 37) or a general neck advice and exercise program alone (n = 37). They attended a 1-hour clinical examination, followed by a maximum of 4 treatment sessions. Assessments were undertaken at baseline, 6 weeks, and 6 months. The primary outcome was the Neck Pain and Disability Scale (NPDS). Analysis was by intention to treat. Results. Seventy-one (96%) participants received their allocated intervention. There was 91% followup at 6 weeks and 92% followup at 6 months. The mean (SD) 6-week improvement (reduction) in NPDS score was 10.6 (20.2) for the specific exercise program and 9.3 (15.7) for the general exercise program. There were no significant between-group differences in the NPDS at either 6 weeks or 6 months. For secondary outcomes, participants in the specific exercise group were less likely to be taking pain medication at 6-week followup (p = 0.02). There were no other significant between-group differences. Conclusion. Adding specific neck stabilization exercises to a general neck advice and exercise program did not provide better clinical outcome overall in the physical therapy treatment of chronic neck pain. (J Rheumatol First Release Dec 15 2008; doi:10.3899/jrheum.080376) Key Indexing Terms: CHRONIC NECK PAIN STRENGTHENING EXERCISES PHYSICAL THERAPY PRIMARY CARE From the Physiotherapy Department, Deeside Community Hospital, Aston, Flintshire; the ARC National Primary Care Centre, Keele University, Keele; and the School of Health and Rehabilitation, Keele University, Keele, Staffordshire, UK. Supported by the Physiotherapy Research Foundation and the Welsh Office. C. Griffiths, MPhil, Physiotherapy Department, Deeside Community Hospital; K. Dziedzic, PhD, ARC National Primary Care Centre, Keele University; J. Waterfield, EdD, School of Health and Rehabilitation, Keele University; J. Sim, PhD, ARC National Primary Care Centre, Keele University. Address reprint requests to J. Sim, ARC National Primary Care Centre, Keele University, Keele, Staffordshire ST5 5BG, UK. E-mail: j.sim@keele.ac.uk Accepted for publication September 23, 2008. |
