TY - JOUR
T1 - Neck-specific strengthening exercises and cognitive therapy for chronic neck pain
T2 - a systematic review
AU - Cox, Laura G.
AU - Kidgell, Dawson J.
AU - Iles, Ross A.
PY - 2019/11/2
Y1 - 2019/11/2
N2 - Background: Neck pain has been estimated to affect one in two people. Cognitive therapy and neck-specific strengthening exercises are two interventions that target different factors related to chronic neck pain in order to decrease pain and disability. Objectives: To critically appraise the effect of a combination of neck-specific strengthening exercises and cognitive therapy compared to the individual therapies on pain and disability in patients with non-specific chronic neck pain. Methods: A systematic search of the five following online databases was undertaken from inception up to April 2017: Ovid MEDLINE, PsycINFO, EMBASE + EMBASE Classic, CINAHL, and PEDro. Key inclusion criteria were as follows: randomized control trials published in English, participants with chronic neck pain (greater than three months), an intervention of cognitive therapy and neck-specific strengthening exercise, and an outcome measure of pain and/or disability. Results: Seven randomized control trials met inclusion criteria, and five were included in meta-analysis. The studies were of a low-to-moderate methodological quality. Evidence was found for the effectiveness of neck-specific strengthening exercises (SMD 0.30, 95%CI 0.09 to 0.52, p =.005) and a combination of cognitive therapy and neck-specific strengthening exercise (SMD 0.50, 95%CI 0.29 to 0.71, p <.0001) in reducing pain and disability compared to a control of prescribed physical activity. The combination of cognitive therapy and neck-specific strengthening exercises was not found to be more effective at reducing pain and disability than neck-specific strengthening exercises alone (SMD 0.22, 95%CI −0.01 to 0.45, p =.06) or cognitive therapy alone (SMD 0.26, 95%CI −0.33 to 0.86, p =.39). Conclusions: The effects of both neck-specific exercises and cognitive therapy observed in this review are statistically significant; however, it is questionable whether they are clinically significant based on the measures used.
AB - Background: Neck pain has been estimated to affect one in two people. Cognitive therapy and neck-specific strengthening exercises are two interventions that target different factors related to chronic neck pain in order to decrease pain and disability. Objectives: To critically appraise the effect of a combination of neck-specific strengthening exercises and cognitive therapy compared to the individual therapies on pain and disability in patients with non-specific chronic neck pain. Methods: A systematic search of the five following online databases was undertaken from inception up to April 2017: Ovid MEDLINE, PsycINFO, EMBASE + EMBASE Classic, CINAHL, and PEDro. Key inclusion criteria were as follows: randomized control trials published in English, participants with chronic neck pain (greater than three months), an intervention of cognitive therapy and neck-specific strengthening exercise, and an outcome measure of pain and/or disability. Results: Seven randomized control trials met inclusion criteria, and five were included in meta-analysis. The studies were of a low-to-moderate methodological quality. Evidence was found for the effectiveness of neck-specific strengthening exercises (SMD 0.30, 95%CI 0.09 to 0.52, p =.005) and a combination of cognitive therapy and neck-specific strengthening exercise (SMD 0.50, 95%CI 0.29 to 0.71, p <.0001) in reducing pain and disability compared to a control of prescribed physical activity. The combination of cognitive therapy and neck-specific strengthening exercises was not found to be more effective at reducing pain and disability than neck-specific strengthening exercises alone (SMD 0.22, 95%CI −0.01 to 0.45, p =.06) or cognitive therapy alone (SMD 0.26, 95%CI −0.33 to 0.86, p =.39). Conclusions: The effects of both neck-specific exercises and cognitive therapy observed in this review are statistically significant; however, it is questionable whether they are clinically significant based on the measures used.
KW - Chronic pain
KW - cognitive therapy
KW - neck pain
KW - strengthening exercises
KW - systematic review
UR - http://www.scopus.com/inward/record.url?scp=85073958193&partnerID=8YFLogxK
U2 - 10.1080/10833196.2019.1664081
DO - 10.1080/10833196.2019.1664081
M3 - Review Article
AN - SCOPUS:85073958193
SN - 1083-3196
VL - 24
SP - 335
EP - 345
JO - Physical Therapy Reviews
JF - Physical Therapy Reviews
IS - 6
ER -