PainRelief.com Interview with:
ROSS ILES PhD, Dip WDP, BPhysio(Hons)
Insurance Work and Health Group
Senior Research Fellow Department of Physiotherapy
Adjunct Senior Lecturer,Health Services Division
School of Public Health and Preventive Medicine
Monash University Melbourne, VIC Australia
PainRelief.com: What is the background for this study
Response: Chronic neck pain is estimated to have a worldwide mean lifetime prevalence of 48.5%, and the pain and disability associated with this condition accounts for 2.5% of the total years lost to disability in Australia. Chronic neck pain is known to be associated with neck muscle weakness in all planes of movement of up to 66% when compared to participants presenting with no history of neck pain. Therefore, neck strengthening exercises are commonly utilised in the treatment of chronic neck pain, with many different programs being described within the literature. Studies investigating the effect of strengthening exercises on chronic neck pain have found a short to intermediate term improvement in pain by a moderate to large amount. However, many strengthening programs do not target the multi-directional weakness which has been shown to be prevalent in this population group.
Through a case series of patients with chronic neck pain we aimed to determine whether a neck-specific progressive resistance program targeting all planes of cervical movement led to a change in pain and disability, and to investigate the relationship between neck strength, pain, and disability.
Data analysis was performed on patients after completing nine sessions of a neck-specific progressive resistance exercise intervention utilising the Melbourne Protocol and the Multi-Cervical Unit (MCU) technology under supervision of the treating physiotherapist. Participants completed isotonic exercises against the MCU provided resistance in the planes of cervical flexion, extension, and lateral flexion, all at neutral cervical rotation and 25 degrees left and right. Neck pain and disability were assessed with the Numerical Rating Scale (NRS) and Neck Disability Index (NDI) respectively, with neck strength measured and recorded through the MCU.