Author: Rutger Mj de Zoete1,2, Nigel R Armfield3, James H McAuley4, Kenneth Chen3,5, Michele Sterling3
1 RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Queensland, Australia firstname.lastname@example.org.
2 School of Allied Health Science and Practice, The University of Adelaide, Adelaide, South Australia, Australia.
3 RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Queensland, Australia.
4 Neuroscience Research Australia and School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia.
5 Geriatric Education and Research Institute, Singapore.
Conference/Journal: Br J Sports Med
Date published: 2020 Nov 2
Other: Special Notes: doi: 10.1136/bjsports-2020-102664. , Word Count: 285
To compare the effectiveness of different physical exercise interventions for chronic non-specific neck pain.
Systematic review and network meta-analysis.
Electronic databases: AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Physiotherapy Evidence Database, PsycINFO, Scopus and SPORTDiscus.
Randomised controlled trials (RCTs) describing the effects of any physical exercise intervention in adults with chronic non-specific neck pain.
The search returned 6549 records, 40 studies were included. Two networks of pairwise comparisons were constructed, one for pain intensity (n=38 RCTs, n=3151 participants) and one for disability (n=29 RCTs, n=2336 participants), and direct and indirect evidence was obtained. Compared with no treatment, three exercise interventions were found to be effective for pain and disability: motor control (Hedges' g, pain -1.32, 95% CI: -1.99 to -0.65; disability -0.87, 95% CI: -1.45 o -0.29), yoga/Pilates/Tai Chi/Qigong (pain -1.25, 95% CI: -1.85 to -0.65; disability -1.16, 95% CI: -1.75 to -0.57) and strengthening (pain -1.21, 95% CI: -1.63 to -0.78; disability -0.75, 95% CI: -1.28 to -0.22). Other interventions, including range of motion (pain -0.98 CI: -2.51 to 0.56), balance (pain -0.38, 95% CI: -2.10 to 1.33) and multimodal (three or more exercises types combined) (pain -0.08, 95% CI: -1.70 to 1.53) exercises showed uncertain or negligible effects. The quality of evidence was very low according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria.
There is not one superior type of physical exercise for people with chronic non-specific neck pain. Rather, there is very low quality evidence that motor control, yoga/Pilates/Tai Chi/Qigong and strengthening exercises are equally effective. These findings may assist clinicians to select exercises for people with chronic non-specific neck pain.
Prospero registration number:
Keywords: chronic; exercise; meta-analysis; neck.
PMID: 33139256 DOI: 10.1136/bjsports-2020-102664