Effectiveness of cranio-cervical exercise combined with usual care among patients with chronic neck pain

Abstract

Background: Chronic neck pain (CNP) is defined as pain in the neck with or without pain referred into one or both upper limbs that last for at least 3 months. The prevalence neck pain in the general population ranges from 0.4% to 86.8% worldwide. However, neck pain triggered by imbalance between superficial and deep neck muscles was regarded as important factors for this increased prevalence. Cranio-cervical exercise (CCE) maintains balance between these muscles. Objectives: To determine and compare patient rated general neck pain, neck ROM, neck muscle strength and disability before and after application CCE combined with usual care among patients with CNP. Methodology: Classic experimental study design was used in this study. 28 patients with CNP were randomly assigned into two groups from outdoor musculo-skeletal unit, CRP. Among them 14 patients were assigned into trial group received CCE with usual care and another 14 into control group received only usual care. Total treatment sessions were six comprising of 2 sessions per week for 3 weeks. Single blinding procedure was used during data collection. Outcome measurement tools: Numerical pain rating scale (NPRS) was used to measure pain and universal goniometer to measure ROM, manual muscle testing to measure muscle strength and NDI to measure neck disability. Analysis of data: Inferential statistics such as Mann-Whitney U test, Unpaired t, Paired t and Wilcoxon test was done using SPSS version 20. Results: It was observed that pain and neck disability had reduced and ROM and muscle strength improved both between and within group results except flexion and activation of cervical flexor muscle (P>.05). Conclusion: This research showed that CCE combined with usual care was more effective than only usual care for patients with chronic neck pain.