From: Health Qual Life Outcomes. 2010 May 14;8(1):48. [Epub ahead of print]
Chronic neck pain is a common condition associated not only with a decrease in neck muscle strength, but also with decrease in health-related quality of life (HRQoL). While neck strength training has been shown to be effective in improving neck muscle strength and reducing neck pain, HRQoL among patients with neck pain has been reported as an outcome in only two short-term exercise intervention studies. Thus, reports on the influence of a long-term neck strength training intervention on HRQoL among patients with chronic neck pain have been lacking.
Neck pain is one of the most common musculoskeletal disorders in Western societies. Along with considerable costs for the individual and the society, neck pain is a frequent source of disability causing humane suffering and affecting the well-being of individuals. Just as health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity, the outcome measures of an intervention ought to be multidimensional and include the subjective experience of the patient. This can be achieved using a health-related quality of life (HRQoL) measurement tool.
Since neck pain is associated with a decrease in neck muscle strength, neck strength training has been one means in seeking cure for neck pain. In addition to gaining neck muscle strength, neck strength training has been shown to be effective in reducing neck pain and the disability associated with it. In a recent best-evidence synthesis and Cochrane review it was concluded that interventions that involved exercise combined with manual therapy were more effective in treating patients with neck pain than were alternative strategies.
Although strength training seems to be an efficient way of treating patients with neck pain, its effect on HRQoL has not been shown. The authors found only two studies where the influence of strength exercises on neck pain was assessed with HRQoL measurements. In those short-term exercise studies no significant gains in HRQoL were observed. Because short-term training have been shown to produce only temporary improvements in various outcome measures, intensive resistance training for at least one year is recommended to gain sustainable results. Thus, the purpose of the present study was to evaluate whether 12 months of neck strength or endurance training could improve HRQoL in females with chronic neck pain.
This study reports the effect of one-year neck strength training on HRQoL in females with chronic neck pain. One hundred eighty female office workers, 25 to 53 years of age, with chronic neck pain were randomized to a strength training group (n = 60), endurance training group (n = 60) or control group (n = 60). The strength training group performed high-intensity isometric neck strengthening exercises with an elastic band while the endurance training group performed lighter dynamic neck muscle training. The control group received a single session of guidance on stretching exercises. HRQoL was assessed using the generic 15D questionnaire at baseline and after 12 months.
Training led to statistically significant improvement in the 15D total scores for both training groups, whereas no changes occurred for the control group. The strength training group improved significantly in five of 15 dimensions, while the endurance training group improved significantly in two dimensions. Effect size (and 95% confidence intervals) for the 15D total score was 0.39 (0.13 to 0.72) for the strength training group, 0.37 (0.08 to 0.67) for the endurance training group, and -0.06 (-0.25 to 0.15) for the control group.
One year of either strength or endurance training seemed to moderately enhance the HRQoL of female patients with chronic neck pain. Neck and upper body training can be recommended to improve HRQoL of females with neck pain if they are motivated for longterm regular exercise.
