| Author, Year, Followup,a Pain Duration, Study Quality | Intervention | Population | Function and Pain Outcomes | Other Outcomes |
|---|---|---|---|---|
6 and 12 months Duration of pain: NR Poor | A. Dynamic strengthening exercise (muscle performance exercise) (n=61): for the neck/shoulder muscles, performed in in the workplace; 20 minute sessions, 3 times a week (2 of the 3 weekly sessions were supervised by experienced instructors) B. Lifestyle physical exercise and activity increase (combination exercise) (n=59): workplace activities such as steppers placed near the copying machines, punch bags in the hall, group sessions of Nordic walking, and strength and aerobic fitness exercise programs C. Control group (n=62): ergonomics, stress management, organization of work, cafeteria food quality Treatment lasted 1 year. All groups were allowed 1 hour per week during working time for activities | A + B + C Age: 45 years Female: 78% Office workers: 100% A vs. B vs. C Baseline pain (0-10 VAS): 5.0 vs. 5.0 vs. 4.7 | A vs. C 6 months Pain VAS: 3.4 vs. 4.2, difference −0.8 (95% CI −0.9 to −0.7) 12 monthsc Pain VAS: 3.8 vs. 4.6, difference −0.80 (95% CI −0.87 to −0.73) Days of pain in last 3 months (0-90): 25 vs. 30, p>0.05 B vs. C 6 months Pain VAS: 3.6 vs. 4.2, difference −0.6 (95% CI −0.7 to −0.5) 12 monthsc Pain VAS: 3.6 vs. 4.6, difference −1.0 (95% CI −1.1 to −0.9) Days of pain in last 3 months: 26 vs. 30, p>0.05 | NR |
Aslan Telci, 2012100 6 months Duration of pain: 12 months Poor | A. Combination exercises (n=20): consisting of posture, active range of motion, stretching, isometric and dynamic strengthening and endurance exercises, relaxation and proprioception exercises. Clinic followup once a week to maintain motivation and check whether exercises performed correctly for a total of 3 weeks and home exercise for at least another month. B. NSAIDs and muscle relaxants for 15 days (n=20): all patients received verbal advice regarding pain control, posture, and ergonomics. | A vs. B Age: 48 vs. 52 years Female: 85% vs. 75% BMI: 25 vs. 27 Employed: 50% vs. 40% Education year: 12 vs. 11 Baseline NDI (0-50): 14.0 vs. 10.7 Baseline pain (0-10 VAS): 6.7 vs. 6.4 | A vs. B 3 month NDI: 9.4 vs. 11.5, difference −2.2 (95% CI −5.8 to 1.5) Pain VAS: 4.1 vs. 5.1, difference −1.0 (95% CI −2.3 to 0.3) 6 month NDI: 11.9 vs. 13.7, difference −1.8 (95% CI −5.7 to 2.1) Pain VAS: 4.5 vs. 5.3, difference −0.8 (95% CI −2.3 to 0.7) | A vs. B 3 month NHP (0-100): 89.2 vs. 230.0, difference −140.8 (95% CI −214.0 to −67.5) BDI (0-63): 6.8 vs. 10.7, difference −4.0 (95% CI −8.4 to 0.5) 6 month NHP (0-100): 122.3 vs. 257.6, difference −135.3 (95% CI −209.1 to −61.5) BDI (0-63): 8.3 vs. 11.8, difference −3.8 (95% CI −8.5 to 1.0) |
de Araujo Cazotti, 2018101 3 months Duration of pain: Range, mean 69 to 86 months Fair [New trial] | A. Pilates (muscle performance exercise) (n=32): 1 hour session, 2 times/week, for 12 weeks. Repetitions/exercise varied from 6 to 12. 91% of participants completed all of the scheduled sessions. B. Pharmacological treatment (n=32): 750 mg acetaminophen every 6 hours if they were experiencing pain. Participants in group A were also instructed to do the same of they were experiencing pain. | A vs. B Age: 49 vs. 49 years Female: 19% vs. 25% Baseline NDI (0-50): 13.3 vs. 12.8 Baseline NPS (0-10): 6.4 vs. 5.8 | A vs. B 3 months NDI: 4.2 vs. 9.8, difference −5.6 (95% CI −8.4 to −2.8) NPS: 1.9 vs. 5.0, difference −3.1 (95% CI −4.2 to −2.0) | A vs. B 3 months SF-36 Physical functioning (0-100): 80.3 vs. 73.1, difference 7.2 (95% CI −2.3 to 16.7) SF-36 Role physical (0-100): 75.0 vs. 55.6, difference 19.4 (95% CI −2.6 to 41.4) SF-36 Bodily pain (0-100): 68.6 vs. 50.4, difference 18.2 (95% CI 6.8 to 29.6) SF-36 General health (0-100): 79.5 vs. 74.8, difference 4.7 (95% CI −7.4 to 16.8) SF-36 Vitality (0-100): 66.6 vs. 56.6, difference 10 (95% CI −0.6 to 20.6) SF-36 Social functioning (0-100): 86.7 vs. 76.2, difference 10.5 (95% CI −2.5 to 23.5) SF-36 Role emotional (0-100): 72.9 vs. 72.9, difference 0 (95% CI −19.4 to 19.4) SF-36 Mental health (0-100): 77.4 vs. 65.2, difference 12.2 (95% CI 2.5 to 21.9) Acetaminophen use, Median (IQR): 0 (0 to 39) vs. 3.5 (0 to 159) |
Lauche, 201642 3 months Duration of pain: NR Poor | A. Combination exercises (n=37): weekly 60-75 minute session for 12 weeks; ergonomic principles, proprioceptive exercises, and isometric and dynamic mobilization, stretching, strengthening neck and core exercises, and relaxation exercises; illustrated written exercises for home use ≥15 minutes/day. B. Wait list (n=39): continuing usual activities/therapies | A vs. B Age: 47 vs. 49 years Female: 86% vs. 82% years Baseline NDI: NR Baseline pain, recently (0-100 VAS): 46.2 vs. 51.5 Baseline pain, considered tolerable (0-100 VAS): 20.5 vs. 20.7 | A vs. B 3 month NDI: 25.1 vs. 29.4, difference −4.3 (95% CI −10.2 to 1.6) Recent pain VAS: 33.1 vs. 44.6, difference −11.5 (95% CI −20.8 to −2.2) Pain with motion VAS: 34.9 vs. 45.5, difference −10.6 (95% CI −18.5 to −2.7) | A vs. B 3 month SF-36 PCS (0-100): difference 2.0 (95% CI −1.6 to 5.6) SF-36 MCS (0-100): difference 0.5 (95% CI −3.9 to 4.9) |
Li, 201743 1.5 months Duration of pain: 4 years Fair | A. Progressive resistance training (muscle performance exercise) (n=38): ≥3 sessions per week for 6 weeks. Sessions consisted of four cervical isometric exercises, each repeated 8-12 times. Resistance progressively increased every 2 weeks, starting at 30% of maximal strength and increased to 70%. B. Fixed resistance training (muscle performance exercise) (n=35): ≥3 sessions per week for 6 weeks. Sessions consisted of four cervical isometric exercises, each repeated 8-12 times. Resistance was fixed at 70% of the participant’s maximal strength. C. Attention control (n=36): Subjected received information and had weekly discussions about workplace ergonomics, stress management, relaxation, meditation, and diet. | A vs. B vs. C Age: 36 vs. 34 vs. 34 BMI: 21 vs. 22 vs. 22 Years working: 9 vs. 9 vs. 10 Pain duration (years): 3 vs. 4 vs. 4 Work (days/week): 5 vs. 6 vs. 5 Computer use (hours/day): 7 vs. 8 vs. 7 Baseline NDI (0-50): 28.3 vs. 28.9 vs. 27.8 Baseline pain (0-10 VAS): 5.3 vs. 5.4 vs. 5.2 | A vs. C 1.5 month NDI: 14.9 (4.9) vs. 26.6 (5.4), difference −11.7 (95% CI −14.1 to −9.3) Pain VAS: 1.9 (0.9) vs. 5.1 (1.0), difference −3.2 (95% CI −3.6 to −2.8) B vs. C 1.5 month NDI: 15.8 (4.8) vs. 26.6 (5.4), difference −10.8 (95% CI −13.2 to −8.4) Pain VAS: 2.5 (0.9) vs. 5.1 (1.0), difference −2.6 (95% CI −3.1 to −2.1) | None |
Stewart, 200744 1.5 and 12 months Duration of pain: 9 months Fair | A. Combination exercise, plus advice (n=66); aerobic, stretching, functional, speed and endurance, trunk and limb strengthening; 1 hour per session for 12 session over 6 weeks B. Advice alone (n=68): included reassurance of a favorable outcome and encouragement to resume light activity | A vs. B Age: 44 vs. 43 years Female: 73% vs. 62% Baseline NDI (0-50): 18.2 vs. 19.7 Baseline PSFS (0-10): 3.9 vs. 4.1 Baseline pain (0-10 VAS): 5.2 vs. 5.3 | A vs. B 1.5 months NDI: 12.0 vs. 15.7, difference −2.7 (95% CI −4.5 to −0.9) PSFS: 6.4 vs. 5.6, difference 0.9 (95% CI 0.3 to 1.6) Pain VAS: 3.2 vs. 4.3, difference −1.1 (95% CI −1.8 to −0.3) 12 months NDI: 12.1 vs. 15.5, difference −2.3 (95% CI −4.9 to 0.3) PSFS: 6.6 vs. 6.0, difference 0.6 (95% CI −0.1 to 1.4) Pain VAS: 3.5 vs. 3.8, difference −0.2 (95% CI 0.6 to −1.0) | A vs. B 1.5 months Bothersomeness (0-10) 3.6 vs. 4.8, p=0.019 SF 36 physical (0-100): 42.1 vs. 38.9, p=0.003 SF 36 mental (0-100): 51.4 vs. 46.4, p=0.005 Global Perceived Effect (−5 to 5) 2.5 vs. 1.5, p=0.006 12 months Bothersomeness 4.1 vs. 4.0, p=0.480 SF 36 physical: 42.3 vs. 38.9, p=0.003 SF 36 mental: 48.4 vs. 46.1, p=0.33 Global Perceived Effect: 2.3 vs. 1.9, p=0.48 |
Viljanen, 200345 3 and 9 months Duration of pain: 11 years Fair | A. Dynamic strengthening exercises (muscle performance exercises) (n=135): physical-therapist guided; 3 times per week for 12 weeks, 30 minute sessions B. No intervention (n=130) | A vs. B Age: 45 vs. 44 years Female: 100% vs. 100% Office workers: 100% Computer work >6 hours per day: 33% vs. 35% Baseline neck disability scalee (0-80): 29 vs. 26 Baseline pain (0-10 VAS): 4.8 vs. 4.1 | A vs. B 3 months Neck disability scalee: 15 vs. 14, adjusted difference −0.1 (95% CI −3.1, 2.9) Pain VAS: 2.9 vs. 2.9, adjusted difference 0.4 (95% CI −0.3, 1.0) 9 months Neck disability scalee: 19 vs. 17, adjusted difference −0.1 (95% CI −3.0 to 2.9) Pain VAS: 3.1 vs. 3.2, adjusted difference 0.5 (95% CI −0.1 to 1.0) | NR |
6 and 36 months Duration of pain: 6.8 years Poor | A. Strength training (muscle performance exercise) (n=29): for neck and shoulder muscles, 3 times per week for 10 weeks, 1 hour/session B. Endurance training (muscle performance exercise) (n=28): using arm-cycling and arm exercises, 30 repetition maximum, 3 times per week for 10 weeks, 1 hour/session C. Coordination training (neuromuscular reeducation exercises) (n=25): focus on balance and postural stability 3 times per week for 10 weeks, 1 hour/session D. Reference group (n=21): stress management 1 time per week for 10 weeks, 2 hour/session | A vs. B vs. C vs. D Age: 38 vs. 39 vs. 38 vs. 39 years Female: 100% all groups Office workers: 100% Baseline pain, at present (0-10 VAS): 2.6 vs. 2.8 vs. 3.3 vs. 3.7 | A vs. B vs. C vs. D 6 months Proportion of patients with frequent pain (several times per week or more): 76% vs. 91% vs. 78% vs. 73%, p=0.50 36 months Pain VAS at present: 3.1 vs. 2.2 vs. 2.7 vs. 1.6, p=0.073 Pain VAS in general (0-10): 3.2 vs. 2.9 vs. 2.9 vs. 2.0, p=0.249 Pain VAS at worst (0-10): 6.1 vs. 5.8 vs. 5.7 vs. 5.8, p=0.902 Frequent pain: 47% vs. 50% vs. 58% vs. 39%, p=0.66 | NR |
BDI = Beck Depression Inventory; BMI = body mass index; CI = confidence interval; MCS = Mental Component Summary; NDI = Neck Disability Index; NHP = Nottingham Health Profile; NR = not reported; NSAID = nonsteroidal anti-inflammatory drug; PCS = Physical Component Summary; PSFS = Patient Specific Functional Scale; SF-36 = Short-Form 36 questionnaire; VAS = visual analog scale
Unless otherwise noted, followup time is calculated from the end of the treatment period
Cluster RCT where clusters were formed from participants working on the same floor
Intervention lasted 12 months and followup is at the end of the intervention
Cluster RCT where clusters were formed from participants selecting a time that best fit their schedule
Neck disability scale was created by investigators from responses to eight questions related to functional limitations due to pain; this scale is not the same as the more common NDI
From: Results
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