Do Therapeutic Exercise and Sleeping Neck Support Benefit Patients with Chronic Neck Pain?

[Guest guest]

Do Therapeutic Exercise and Sleeping Neck Support Benefit Patients with

Chronic Neck Pain?

Category:  30 Health services research

Charlie H Goldsmith1, A Helewa2, K Obright2, Ha Smythe3, P Lee4, Lw Stitt5

1McMaster University, Department of Clinical Epidemiology & Biostatistics,

Hamilton, ON, Canada2School of Physical Therapy, University of Western

Ontario, London, ON, Canada3Department of Medicine, University of Toronto,

The Toronto Western Hospital, Toronto, ON, Canada4Department of Medicine,

University of Toronto, The Mount Sinai Hospital, Toronto, ON,

Canada5Department of Epidemiology & Biostatistics, University of Western

Ontario, London, ON, Canada

Presentation Number: 133

Poster Board Number: 133

Keywords: Neck Pain, Exercises, Sleeping Neck Support

A 12 week randomized 2x2 factorial design comparing active neck exercises

and sleeping neck support in patients with chronic neck pain using a neck

pain questionnaire (NPQ) to measure the primary outcome. A secondary outcome

was the SF-36 health related quality of life scale.

Using a factorial design in a randomized clinical trial, 151 patients were

equally allocated at random to 4 groups: placebo control of hot or cold

packs and superficial massage, active neck exercises, sleeping neck support

pillow, and combined active neck exercises and sleeping neck support pillow.

Patients were treated by physical therapists over a 6 week period and

assessed by trained blinded outcome assessors. The primary outcome measure

was the NPQ where 0 represents no pain and 36 represents maximum pain and

one secondary measure was the 8 dimensional SF-36 quality of life measure.

For the 128/151 (85%) of patients tested at 12 weeks, the NPQ descriptive

statistics of sample size, mean and standard deviation were: Control: 34,

18.7, 10.0; Exercise: 29, 20.1, 11.7; Pillow: 32, 21.5, 13.2; Combined: 33,

14.1, 10.7. Factorial analysis of variance showed that the main effects of

Exercise mean = -6.0(p=0.140) and Pillow mean = -3.2 (p=0.442) were not

satisfactorily significant, but the interaction of Exercise and Pillow mean

= -8.8 (p=0.032) was statistically significant and was considered to be

clinically important. Similar results were seen with the Physical Role

dimension of the SF-36; however, not with the other seven dimensions.

The combined therapy of active neck exercises and sleeping neck support

pillow is needed to provide benefit to patients with chronic neck pain.