About pair thirds of adults report ...

About pair thirds of adults report neck pain at a certain time, but its etiology and optimal treatment remain unclear. Viljanen and colleagues studied the consequence of dynamic exercise or relaxation treatment in nearly 400 Finnish female office workers who had chronic, nonspecific neck pain.

The subject of attention participants were 30 to 60 years of age and reported nonspecific neck pain of at least 12 weeks' duration to an occupational health service. After baseline data-gathering and physical assessment, including measurement of cervical range of motion and muscle force in the neck and shoulders, the 393 women were randomly assigned to treatment or sway groups. The 135 women assigned to dynamic muscle training were instructed in exercises using dumbbells three times weekly for 30 minutes through the whole extent of a 12-week intervention period. Relaxation training was provided three times weekly for 12 weeks to the 128 women assigned to relaxation. The remaining 130 women were asked not to change their flush of physical activity during the entire one-year follow-up period.

Participants in the intervention disposes received one week of reinforcement training six month after randomization. The researchers recorded the on a level of participation in the assigned program and evaluated participants at three six, and 12 month issues monitored included intensity of neck pain, cervical range of motion, dynamic muscle potency patient perception of ability to work, and number of days of sick leave. Pain and disability were assessed using a standardized rating scale. Depression and work-related stres also were monitored using standardized assessment tools.

Follow-up was integral for 91 percent of participants at three month 89 percent at six month and 87 percent at individual year. Overall, women in the dynamic training cluster completed 39 percent of the maximum number of sessions, and those in the relaxation arrange completed 42 percent. At undivided year, women spent an average of 31 minutes for week in dynamic muscle training, compared with 20 minutes in relaxation. The manage group reported no comparable therapeutic activity. All assign places tos reported reduced intensity of neck pain above time, but the improvement was not significantly greater in either of the treatment assemblages compared with women in the repress group. Similarly, no significant differences occurr between the arranges in neck disability, range of motion, ability to work, or number of days of sick leave. The proportion of women in the dynamic exercise dispose who perceived full or considerable recuperation at six months was 53 percent compared with 23 percent of those in the relaxation arrange and 17 percent of those in the regulate group. By 12 months, these percentages had fallen to 26 23 and 12 respectively.

The authors close that although patients reported subjectively greater improvement with dynamic muscle training than with relaxation training, neither of the interventions had any clinically meaningful objective purport on nonspecific neck pain. They finish that patients who maintain normal activities have consequences equivalent to those of the patients treated with either dynamic exercise or relaxation techniques.

Viljanen M et al. Effectiveness of dynamic muscle training, relaxation training, or ordinary activity for chronic neck pain: randomised controll trial. BMJ August 30 2003;327:475-7

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group