Neck pain recovery through physical exercises

Abstract

Neck pain is very common; it has a prevalence of 55% amongst adults who suffer from degenerative disorders of the cervical spine causing neck pain. The main cause of those disorders is mechanical compression. Degenerative disorders of the spine begin as early as the age of 20 and are the leading cause of neck pain. A thorough history and examination help to identify the functional restrictions and plan an effective physical exercise recovery program. Purpose: The aim of this study was to compare which physical exercise program, either isometric exercises with proprioceptive neuromuscular facilitation or myofascial releasing with static stretching, whether by itself or in combination, was more effective and beneficial for the treatment of neck pain. The effectiveness was measured using the Neck Pain and Disability Index Questionnaire (Vernon - Mior), Visual Analogue Scale measurements, AROM, the Cervical Extensor Endurance Test, and the Deep Neck Flexor Endurance Test. Method: A non-randomized, comparative study, where twenty-one individuals with neck pain were placed into three equally organized groups according to their age, gender, pain level, and functional restrictions (seven participants in each group). Group one performed isometric exercises and proprioceptive neuromuscular facilitation (PNF). Group two performed myofascial releasing (MFR) and static stretching. Group three performed the combination; first MFR with static stretching, followed by isometric exercises and PNF. Participants performed an exercise program lasting two weeks on a daily basis with a total of 14 sessions. Procedure: To assess pain and disability levels, subjective and objective data was collected prior to the first session and two days after the last exercise session using the following methods: Neck Pain and Disability Index Questionnaire (Vernon - Mior), Visual Analogue Scale measurements, AROM, the Cervical Extensor Endurance Test, and the Deep Neck Flexor Endurance Test. The screening, subjective and objective data collection, and measurements, as well as distribution of the physical exercise program, and its presentation to patients with neck pain was carried out based on Vuokatti Sport Academy and the cabinet of Vuokatti Hieronta. Quantitative analysis was made by the completion of the exercise program. Results: Although the study consisted of a small group of participants, significant pain reduction and improvement occurred in all three groups. Group 3 showed the most notable improvement in all of the tests. Group 1 showed better performance in the Cervical Extensor Endurance Test and the Deep Neck Flexor En-durance Test, as well as larger increase in AROM in all planes compared to Group 2, which demonstrated positive outcomes in NPDI and VAS. Conclusion: The results conclude that the complex of PNF with isometric exercises is effective in promoting strength and flexibility, which contribute to an increased ROM in the cervical spine and strengthening of the deep neck muscles. While MFR with static stretching is effective in decreasing pain and releasing tension in the fascia, contributing to pain relief and improved postural imbalances related to neck disabilities. However, the most effective showed to be the combination of the two exercise program protocols.