Effectiveness of an 8-week exercise programme on pain and specificity of neck muscle activity in patients with chronic neck pain: a randomized controlled study

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  • University of Göttingen


BACKGROUND: Although exercise can be effective for relief of neck pain, little is known about the effect of exercise on the neural control of neck muscles.

METHODS: A randomized controlled trial was conducted on 46 women with chronic neck pain to investigate the immediate effectiveness of an 8-week exercise programme on pain and directional specificity of neck muscle activity. At baseline, the patients completed questionnaires including the neck disability index (NDI) and performed a circular contraction of their head in the horizontal plane at 15 N force, with continuous change in force direction in the range 0-360°. Electromyography (EMG) was recorded from the sternocleidomastoid (SCM) and splenius capitis (SCap) muscles. Tuning curves of the EMG amplitude were computed, which depicts muscle activity over a range of force directions. The mean point of the tuning curves defined a directional vector, which determined the specificity of muscle activity. Patients were randomly assigned either to a training or control group.

RESULTS: A significant between-group difference in the change in NDI was observed. A reduction in NDI was observed following training (pre: 18.2 ± 7.4; post: 14.1 ± 6.5; p < 0.01) but not for the control group (pre: 17.5 ± 6.3; post: 16.6 ± 7.4). The training group showed higher specificity of muscle activity post-intervention (pre: 18.6 ± 9.8%, post: 24.7 ± 14.3%; p < 0.05), whereas no change occurred for the control group (pre: 19.4 ± 11.9%, post: 18.2 ± 10.1%).

CONCLUSION: An exercise programme that aims to enhance motor control of the cervical spine improves the specificity of neck muscle activity and reduces pain and disability in patients with neck pain.


Original languageEnglish
Pages (from-to)1517-28
Number of pages12
JournalEuropean Journal of Pain
Issue number10
Publication statusPublished - Nov 2013


  • Adolescent, Adult, Cervical Vertebrae, Chronic Pain, Electromyography, Exercise, Exercise Therapy, Female, Humans, Middle Aged, Muscle Contraction, Neck Muscles, Neck Pain, Pain Measurement, Surveys and Questionnaires, Young Adult, Journal Article, Randomized Controlled Trial