Strength training and stretching versus stretching only in the treatment of patients with chronic neck pain: a randomized one-year follow-up study

OBJECTIVE: To compare the effectiveness of a 12-month home-based combined strength training and stretching programme against stretching alone in the treatment of chronic neck pain. DESIGN: A randomized follow-up study. PARTICIPANTS: One hundred and one patients with chronic non-specific neck pain were randomized in two groups. INTERVENTION: The strength training and stretching group was supported by 10 group training sessions and the stretching group was instructed to perform stretching exercises only as instructed in one group session. MAIN OUTCOME MEASUREMENTS: Neck pain, disability, neck muscle strength and mobility of cervical spine were measured before and after the intervention. RESULTS: No significant differences in improvement in neck pain and disability were found between the two training groups. Mean (SD) pain decreased from 64 (17) mm by 37 (95% confidence interval (CI) 44 to 30) mm in the strength training and stretching group, and from 60 (17) mm by 32 (39 to 25) mm in the stretching group. The improvements in disability were significant in both groups (P<0.001), while the changes in neck strength and mobility were minor. Training adherence decreased over time from the targeted three sessions a week, ending up at 1.1 (0.7) times a week for strength training and stretching group and 1.4 (0.8) times a week for stretching group. CONCLUSIONS: No statistically significant differences in neck pain and disability were observed between the two home-based training regimens. Combined strength training and stretching or stretching only were probably as effective in achieving a long-term improvement although the training adherence was rather low most of the time.