Cochrane · systematic review · CD004250

Exercises for mechanical neck disorders

Gross, A, Kay, TM, Paquin, JP, et al. · Cochrane Database of Systematic Reviews · 2015 · Cochrane Library

Back and Neck2 versionsAMSTAR 2: not assessed

SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.

Questions

current version

GRADE rated

No studies

Included studies

No studies 8 · 15.4%Ungraded 5 · 9.6%Very low 2 · 3.8%Low 15 · 28.8%Moderate 22 · 42.3%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

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Chronic MND: Cervical/UE Stretch/ROM Exercises + Cervical/Scapulothoracic+/‐UE Strengthening + Dynamic/Static Cervical Stabilization + ANOTHER INTERVENTION compared to THAT SAME INTERVENTION

Population: patients with mechanical neck disorders

6 questions

Outcome	Effect	Evidence	Status / GRADE
Pain Intensity: VAS 0 no pain to 10 worst pain ( Chronic MND: Cervical/UE Stretch/ROM Exercises + Cervical/Scapulothoracic+/‐UE Strengthening + Dynamic/Static Cervical Stabilization + ANOTHER INTERVENTION vs THAT SAME INTERVENTION	no estimate extracted	3 studies · 241 participants	Moderate Downgraded: risk of bias
Function: NDI 0 no disability to 50 maximum disability ( Chronic MND: Cervical/UE Stretch/ROM Exercises + Cervical/Scapulothoracic+/‐UE Strengthening + Dynamic/Static Cervical Stabilization + ANOTHER INTERVENTION vs THAT SAME INTERVENTION	no estimate extracted	3 studies · 241 participants	Moderate Downgraded: risk of bias
Quality of Life: SF‐36 (physical component) Chronic MND: Cervical/UE Stretch/ROM Exercises + Cervical/Scapulothoracic+/‐UE Strengthening + Dynamic/Static Cervical Stabilization + ANOTHER INTERVENTION vs THAT SAME INTERVENTION	no estimate extracted	2 studies · 165 participants	Low Downgraded: risk of bias
Patient Satisfaction: 1 to 7; completely satisfied to completely dissatisfied ( Chronic MND: Cervical/UE Stretch/ROM Exercises + Cervical/Scapulothoracic+/‐UE Strengthening + Dynamic/Static Cervical Stabilization + ANOTHER INTERVENTION vs THAT SAME INTERVENTION	no estimate extracted	1 study · 101 participants	Moderate Downgraded: risk of bias
Global Perceived Effect: Patient‐ Rated Improvement 1 more improvement to 9 less improvement ( Chronic MND: Cervical/UE Stretch/ROM Exercises + Cervical/Scapulothoracic+/‐UE Strengthening + Dynamic/Static Cervical Stabilization + ANOTHER INTERVENTION vs THAT SAME INTERVENTION	no estimate extracted	1 study · 101 participants	Moderate Downgraded: risk of bias
Adverse Effects Chronic MND: Cervical/UE Stretch/ROM Exercises + Cervical/Scapulothoracic+/‐UE Strengthening + Dynamic/Static Cervical Stabilization + ANOTHER INTERVENTION vs THAT SAME INTERVENTION	no estimate extracted	3 studies · 8 participants	Ungraded

Chronic MND: Cervical Stretch/ROM Exercises + Cervical/Scapulothoracic Strengthening + Static/Dynamic Cervical/Shoulder Stabilization compared to WAIT LIST

Population: patients with chronic mechanical neck disorders

5 questions

Outcome	Effect	Evidence	Status / GRADE
Pain Intensity: VAS 0 no pain to 100 worst pain; ( Chronic MND: Cervical Stretch/ROM Exercises + Cervical/Scapulothoracic Strengthening + Static/Dynamic Cervical/Shoulder Stabilization vs WAIT LIST	no estimate extracted	2 studies · 147 participants	Moderate Downgraded: risk of bias, imprecision
Function: NPDI or NDI 0 no disability to 100 maximum disability; ( Chronic MND: Cervical Stretch/ROM Exercises + Cervical/Scapulothoracic Strengthening + Static/Dynamic Cervical/Shoulder Stabilization vs WAIT LIST	no estimate extracted	2 studies · 147 participants	Moderate Downgraded: risk of bias, imprecision
Quality of Life: SF‐36 (physical component) Chronic MND: Cervical Stretch/ROM Exercises + Cervical/Scapulothoracic Strengthening + Static/Dynamic Cervical/Shoulder Stabilization vs WAIT LIST	no estimate extracted	2 studies · 143 participants	Moderate Downgraded: risk of bias, imprecision
Global Perceived Effect: General Health Perception 0 worse to 100 better ( Chronic MND: Cervical Stretch/ROM Exercises + Cervical/Scapulothoracic Strengthening + Static/Dynamic Cervical/Shoulder Stabilization vs WAIT LIST	no estimate extracted	1 study · 70 participants	Moderate Downgraded: imprecision
Adverse Effects Chronic MND: Cervical Stretch/ROM Exercises + Cervical/Scapulothoracic Strengthening + Static/Dynamic Cervical/Shoulder Stabilization vs WAIT LIST	no estimate extracted	NR	No studies

Chronic MND: Qigong Stretch/ROM + Endurance Training + Dynamic Stabilization + Cognitive (mindfulness & emotional balance) compared to WAIT LIST

Population: patients with chronic mechanical neck disorders

5 questions

Outcome	Effect	Evidence	Status / GRADE
Pain Intensity: VAS 0 no pain to 100 worst pain ( Chronic MND: Qigong Stretch/ROM + Endurance Training + Dynamic Stabilization + Cognitive (mindfulness & emotional balance) vs WAIT LIST	no estimate extracted	2 studies · 148 participants	Moderate Downgraded: risk of bias
Function: NPDI 0 no disability to 100 maximum disability ( Chronic MND: Qigong Stretch/ROM + Endurance Training + Dynamic Stabilization + Cognitive (mindfulness & emotional balance) vs WAIT LIST	no estimate extracted	2 studies · 148 participants	Moderate Downgraded: risk of bias
Quality of Life: SF‐36 (physical component) Chronic MND: Qigong Stretch/ROM + Endurance Training + Dynamic Stabilization + Cognitive (mindfulness & emotional balance) vs WAIT LIST	no estimate extracted	2 studies · 148 participants	Moderate Downgraded: risk of bias, imprecision
Global Perceived Effect: General Health Perception 0 worse to 100 better ( Chronic MND: Qigong Stretch/ROM + Endurance Training + Dynamic Stabilization + Cognitive (mindfulness & emotional balance) vs WAIT LIST	no estimate extracted	1 study · 70 participants	Moderate Downgraded: risk of bias, imprecision
Adverse Effects Chronic MND: Qigong Stretch/ROM + Endurance Training + Dynamic Stabilization + Cognitive (mindfulness & emotional balance) vs WAIT LIST	no estimate extracted	NR	No studies

Acute Radiculopathy: Cervical Stretch/ROM + Cervical/Scapulothoracic/UE Strengthening + Static/Dynamic Cervical Stabilization vs WAIT LIST

Population: patients with acute radiculopathy

4 questions

Outcome	Effect	Evidence	Status / GRADE
Pain Intensity: VAS 0 no pain to 10 worst pain ( Acute Radiculopathy: Cervical Stretch/ROM + Cervical/Scapulothoracic/UE Strengthening + Static/Dynamic Cervical Stabilization vs WAIT LIST	no estimate extracted	1 study · 133 participants	Low Downgraded: risk of bias
Function: NDI 0 no disability to 50 maximum disability ( Acute Radiculopathy: Cervical Stretch/ROM + Cervical/Scapulothoracic/UE Strengthening + Static/Dynamic Cervical Stabilization vs WAIT LIST	no estimate extracted	1 study · 133 participants	Low Downgraded: risk of bias
Patient Satisfaction: 5‐point scale, 1 to 5; very satisfied to unsatisfied ( Acute Radiculopathy: Cervical Stretch/ROM + Cervical/Scapulothoracic/UE Strengthening + Static/Dynamic Cervical Stabilization vs WAIT LIST	no estimate extracted	1 study · 129 participants	Low Downgraded: risk of bias
Adverse Effects Acute Radiculopathy: Cervical Stretch/ROM + Cervical/Scapulothoracic/UE Strengthening + Static/Dynamic Cervical Stabilization vs WAIT LIST	no estimate extracted	NR	No studies

Acute to subacute CGH: Cervical stretch/ROM vs SHAM

Population: patients with subAcute cervicogenic headache (CGH)

2 questions

Outcome	Effect	Evidence	Status / GRADE
Pain Intensity: VAS 0 no pain to 100 worst pain ( Acute to subacute CGH: Cervical stretch/ROM vs SHAM	no estimate extracted	1 study · 32 participants	Low
Adverse effects Acute to subacute CGH: Cervical stretch/ROM vs SHAM	no estimate extracted	NR	No studies

Chronic CGH: Cervical/Scapulothoracic Strengthening with Endurance Training + Craniocervical Pressure Biofeedback + Dynamic Cervical Stabilization vs NO INTERVENTION

Population: patients with chronic CGH

4 questions

Outcome	Effect	Evidence	Status / GRADE
Pain Intensity: VAS 0 no pain to 10 worst pain ( Chronic CGH: Cervical/Scapulothoracic Strengthening with Endurance Training + Craniocervical Pressure Biofeedback + Dynamic Cervical Stabilization vs NO INTERVENTION	no estimate extracted	1 study · 97 participants	Moderate
Function: NPNPQ 0% no disability to 100% maximum disability ( Chronic CGH: Cervical/Scapulothoracic Strengthening with Endurance Training + Craniocervical Pressure Biofeedback + Dynamic Cervical Stabilization vs NO INTERVENTION	no estimate extracted	1 study · 97 participants	Moderate
Global Perceived Effect: VAS 0 to 100 ( Chronic CGH: Cervical/Scapulothoracic Strengthening with Endurance Training + Craniocervical Pressure Biofeedback + Dynamic Cervical Stabilization vs NO INTERVENTION	no estimate extracted	1 study · 97 participants	Moderate
Adverse effects Chronic CGH: Cervical/Scapulothoracic Strengthening with Endurance Training + Craniocervical Pressure Biofeedback + Dynamic Cervical Stabilization vs NO INTERVENTION	no estimate extracted	6 participants	Ungraded

Chronic CGH: Cervical/Scapulothoracic Strengthening with Endurance Training + Craniocervical Pressure Biofeedback + Dynamic Cervical Stabilization + Manual Therapy vs Manual Therapy

Population: patients with Chronic CGH

4 questions

Outcome	Effect	Evidence	Status / GRADE
Pain Intensity: 6 weeks treatment VAS 0 no pain to 10 worst pain ( Chronic CGH: Cervical/Scapulothoracic Strengthening with Endurance Training + Craniocervical Pressure Biofeedback + Dynamic Cervical Stabilization + Manual Therapy vs Manual Therapy	no estimate extracted	1 study · 96 participants	Moderate
Function: NPNPQ 0% no disability to 100% maximum disability ( Chronic CGH: Cervical/Scapulothoracic Strengthening with Endurance Training + Craniocervical Pressure Biofeedback + Dynamic Cervical Stabilization + Manual Therapy vs Manual Therapy	no estimate extracted	1 study · 96 participants	Moderate
Global Perceived Effect: VAS 0 to 100 ( Chronic CGH: Cervical/Scapulothoracic Strengthening with Endurance Training + Craniocervical Pressure Biofeedback + Dynamic Cervical Stabilization + Manual Therapy vs Manual Therapy	no estimate extracted	1 study · 96 participants	Moderate
Adverse effects Chronic CGH: Cervical/Scapulothoracic Strengthening with Endurance Training + Craniocervical Pressure Biofeedback + Dynamic Cervical Stabilization + Manual Therapy vs Manual Therapy	no estimate extracted	6 participants	Ungraded

Chronic MND: Cervical/UE Stretch/ROM Exercise + Cervical/UE Strengthening + Dynamic Cervical Stabilization vs PLACEBO or SHAM

Population: patients with chronic MND

3 questions

Outcome	Effect	Evidence	Status / GRADE
Pain Intensity: VAS 0 no pain to 100 worst pain ( Chronic MND: Cervical/UE Stretch/ROM Exercise + Cervical/UE Strengthening + Dynamic Cervical Stabilization vs PLACEBO or SHAM	mean difference 0.26	1 study · 77 participants	Low Downgraded: risk of bias, imprecision
Function: 2 months treatment NDI 0 no disability to 50 maximum disability ( Chronic MND: Cervical/UE Stretch/ROM Exercise + Cervical/UE Strengthening + Dynamic Cervical Stabilization vs PLACEBO or SHAM	mean difference 0.12	1 study · 77 participants	Low Downgraded: risk of bias, imprecision
Adverse effects Chronic MND: Cervical/UE Stretch/ROM Exercise + Cervical/UE Strengthening + Dynamic Cervical Stabilization vs PLACEBO or SHAM	no estimate extracted	NR	No studies

Chronic MND: Cervical Stretch/ROM Exercises + Dynamic Cervical Stabilization vs SHAM

Population: patients with chronic MND

3 questions

Outcome	Effect	Evidence	Status / GRADE
Pain Intensity: VAS 0 no pain to 100 worst pain ( Chronic MND: Cervical Stretch/ROM Exercises + Dynamic Cervical Stabilization vs SHAM	mean difference 0.04	1 study · 50 participants	Low Downgraded: risk of bias, imprecision
Function: NDI 0 no disability to 50 maximum disability ( Chronic MND: Cervical Stretch/ROM Exercises + Dynamic Cervical Stabilization vs SHAM	mean difference 0.14	1 study · 50 participants	Low Downgraded: risk of bias, imprecision
Adverse effects Chronic MND: Cervical Stretch/ROM Exercises + Dynamic Cervical Stabilization vs SHAM	no estimate extracted	NR	No studies

Chronic MND: Cervical/Scapulothoracic/UE Stretch + UE Endurance Training vs NO INTERVENTION or WAIT LIST

3 questions

Outcome	Effect	Evidence	Status / GRADE
Pain Intensity: VAS 0 no pain to 100 worst pain ( Chronic MND: Cervical/Scapulothoracic/UE Stretch + UE Endurance Training vs NO INTERVENTION or WAIT LIST	mean difference 0	1 study · 393 participants	Moderate
Function: NDI 0 no disability to 50 maximum disability ( Chronic MND: Cervical/Scapulothoracic/UE Stretch + UE Endurance Training vs NO INTERVENTION or WAIT LIST	mean difference 0.07	1 study · 393 participants	Moderate
Adverse effects Chronic MND: Cervical/Scapulothoracic/UE Stretch + UE Endurance Training vs NO INTERVENTION or WAIT LIST	no estimate extracted	NR	No studies

Acute to Chronic MND: Scapulothoracic/UE Endurance Training vs CONTROL

Population: patients with Acute to Chronic MND

2 questions

Outcome	Effect	Evidence	Status / GRADE
Pain Intensity: VAS 0 no pain to 10 worst pain ( Acute to Chronic MND: Scapulothoracic/UE Endurance Training vs CONTROL	no estimate extracted	1 study · 198 participants	Moderate Downgraded: imprecision
Adverse effects Acute to Chronic MND: Scapulothoracic/UE Endurance Training vs CONTROL	no estimate extracted	2 participants	Ungraded

Subacute to Chronic WAD: Trunk/Extremity Stretch/ROM + Trunk/Extremity Strengthening + Trunk/Extremity Endurance Training + Pattern/Synchronization: Coordination + Cardiovascular/Aerobic + Cognitive (CBT) + ANOTHER TREATMENT vs THAT SAME OTHER TREATMENT

Population: patients with subacute/chronic WAD

5 questions

Outcome	Effect	Evidence	Status / GRADE
Pain Intensity: VAS 0 no pain to 10 worst pain ( Subacute to Chronic WAD: Trunk/Extremity Stretch/ROM + Trunk/Extremity Strengthening + Trunk/Extremity Endurance Training + Pattern/Synchronization: Coordination + Cardiovascular/Aerobic + Cognitive (CBT) + ANOTHER TREATMENT vs THAT SAME OTHER TREATMENT	no estimate extracted	1 study · 132 participants	Low Downgraded: risk of bias, imprecision
Function: NDI 0 no disability to 50 maximum disability ( Subacute to Chronic WAD: Trunk/Extremity Stretch/ROM + Trunk/Extremity Strengthening + Trunk/Extremity Endurance Training + Pattern/Synchronization: Coordination + Cardiovascular/Aerobic + Cognitive (CBT) + ANOTHER TREATMENT vs THAT SAME OTHER TREATMENT	no estimate extracted	1 study · 132 participants	Low Downgraded: risk of bias, imprecision
Global perceived effect: ‐5 to 5 scale; vastly worse to completely recovered ( Subacute to Chronic WAD: Trunk/Extremity Stretch/ROM + Trunk/Extremity Strengthening + Trunk/Extremity Endurance Training + Pattern/Synchronization: Coordination + Cardiovascular/Aerobic + Cognitive (CBT) + ANOTHER TREATMENT vs THAT SAME OTHER TREATMENT	no estimate extracted	1 study · 132 participants	Low Downgraded: risk of bias, imprecision
Quality of Life: SF‐36 0 high disability to 100 no disability ( Subacute to Chronic WAD: Trunk/Extremity Stretch/ROM + Trunk/Extremity Strengthening + Trunk/Extremity Endurance Training + Pattern/Synchronization: Coordination + Cardiovascular/Aerobic + Cognitive (CBT) + ANOTHER TREATMENT vs THAT SAME OTHER TREATMENT	no estimate extracted	1 study · 132 participants	Low Downgraded: risk of bias, imprecision
Adverse effects Subacute to Chronic WAD: Trunk/Extremity Stretch/ROM + Trunk/Extremity Strengthening + Trunk/Extremity Endurance Training + Pattern/Synchronization: Coordination + Cardiovascular/Aerobic + Cognitive (CBT) + ANOTHER TREATMENT vs THAT SAME OTHER TREATMENT	no estimate extracted	2 studies · 3 participants	Ungraded

Acute to Chronic MND: Scapulothoracic + UE Strengthening vs CONTROL

Population: patients with Acute to Chronic MND

6 questions

Outcome	Effect	Evidence	Status / GRADE
Pain Intensity: VAS 0 no pain to 100 worst pain ( Acute to Chronic MND: Scapulothoracic + UE Strengthening vs CONTROL	no estimate extracted	3 studies · 157 participants	Moderate Downgraded: imprecision, inconsistency, indirectness
Pain Intensity: VAS 0 no pain to 100 worst pain ( Acute to Chronic MND: Scapulothoracic + UE Strengthening vs CONTROL	no estimate extracted	1 study · 163 participants	Very low Downgraded: imprecision, inconsistency, indirectness
Pain Intensity: VAS 0 no pain to 100 worst pain ( Acute to Chronic MND: Scapulothoracic + UE Strengthening vs CONTROL	no estimate extracted	1 study · 26 participants	Low Downgraded: imprecision, inconsistency, indirectness
Function: DASH 20% no difficulty to 100% fully unable ( Acute to Chronic MND: Scapulothoracic + UE Strengthening vs CONTROL	no estimate extracted	1 study · 163 participants	Very low Downgraded: imprecision, inconsistency, indirectness
Work ability index: 7 poor ability to 49 excellent ability treatment ( Acute to Chronic MND: Scapulothoracic + UE Strengthening vs CONTROL	no estimate extracted	1 study · 88 participants	Low Downgraded: imprecision, inconsistency, indirectness
Adverse effects Acute to Chronic MND: Scapulothoracic + UE Strengthening vs CONTROL	no estimate extracted	NR	No studies