Efficacy of a proprioceptive exercise program in patients with nonspecific neck pain. A randomized controlled trial.

BACKGROUND Nonspecific neck pain is associated with chronic pain, disability, reduced cervical mobility, postural control disorders and impaired proprioceptive control. AIM To compare the effectiveness of two therapeutic exercise programs (i.e. cervical proprioception and cervical mobility) in reducing pain and disability in individuals with nonspecific neck pain. We further aimed to compare the effectiveness of the two treatments in improving pressure pain threshold, cervical range of motion and head repositioning accuracy. DESIGN Randomized controlled trial. SETTING Private rehabilitation clinic. POPULATION Forty-two participants diagnosed with nonspecific neck pain, aged 18-65 years, were randomized to a Cervical Mobility Group (n=22) or a Proprioception Group (n=20). METHODS The Cervical Mobility Group combined a passive treatment and active mobility exercises, whereas the Proprioception Group combined a passive treatment and proprioceptive exercises. Pain intensity, disability, pressure pain threshold, range of motion, and head repositioning accuracy were assessed at baseline and after 10 sessions. RESULTS Pain intensity and disability significantly improved for both interventions (p<0.01), but such improvement was greater for pain intensity in the Proprioception Group than in the Cervical Mobility Group (p<0.01). Pressure pain threshold, range of motion and head repositioning accuracy improved only in the Proprioception Group (p<0.01). CONCLUSIONS A program based on cervical proprioception exercises improves pain, disability, pressure pain threshold, range of motion and head repositioning accuracy in patients with nonspecific neck pain. However, a program based on cervical mobility exercises only improves pain intensity and disability, while such improvement is not clinically relevant. CLINICAL REHABILITATION IMPACT The proprioceptive exercise program may be considered as the treatment of choice in patients with nonspecific neck pain.