Exercises for mechamical neck disorders

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Kay TM et al (2005) reviewed assess the effectiveness of exercise therapy to relieve pain, or improve function, disability, patient satisfaction, and global perceived effect in adults with mechanical neck disorders (MND).
They found:
1. Specific exercises may be effective for the treatment of acute and chronic MND, with or without headache.
2. To be of benefit, a stretching and strengthening exercise program should concentrate on the musculature of the cervical, shoulder-thoracic area, or both.
3. A multimodal care approach of exercise, combined with mobilisation or manipulation for subacute and chronic MND with or without headache, reduced pain, improved function, and global perceived effect in the short and long term.
4. The relative benefit of other treatments (such as physical modalities) compared with exercise or between different exercise programs needs to be explored.

The evidences they found are:
1. There is limited evidence of benefit that acute range of motion (AROM) may reduce pain in acute MND (whiplash associated disorder (WAD)) in the short term.
2. There is moderate evidence of benefit that neck strengthening exercises reduce pain, improve function and global perceived effect for chronic neck disorder with headache in the short and long term.
3. There is unclear evidence regarding the impact of a stretching and strengthening program on pain, function and global perceived effect for MND.
4. However, when this stretching and strengthening program focuses on the cervical or cervical and shoulder/thoracic region, there is moderate evidence of benefit on pain in chronic MND and neck disorder plus headache, in the short and long term.
5. There is strong evidence of benefit favouring a multimodal care approach of exercise combined with mobilisation or manipulation for subacute and chronic MND with or without headache, in the short and long term.
6. A program of eye fixation or proprioception exercises imbedded in a more complete program shows moderate evidence of benefit for pain, function, and global perceived for chronic MND in the short term, and on pain and function for acute and subacute MND with headache or WAD in the long term.
7. There is limited evidence of benefit on pain relief in the short term for a home mobilisation program with other physical modalities over a program of rest then gradual mobilisation for acute MND or WAD.
8. There was evidence of no difference between the different exercise approaches.

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