Isometric Exercise for the Cervical Extensors Can Help Restore Physiological Lordosis and Reduce Neck Pain: A Randomized Controlled Trial

American Journal of Physical Medicine & Rehabilitation. 96(9):621–626, SEP 2017

DOI: 10.1097/PHM.0000000000000698 , ,
PMID: 28118272

Issn Print: 0894-9115

Publication Date: 2017/09/01

Mahmut Alpayci

Abstract
Objective
The aim of this study was to investigate whether isometric neck extension exercise restores physiological cervical lordosis and reduces pain.

Design
Sixty-five patients with loss of cervical lordosis were randomly assigned to exercise (27 women, 7 men; mean age, 32.82 ± 8.83 yrs) and control (26 women, 5 men; mean age, 33.48 ± 9.67 yrs) groups. Both groups received nonsteroidal anti-inflammatory drugs for 10 days. The exercise group received additional therapy as a home exercise program, which consisted of isometric neck extension for 3 mos. Neck pain severity and cervical lordosis were measured at baseline and at 3 mos after baseline.

Results
Compared with baseline levels, cervical lordosis angle was significantly improved in the exercise group (P < 0.001) but not in the control group (P = 0.371) at the end of 3 mos. Moreover, the exercise group was significantly superior to the control group considering the number of patients in whom cervical lordosis angle returned to physiological conditions (85.2% vs. 22.5%; P < 0.001). At the end of 3 mos, pain intensity was significantly reduced in both groups compared with baseline levels (for all, P < 0.001). Nevertheless, considering the change from baseline to month 3, the reduction in pain was about twice in the exercise group compared with the control group (P < 0.001).

Conclusions
Isometric neck extension exercise improves cervical lordosis and pain.

Journal Reference

From the article: All participants were contacted by telephone two times a month to increase their motivation. To improve exercise adherence, a simple exercise protocol was designed and an education including combination of theoretical knowledge and practical application of exercise was given to the exercise group. During exercise, the patients sat in an upright position and placed their hands at the back of the head. The patients then tried to push the head backward while resisting backward motion with the hands (3  30 secs/day). The erect posture of the spine and neutral head position were maintained throughout the exercise. Written instructions were provided to all patients in the exercise group to perform a 3-mo period of exercise on their own.

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