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Exercises for mechanical neck disorders

  1. Theresa M Kay1,*,
  2. Anita Gross2,
  3. Charles H Goldsmith3,
  4. Jan L Hoving4,
  5. Gert Brønfort5

Editorial Group: Cochrane Back Group

Published Online: 7 OCT 2009

Assessed as up-to-date: 29 FEB 2004

DOI: 10.1002/14651858.CD004250.pub3

Database Title

Additional Information

How to Cite

Kay TM, Gross A, Goldsmith CH, Hoving JL, Brønfort G. Exercises for mechanical neck disorders. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD004250. DOI: 10.1002/14651858.CD004250.pub3.

Author Information

  1. 1

    Baycrest - Geriatric Health Care System, Clinical Programs and Collaborative Practice, Toronto, ON, Canada

  2. 2

    McMaster University, School of Rehabilitation Science & Dept Clinical Epidemiology and Biostatistics, Hamilton, Ontario, Canada

  3. 3

    McMaster University, Department of Clinical Epidemiology & Biostatistics, Hamilton, Ontario, Canada

  4. 4

    Academic Medical Center, Universiteit van Amsterdam, Coronel Institute of Occupational Health, Amsterdam, Netherlands

  5. 5

    Northwestern Health Sciences University, Wolfe-Harris Center for Clinical Studies, Bloomington, MN, USA

*Theresa M Kay, Clinical Programs and Collaborative Practice, Baycrest - Geriatric Health Care System, 3560 Bathurst Street, Room 283, Brain Health Centre, Toronto, ON, M6A 2E1, Canada. tkay@baycrest.org.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 7 OCT 2009

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Allison 2002 {published data only}
Allison 2002:AT v CG {published data only}
  • refer to Allison 2002.
Allison 2002:AT v NT {published data only}
  • refer to Allison 2002.
Brodin 1985 {published data only}
Brodin 1985: 2 v 1 {published data only}
  • refer to Brodin 1985.
Brodin 1985: 3 v 1 {published data only}
  • refer to Brodin 1985.
Brodin 1985: 3 v 2 {published data only}
  • refer to Brodin 1985.
Bronfort 2001 {published data only}
  • Bronfort G, Aker PD, Evans R, Goldsmith CH, Nelson B, Vernon H. A randomized controlled clinical trial of rehabilitative exercise and chiropractic spinal manipulation for chronic neck pain. Spine 2001;26(7):788-99.
  • Bronfort G, Evan R, Nelson B. Aker PD, Goldsmith CH, Vernon H. A randomized controlled clinical trial of spinal manipulation and exercise for chronic neck pain: A report on neck performance outcomes after 11 weeks and long-term effects on patient-rated outcomes. Proceedings of the Scientific symposium, 1997 World Chiropractic Congress. 1998:62-8. [: {CO97:65}]
  • Bronfort G, Evans R, Nelson B, Aker PD, Goldsmith CH, Vernon H. A randomized controlled clinical trial of rehabilitative exercise and spinal manipulation for chronic neck pain. Effects on neck pain and disability, functional health status, biomechanical neck dysfunction, and somato-visceral symptoms. Proceedings of the 1998 International Conference of Spinal Manipulation. 1998:67-70. [: {CO97:310}]
Bronfort: MedX v SMT {published data only}
  • refer to Bronfort 2001.
Bronfort:SMT/ExvMedX {published data only}
  • refer to Bronfort 2001.
Brontfort:SMT/ExvSMT {published data only}
  • refer to Bronfort 2001.
Fitz-Ritson 1995 {published data only}
Gam 1998 {published data only}
  • Gam AN, Warming S, Larsen LH, Jensen B, Hoydalsmo O, Allon I, et al. Treatment of myofascial trigger-points with ultrasound combined with massage and exercise - a randomised controlled trial. Pain 1998;77:73-9. [: CO2002]
Gam SUSvsCG {published data only}
  • refer to Gam 1998.
Gam USvCG {published data only}
  • refer to Gam 1998.
Geibel 1997 {published data only}
  • Giebel GD, Edelmann M, Huser R. Die distorsion der halswirbelsaule: Fruhfunktionalle vs. ruhigstellende behandlung. Zentralbl Chir 1997;122:517-21.
Goldie 1970 {published data only}
  • Goldie I, Landquist A. Evaluation of the effects of different forms of physiotherapy in cervical pain. Scand J Rehab Med 1970;2-3:117-21.
Goldie: ex v cnt {published data only}
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Goldie: ex v trac {published data only}
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Hagberg 2000 {published data only}
  • Hagberg M, Harms-Ringdahl K, Nisell R, Hjelm EW. Rehabilitation of neck-shoulder pain in women industrial workers: A randomized trial comparing isometric shoulder endurance training with isometric shoulder strength training. Arch Phys Med Rehabil 2000;81:1051-8.
Hanten 2000 {published data only}
  • Hanten WP, Olson SL, Butts NL, Nowicki AL. Effectiveness of a home program of ischemic pressure followed by sustained stretch for treatment of myofascial trigger points. Physical Therapy 2000;80(10):997-1003.
Hoving 2002 {published data only}
  • Hoving JL, de Vet HCW, Koes BW, van Mameren H, Deville WJLM, van der Windt DAWM, et al. Manual therapy, physical therapy, or continued care by the general practitioner for patients with neck pain: long-term results from a pragmatic randomized trial. In: Hoving JL editor(s). 1st Edition. Wageningen: Pons & Looijen bv, 2001:59-73. [: CO97]
  • Hoving JL, Koes BW, de Vet HCW, van der Windt DAWM, Assendelft WJJ, van Mameren H, et al. Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain. Annals of Internal Medicine 2002;136(10):713-22. [: CO2002]
  • Korthals-de Bos IBC, Hoving JL, van Tulder MW, Rutten-van Molken MPMH, Ader HJ, de Vet HCW, et al. Manual therapy is more cost-effective than physical therapy and GP care for patients with neck pain. In: Hoving JL editor(s). 1st Edition. Wageningen: Pons & Looijen bv, 2001:75-90. [: CO97]
Hoving 2002: GP v MT {published data only}
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Hoving 2002: PT v GP {published data only}
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Hoving 2002: PT v MT {published data only}
  • refer to Hoving 2002.
Jordan 1998 {published data only}
  • Jordan A, Bendix T, Nielsen H, Hansen FR, Host D, Winkel A. Intensive training, physiotherapy, or manipulation for patients with chronic neck pain: A prospective single-blind randomized clinical trial. Spine 1998;23(3):311-9.
  • Jordan A, Bendix T, Nielsen H, Hansen FR, Host D, Winkel A. Intensive training, physiotherapy, or manipulation for patients with chronic neck pain. A prospective single-blind randomized clinical trial.. Proceedings of the 1996 International conference on spinal manipulation. 1996.
Jordan 1998: Int vCH {published data only}
  • refer to Jordan 1998.
Jordan 1998:CHvPT {published data only}
  • refer to Jordan 1998.
Jordan 1998:Int v PT {published data only}
  • refer to Jordan 1998.
Jull 2002 {published data only}
  • Jull G, Trott P, Potter H, Zito G, Niere K, Shirley D, et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine 2002;27(17):1835-43. [: CO2002]
Jull 2002:ExT v Cntl {published data only}
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Jull 2002:ExT v MT {published data only}
  • refer to Jull 2002.
Jull 2002:MTExT v MT {published data only}
  • refer to Jull 2002.
Jull 2002:MTExT vExT {published data only}
  • refer to Jull 2002.
Jull 2002:MTExTvCntl {published data only}
  • refer to Jull 2002.
Karlberg 1996 {published data only}
  • Karlberg M, Magnusson M, Eva-Maj M, Melander A, Moritz U. Postural and symptomatic improvement after physiotherapy in patients with dizziness of suspected cervical origin. Archives of Physical Medicine and Rehabilitation 1996;77:874-82. [: {CO97:262}]
Koes 1992 {published data only}
  • Koes B. A randomized clinical trial of manual therapy and physiotherapy for persistent back and neck complaints. Subgroup analysis and relationship between outcomes measure. Journal of Manipulative and Physiological Therapeutics 1993;16(4):211-9. [: {CO97:2320}]
  • Koes B, Bouter LM, Knipshild PG. The effectiveness of manual therapy, physiotherapy and continued treatment by general practitioner for chronic nonspecific back and neck complaints. Journal of Manipulative and Physiological Therapeutics 1991;14(9):498-502. [: {C097:3285}]
  • Koes BW. Efficacy of manual therapy and physiotherapy for back and neck complaints (Thesis). den Haag: Cip-Gegevens Koninklijke Bibliotheek, 1992a. [: {CO97:124}]
  • Koes BW, Bouter LM, van Mameren H, Esser AH, Verstegen GH, Hofhuizen DM, et al. Randomized clinical trial of manual therapy and physiotherapy for persistent back and neck complaints. Manual Therapy in the Netherlands 1992d, (1):7-12. [: {CO97:128}]
  • Koes BW, Bouter LM, van Mameren H, Esser AH, Verstegen GM, Hofhuizen DM, et al. A blind randomized clinical trial of manual therapy and physiotherapy for chronic back and neck complaints: Physical outcome measures. J Manipulative Physiol Ther 1992e;15(1):16-23. [: {CO97:126}]
  • Koes BW, Bouter LM, van Mameren H, Esser AH, Verstegen GM, Hofhuizen DM, et al. Randomized clinical trial of manipulative therapy and physiotherapy for persistent back and neck complaints: results of one year follow up. BMJ 1992b;304(6827):601-5. [: {CO97:127}]
  • Koes BW, Bouter LM, van Mameren H, Essers AH, Verstegen GM, Hofhuizen DM, et al. The effectiveness of manual therapy, physiotherapy, and treatment by the general practitioner for nonspecific back and neck complaints. Spine 1992c;17(1):28-35. [: {CO97:129}]
Koes 1992: GP v MT {published data only}
  • refer to Koes 1992.
Koes 1992: GP v pl {published data only}
  • refer to Koes 1992.
Koes 1992: PT v GP {published data only}
  • refer to Koes 1992.
Koes 1992: PT v pl {published data only}
  • refer to Koes 1992.
Koes 1992:PT v MT {published data only}
  • refer to Koes 1992.
Kogstad 1978 {published data only}
  • Kogstad OA, Karterud S, Gudmundsen J. Cervicobrachialgia. A controlled trial with conventional treatment and manipulation. Tidiskr Nor Loegeforen 1978;98(16):845-8. [: CO2002:]
Kogstad 1978:CT v MT {published data only}
  • refer to Kogstad 1978.
Kogstad 1978:CT v Pl {published data only}
  • refer to Kogstad 1978.
Levoska 1993 {published data only}
  • Levoska S, Keinanen-Kiukaanneimi S. Active or passive physiotherapy for occupational cervicobrachial disorders? A comparison of two treatment methods with a 1-year follow-up. Arch Phys Med Rehabil 1993;74:425-30.
Lundblad 1999 {published data only}
  • Lundblad I, Elert J, Gerdle B. Randomized Controlled Trial of Physiotherapy and Feldenkrais Interventions in Female Workers with Neck-Shoulder Complaints. Journal of Occupational Rehabilitation 1999;9(3):179-94.
Lundblad 1999: PTvCG {published data only}
  • refer to Lundblad 1999.
Lundblad 1999: PTvFG {published data only}
  • refer to Lundblad 1999.
McKinney 1989 {published data only}
McKinney 1989: 2 v 1 {published data only}
  • refer to McKinney 1989.
McKinney 1989: 2 v 3 {published data only}
  • refer to McKinney 1989.
McKinney 1989: 3 v 1 {published data only}
  • refer to McKinney 1989.
Mealy 1986 {published data only}
  • Mealy K, Brennan H, Fenelon GC. Early mobilisation of acute whiplash injuries. British Medical Journal 1986;92:656-7.
Pennie 1990 {published data only}
Persson 2001 {published data only}
  • Persson L, Karlberg M, Magnusson M. Effects of different treatments on postural performance in patients with cervical root compression. A randomized prospective study assessing the importance of the neck in postural control. Journal of Vestibular Research 1996;6(6):439-53. [: CO2002]
  • Persson LCG, Carlsson CA, Carlsson JY. Long-lasting cervical radicular pain managed with surgery, physiotherapy, or a cervical collar. A prospective, randomized study. Spine 1997;22(7):751-8. [: CO97: 324]
  • Persson LCG, Lilja A. Pain, coping, emotional state and physical function in patients with chronic radicular neck pain. A comparison between patients treated with surgery, physiotherapy or neck collar - a blinded, prospective randomized study. Disability and Rehabilitation 2001;23(8):325-35. [: CO2002:2809]
  • Persson LCG, Moritz U, Brandt L, Carlsson CA. Cervical radiculopathy: pain, muscle weakness and sensory loss in patients with cervical radiculopathy treated with surgery, physiotherapy or cervical collar. A prospective, controlled study. Eur Spine J 1997;6(4):256-66. [: CO97: 1493]
Persson 2001:PTv col {published data only}
  • refer to Persson 2001.
Persson 2001:PTvsurg {published data only}
  • refer to Persson 2001.
Provinciali 1996 {published data only}
  • Provinciali L, Baroni M, Illuminati L, Ceravolo MG. Multimodal treatment to prevent the late whiplash syndrome. Scandinavian Journal of Rehabilitation Medicine 1996;28:105-11.
Randlov 1998 {published data only}
  • Randlov A, Ostergaard M, Manniche C, Kryger P, Jordan A, Heegaard S, Holm B. Intensive dynamic training for females with chronic neck/shoulder pain. A randomized controlled trial. Clin Rehabil 1998;12(3):200-10.
Revel 1994 {published data only}
  • Revel M, Minguet M, Gergoy P, Vaillant J, Manuel JL. Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck apin: a randomized controlled study. Archives of Physical Medicine Rehabilitation 1994;75:895-9.
Rosenfeld 2000 {published data only}
Rosenfeld:DExvDED {published data only}
  • refer to Rosenfeld 2000.
Rosenfeld:DExvEED {published data only}
  • refer to Rosenfeld 2000.
Rosenfeld:EExvDED {published data only}
  • refer to Rosenfeld 2000.
Rosenfeld:EExvDEx {published data only}
  • refer to Rosenfeld 2000.
Rosenfeld:EExvEED {published data only}
  • refer to Rosenfeld 2000.
Soderlund 2000 {published data only}
  • Soderlund A, Lindberg P. Acute whiplash-associated disorders (WAD): the effects of early mobilization and prognostic factors in long-term symptomatology. Clinical Rehabilitation 2000;14:457-67. [: CO2002]
Soderlund 2001 {published data only}
  • Soderlund A, Lindberg P. Cognitive Behavioural Components in Physiotherapy Management of Chronic Whiplash Associated Disorders (WAD) - A Randomised Group Study. Physiotherapy Theory and Practice 2001;17:229-38.
Taimela 2000 {published data only}
Taimela:Activevcontr {published data only}
  • refer to Taimela 2000.
Taimela:Activevhome {published data only}
  • refer to Taimela 2000.
Taimela:Homevcontrol {published data only}
  • refer to Taimela 2000.
Takala 1994 {published data only}
  • Takala EP, Viikari-Juntura E, Tynkkynen EM. Does group gymnastics at the workplace help in neck pain? A controlled study. Scandinavian Journal of Rehabilitation Medicine 1994;26:17-20.
Vasseljen 1995 {published data only}
  • Vasseljen O, Johansen BM, Westgaard RH. The effect of pain reduction on perceived tension and EMG-recoded trapezius muscle activity in workers with shoulder and neck pain. 1995; 27:243-252. Scandinavian Journal of Rehabilitation Medicine 1995;27:243-52.
Waling 2002 {published data only}
Waling 2002:Co v C {published data only}
  • refer to Waling 2002.
Waling 2002:EvC {published data only}
  • refer to Waling 2002.
Waling 2002:SvC {published data only}
  • refer to Waling 2002.
Ylinen 2003 {published data only}
Ylinen 2003: EvC {published data only}
  • refer to Ylinen 2003.
Ylinen 2003: SvC {published data only}
  • refer to Ylinen 2003.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Bissett 1985 {published data only}
  • Bissett A, Mitchell KR, Major G. The cervico-brachial pain syndrome: Muscle activity and pain relief. Behaviour Change 1985;2(2):129-35.
Brewerton 1966 {published data only}
  • Brewerton DA. Pain in the neck and arm: a multicentre trial of the effects of physiotherapy: Arranged by the British Association of Physical Medicine. BMJ 1966;1:253-8.
Carlsson 1990 {published data only}
  • Carlsson J, Fahlcrantz A, Augustinsson L. Muscle tenderness in tension headache treated with acupuncture or physiotherapy. Cephalgia 1990;10(3):131-41.
    Direct Link:
Foley-Nolan 1992 {published data only}
  • Foley-Nolan D, Moore K, Codd M, Barry C, O'Connor P, Coughlan RJ. Low energy high frequency pulsed electromagnetic therapy for acute whiplash injuries: A double blind randomized controlled study. Scandinavian Journal of Rehabilitation Medicine 1992;24:51-9. [: CO97;61]
Friedrich 1996 {published data only}
  • Friedrich M, Cermak T, Maderbacher P. The effect of brochure use versus therapist teaching on patients performing therapeutic exercise and on changes in impairment status. Physical Therapy 1996;76(10):1082-8.
Hanten 1997 {published data only}
  • Hanten WP, Barrett M, Gillespie-Plesko M, Jump KA, Olson SL. Effects of active head retraction with retraction/extension and occipital release on the pressure pain threshold of cervical and scapular trigger points. Physiotherapy Theory and Practice 1997;13:285-91. [: CO2002]
Herring 1992 {published data only}
  • Herring C. The effects of controlled passive mobilization and controlled passive stretch on cervical intersegmental hypermobility in acute cervical strain/sprain injuries. Transactions of the consortium for chiropractic research. 1992:28.
Highland 1992 {published data only}
  • Highland TR, Dreisinger TE, Vie LL, Russell GS. Changes in isometric strength and range of motion of the isolated cervical spine after eight weeks of clinical rehabilitation. Spine 1992;17(6):S77-S82.
Hurwitz 2002 {published data only}
  • Hurwitz EL, Morgenstern H, Harber P, Kominski GF, Yu F, Adams AH. A Randomized Trial of Chiropractic Manipulation and Mobilization for Patients With Neck Pain: Clinical Outcomes From the UCLA Neck-Pain Study. Research and Practice 2002;92(10):1634-41. [: CO2002:]
Kamwendo 1991 {published data only}
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Linton 2001a {published data only}
Nordemar 1981 {published data only}
Rundcrantz 1991 {published data only}
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Skargren 1997 {published data only}
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  • Skargren EI, Oberg BE, Carlsson PG, Gade M. Cost and effectiveness analysis of chiropractic and physiotherapy treatment for low back and neck pain: Six-month follow-up. Spine 1997;22(18):2167-71. [: CO2002;CO97]

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Guerriero 1997 {published data only}
  • Guerriero D. Comparative effects of manipulation and physical therapy on motion in the cervical spine. Proceedings of the International Conference on Spinal Manipulation. 1991.
Gurumoorthy 2000 {published data only}
  • Gurumoorthy D, Twomey L.T, Batalin N.J. A prospective study of acute whiplash injury and its clinical management. Internation Federation of Manipulation Therapy, 7th Scientific Conference. November 2000:Abstract 78. [: CO2002]
Reginiussen 2000 {published data only}
  • Reginiussen T, Johnsen R, Torstensen TA. Efficiency of manual therapy on patients with cervicogenic headache. A randomized single blinded controlled trial. Internation Federation of Manipulation Therapy, 7th Scientific Conference. November 2000:Abstract 105.
Stokke 1995 {published data only}
  • Stokke O. A randomized comparison of chiropractic and physiotherapy treatment of neck pain of functional (Mechanical) Origins: A controlled clinical trial. Conference Proceedings of the Chiropractic Centennial Foundation. 1995:372-3.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Australian Guideline 2003
  • Australian Acute Musculoskeletal Pain Guidelines Group, Australian National Health and Medical Research Council. Evidence-Based Management of Acute Musculoskeletal Pain. Brisbane: Australian Academic Press (www.australianacademicpress.com.au), December 2003.
Borghouts 1998
Borghouts 1999
Bronfort 2004
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Cicchetti 1976
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Côté 1998
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Dupont 1990
Goldsmith 1993
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Gross 2002
Gross 2002b
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Gross 2004
  • Gross AR, Hoving JL, Haines TA, Goldsmith CH, Kay T, Aker P, et al. Manipulation and mobilisation for mechanical neck disorders. Cochrane Database of Systematic Reviews 2004, Issue 1. [Art. No.: CD004249. DOI: ]
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Stratford 1999
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References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Aker 1996
Gross 1996
  • Gross AR, Aker PD, Goldsmith CH, Peloso P. Conservative management of mechanical neck disorders: A meta-analysis. Online J Curr Clin Trials 1996 July 30;5:Doc No 200-1.
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