OBJECTIVE: To analyse effects and dose-response-relationship of the most effective exercises for improving pain and disability in people with chronic non-specific neck pain. DESIGN: Intervention systematic review with meta-analysis. LITERATURE SEARCH: We searched the PubMed, PEDro, and CENTRAL databases to 30.09.2022. STUDY SELECTION CRITERIA: Randomized controlled trials that involved people with chronic neck pain adopting a longitudinal exercise intervention and assessed one pain and/or disability outcome were included. DATA SYNTHESIS: Restricted maximum-likelihood random-effects meta-analyses were modelled separately for resistance, mindfulness-based and motor control exercise; standardized mean differences (Hedge's g, SMD) were effect estimators. Meta-regressions (dependent variable: effect sizes of the interventions; independent variables: training dose and control group effects) were conducted to explore the dose-response-relationship for therapy success of any exercise type. RESULTS: We included 68 trials. Compared to true control, effects on pain and disability were significantly larger for resistance exercise (pain: SMD -1.27 (95% CI -2.26 to -0.28), I2 96%, disability: -1.76 (-3.16 to -0.37), I2 98%), motor control exercise (pain: -2.29 (-3.82 to -0.75), I2 98%, disability: -2.42 (-3.38 to -1.47), I2 94%), and Yoga/Pilates/TaiChi/QuiGong (pain: 1.91 (-3.28 to -0.55), I2 96%, disability: -0.62 (-0.85 to -0.38), I2 0%). Yoga/Pilates/TaiChi/QuiGong was more effective than other exercises (-0.84 (-1.553 to -0.13), I2 86%) for reducing pain. For disability, motor control exercise was superior to other exercises (-0.70 (-1.23 to -0.17), I2 98%). There was no dose-response-relationship for resistance exercise (R2 = 0.32). Higher frequencies (estimate -0.10) and longer durations (estimate -0.11) of motor control exercise had larger effects on pain (R2 0.72). Longer sessions (estimate -0.13) of motor control exercise had larger effects on disability (R2 0.61). CONCLUSION: Resistance, mindfulness-based and motor control exercise were effective for reducing neck pain (very low to moderate certainty evidence). Higher frequencies and longer duration of sessions had a significant effect on pain for motor control exercise.

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