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Effect of therapeutic exercise on pain and disability in the management of chronic nonspecific neck pain: systematic review and meta-analysis of randomized trials
Bertozzi L, Gardenghi I, Turoni F, Villafane JH, Capra F, Guccioni AA, Pillastrini P
Physical Therapy 2013 Aug;93(8):1026-1036
systematic review

BACKGROUND: Given the prevalence of chronic non-specific neck pain (CNSNP) internationally, attention has increasingly been paid in recent years to evaluate the efficacy of therapeutic exercise (TE) with this condition. PURPOSE: The purpose of this study was to conduct a current review of RCTs concerning the effect of TE on pain and disability among people with CNSNP, perform a meta-analysis, and summarize current understanding. DATA SOURCES: Data were obtained from Medline, CINAHL, Embase, PEDro, and CENTRAL databases from their inception to August 2012. Reference lists of relevant literature reviews were also tracked. STUDY SELECTION: All published randomized trials without any restriction regarding time of publication or language were considered for inclusion. Study subjects had to be symptomatic adults with only CNSNP. DATA EXTRACTION: Two reviewers independently selected the studies, conducted the quality assessment, and extracted the results. Data were pooled in a meta-analysis using a random-effects model. DATA SYNTHESIS: Seven studies met inclusion criteria. TE proved to have medium significant short and intermediate term effects on pain (g = -0.53, 95% CI -0.86 to -0.20, and g = -0.45, 95% CI -0.82 to -0.07 respectively) and medium but not significant short and intermediate term effects on disability (g = -0.39, 95%CI -0.86 to 0.07, and g = -0.46, 95% CI -1.00 to -0.08). LIMITATIONS: Only one study investigated the effect of TE on pain and disability at follow-up longer than 6 months after intervention. CONCLUSIONS: Consistent with other reviews, the results support the use of TE in the management of CNSNP. In particular, a significant overall effect size was found supporting TE for its effect on pain in both the short and intermediate terms.

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