Implementation of neck/shoulder rehabilitation in primary health care clinics.
OBJECTIVE
To provide primary health care practitioners with the practical information necessary to implement rehabilitation of patients with neck/shoulder pain in clinical facilities. Equipment and program design are discussed in detail.


METHODS
A Medline literature search was performed. English and Scandinavian language references were included in the review. Key words included neck/shoulder pain, neck pain, rehabilitation, equipment, exercise.


METHODS
The studies selected included clinical trials in which rehabilitation was the main intervention in the treatment of patients with neck/shoulder pain.


RESULTS
Reestablishing functional capacities of the musculature of the cervical spine can be accomplished with modest equipment and can be easily incorporated into the clinical setting. The extensors of the cervical spine are the most important muscle group that require rehabilitation and exhibit the highest values in all strength parameters. High-intensity rehabilitative protocols accompanied by the encouragement of fellow patients and support from personnel are essential for treatment success.


CONCLUSIONS
Complete primary health care treatment of patients with chronic, recurrent and post-traumatic neck/shoulder pain will necessitate longer rehabilitation programs. Future studies will provide additional information regarding specific program design.
National University Hospital, Copenhagen, Denmark.
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Jordan
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Ostergaard
D018771:Arthralgia / Q000534:rehabilitation*; D002684:Chiropractic / Q000379:methods*; D015444:Exercise; D006801:Humans; D010146:Pain / Q000534:rehabilitation*; D011320:Primary Health Care; D015397:Program Evaluation; D012785:Shoulder Joint