[Assessment of active exercises in cervical pain syndrome].
OBJECTIVE
The goals of the research were: a) to identify possible serious and specific causes of neck pain; b) to identify psychological and social barriers for recovery; c) to determine the degree of dysfunction caused by nonspecific neck pain; d) reduce pain; e) improve functioning and reduce disablement; f) prevent recurrences and development of chronic forms. ATTENDEES AND METHODS: As a sample for this research we selected patients with the verified neck pain syndrome, 120 of them in total which we divided into two groups with 60 patients. One group is treated with the classic rehabilitation method and the other cohort underwent active exercises during a six months period. For testing we used WAD scale and NDI questionnaires, which are approved all around the world and described in available literature.


RESULTS
In the time period from January 3rd until December 31st 2006 there was a total of 6163 specialist evaluations, first or control ones. During the same time period physical rehabilitation started 516 patients with the neck pain syndrome from which: 426 women (82.3%) and 90 men (17.7%). Majority of patients axial neck pain was diagnosed or not complicated neck pain syndrome (G 54.2), but for the patient in Center for physical rehabilitation much more frequent is cervical brachial compared to the reference data. In baseline, demographic and clinical data for the 120 respondents did not have significant statistical deviations. Average patient's age is 47 years, with very low variation coefficient. Variation coefficient; V(A) = 13 % (very low) V(B) = 13% (very low). Also within baseline, the pain (VAS) and self estimated functionality impairment (NDI), was also similar for both groups. All respondents N = 120 had the initial evaluation of functioning status 3. After 6 months reevaluation we gave significant differences in clinical state levels of the patients from the training (A) and the control group (B). If we analyze the relationship between frequencies, we can conclude that the patients--but not all, which exercised in their homes, have better functional status and reduced pain, and 10% of them did not have any problems. But, also 15% of patients that did not exercise within home program have improvement in clinical status, which can be explained with the usual, spontaneous remission of the neck pain syndrome.


CONCLUSIONS
According to the results of the conducted research, continuous and long lasting exercised to strengthen the neck muscled with the home exercise program are efficient in the treatment of patients suffering from neck pain syndrome. Ten percent of the patients that exercised did not feel the subjective problems, which 60% of them had significant reduction of pain, reduction in use of analgesics and anti rheumatic medications, with improvement in local and general functioning status as well as daily activities in life and work, and that is statistically highly significant advantage compared to the patients that did not exercise. Work in the department of physical and family medicine, organized at the local community level, provides good basis for the scientific research and possibility to implement prevention programs, with necessary interdisciplinary and cooperation between teams. The perspectives are the following: In general, evidence degree for a neck pain is quite low. Determination of guidelines for better systematization of therapy is important prerequisite for the future efficacy researches of various concepts.
Karić-Skrijelj
Mediha
M
Medicinski fakultet Univerziteta u Sarajevu.
Majić
Izet
I
Vavra-Hadziahmetović
Narcisa
N
Skopljak
Amira
A
Pasagić
Almir
A
D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology / Q000534:rehabilitation*; D013577:Syndrome