title: Effect of neck exercises on cervicogenic headache: a randomized controlled trial.
abstract: OBJECTIVE
  To compare the efficacy of three 12-month training programmes on headache and upper extremity pain in patients with chronic neck pain.
  
  
  METHODS
  A total of 180 female office workers, with chronic, non-specific neck pain were randomly assigned to 3 groups. The strength group performed isometric, dynamic and stretching exercises. The endurance group performed dynamic muscle and stretching exercises. The control group performed stretching exercises. Pain was assessed with a visual analogue scale. Each group was divided into 3 subgroups according to headache intensity.
  
  
  RESULTS
  At the 12-month follow-up headache had decreased by 69% in the strength group, 58% in the endurance group and 37% in the control group compared with baseline. Neck pain diminished most in the strength group with the most severe headache (p < 0.001). In the dose analysis, one metabolic equivalent per hour of training per week accounted for a 0.6-mm decrease in headache on the visual analogue scale. Upper extremity pain decreased by 58% in the strength group, 70% in the endurance group and 21% in the control group.
  
  
  CONCLUSIONS
  All of the training methods decreased headache. However, stretching, which is often recommended for patients, was less effective alone than when combined with muscle endurance and strength training. Care must be taken in recommending the type of training to be undertaken by patients with severe cervicogenic headache.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Central Hospital of Central Finland, Jyväskylä, Finland. jari.ylinen@ksshp.fi
authors.forename: Jari
authors.initials: J
authors.lastname: Ylinen
authors.forename: Riku
authors.initials: R
authors.lastname: Nikander
authors.forename: Matti
authors.initials: M
authors.lastname: Nykänen
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.forename: Arja
authors.initials: A
authors.lastname: Häkkinen
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D052580:Muscle Stretching Exercises / Q000379:methods*; D019547:Neck Pain / Q000150:complications / Q000534:rehabilitation / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D059408:Pain Management; D010147:Pain Measurement; D051298:Post-Traumatic Headache / Q000209:etiology / Q000534:rehabilitation / Q000628:therapy*; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology