title: Effect of therapeutic exercise on pain and disability in the management of chronic nonspecific neck pain: systematic review and meta-analysis of randomized trials.
abstract: BACKGROUND
  Given the prevalence of chronic nonspecific neck pain (CNSNP) internationally, attention has increasingly been paid in recent years to evaluating the efficacy of therapeutic exercise (TE) in the management of this condition.
  
  
  OBJECTIVE
  The purpose of this study was to conduct a current review of randomized controlled trials concerning the effect of TE on pain and disability among people with CNSNP, perform a meta-analysis, and summarize current understanding.
  
  
  METHODS
  Data were obtained from MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Physiotherapy Evidence Database (PEDro), and Cochrane Central Register of Controlled Trials (CENTRAL) databases from their inception to August 2012. Reference lists of relevant literature reviews also were tracked.
  
  
  METHODS
  All published randomized trials without any restriction regarding time of publication or language were considered for inclusion. Study participants had to be symptomatic adults with only CNSNP.
  
  
  METHODS
  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.
  
  
  RESULTS
  Seven studies met the inclusion criteria. Therapeutic exercise proved to have medium and significant short-term and intermediate-term effects on pain (g=-0.53, 95% confidence interval [CI]=-0.86 to -0.20, and g=-0.45, 95% CI=-0.82 to -0.07, respectively) and medium but not significant short-term 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, respectively).
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Physical Therapy, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Bertozzi
authors.forename: Ivan
authors.initials: I
authors.lastname: Gardenghi
authors.forename: Francesca
authors.initials: F
authors.lastname: Turoni
authors.forename: Jorge Hugo
authors.initials: JH
authors.lastname: Villafañe
authors.forename: Francesco
authors.initials: F
authors.lastname: Capra
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Guccione
authors.forename: Paolo
authors.initials: P
authors.lastname: Pillastrini
mesh_terms: D002908:Chronic Disease; D006233:Persons with Disabilities / Q000534:rehabilitation*; D019468:Disease Management; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D019547:Neck Pain / Q000534:rehabilitation*; D059408:Pain Management / Q000379:methods; D026741:Physical Therapy Modalities; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic