title: Pain education combined with neck- and aerobic training is more effective at relieving chronic neck pain than pain education alone--A preliminary randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the effect of training and pain education vs pain education alone, on neck pain, neck muscle activity and postural sway in patients with chronic neck pain.
  
  
  METHODS
  Twenty women with chronic neck pain were randomized to receive pain education and specific training (neck-shoulder exercises, balance and aerobic training) (INV), or pain education alone (CTRL). Effect on neck pain, function and Global Perceived Effect (GPE) were measured. Surface electromyography (EMG) was recorded from neck flexor and extensor muscles during performance of the Cranio-Cervical Flexion Test (CCFT) and three postural control tests (two-legged: eyes open and closed, one-legged: eyes open). Sway parameters were calculated.
  
  
  RESULTS
  Fifteen participants (CTRL: eight; INV: seven) completed the study. Per protocol analyses showed a larger pain reduction (p = 0.002) for the INV group with tendencies for increased GPE (p = 0.06), reduced sternocleidomastoid activity during the CCFT (p = 0.09), reduced sway length (p = 0.09), and increased neck extensor activity (p = 0.02) during sway compared to the CTRL group.
  
  
  CONCLUSIONS
  Pain education and specific training reduce neck pain more than pain education alone in patients with chronic neck pain. These results provide encouragement for a larger clinical trial to corroborate these observations.
authors.affiliation: Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; University College Lillebaelt, Education of Radiography, Odense, Denmark. Electronic address: kabr2@ucl.dk.
authors.forename: K
authors.initials: K
authors.lastname: Brage
authors.affiliation: Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
authors.forename: I
authors.initials: I
authors.lastname: Ris
authors.affiliation: Pain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Göttingen, Germany; Department of Neurorehabilitation Engineering, Bernstein Focus Neurotechnology, Bernstein Center for Computational Neuroscience, University Medical Center Göttingen, Georg-August University, Göttingen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Falla
authors.affiliation: Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Søgaard
authors.affiliation: Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Bergen University College, Institute of Occupational Therapy, Physiotherapy and Radiography, Department of Health Sciences, Bergen, Norway.
authors.forename: B
authors.initials: B
authors.lastname: Juul-Kristensen
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000175:diagnosis / Q000628:therapy*; D003131:Combined Modality Therapy; D004576:Electromyography; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000503:physiopathology; D019547:Neck Pain / Q000175:diagnosis / Q000628:therapy*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010353:Patient Education as Topic / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology; D018570:Risk Assessment; D016037:Single-Blind Method; D016896:Treatment Outcome
keywords: Cranio-cervical flexion; Electromyography; Neck pain; Physiotherapy