title: Comparison of cranio-cervical flexion training versus cervical proprioception training in patients with chronic neck pain: A randomized controlled clinical trial.
abstract: OBJECTIVE
  To compare the effects of cranio-cervical flexion vs cervical proprioception training on neuromuscular control, pressure pain sensitivity and perceived pain and disability in patients with chronic neck pain.
  
  
  METHODS
  Twenty-eight volunteers with chronic non-specific neck pain were randomly assigned to 1 of 2 interventions and undertook 6 physiotherapist-supervised sessions over a period of 2 months. Both groups performed daily home exercise. Performance on the cranio-cervical flexion test, pressure pain thresholds and reported levels of pain and disability were measured before and immediately after the first treatment session, 1 month after starting treatment and 2 months after starting treatment (at completion of the intervention).
  
  
  RESULTS
  At 2 months, both groups improved their performance on the cranio-cervical flexion test (p < 0.05), but this did not differ between groups (p > 0.05). Both groups showed a reduction in their pain at rest and disability at 2 months, but this was also not different between groups (p > 0.05). Pressure pain sensitivity did not change for either group.
  
  
  CONCLUSIONS
  Both specific cranio-cervical flexion training and proprioception training had a comparable effect on performance on the cranio-cervical flexion test, a test of the neuromuscular control of the deep cervical flexors. These results indicate that proprioception training may have positive effects on the function of the deep cervical flexors.
authors.affiliation: Department of Physical Therapy, University of Alcalá, Alcalá de Henares, Madrid, Spain.
authors.forename: Tomás
authors.initials: T
authors.lastname: Gallego Izquierdo
authors.forename: Daniel
authors.initials: D
authors.lastname: Pecos-Martin
authors.forename: Enrique
authors.initials: E
authors.lastname: Lluch Girbés
authors.forename: Gustavo
authors.initials: G
authors.lastname: Plaza-Manzano
authors.forename: Ricardo
authors.initials: R
authors.lastname: Rodríguez Caldentey
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Mayor Melús
authors.forename: Diego
authors.initials: D
authors.lastname: Blanco Mariscal
authors.forename: Deborah
authors.initials: D
authors.lastname: Falla
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000503:physiopathology / Q000534:rehabilitation*; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000503:physiopathology; D019547:Neck Pain / Q000503:physiopathology / Q000534:rehabilitation*; D017288:Pain Threshold / Q000502:physiology; D011434:Proprioception / Q000502:physiology*; D064232:Visual Analog Scale