title: Respiratory muscle endurance training reduces chronic neck pain: A pilot study.
abstract: BACKGROUND
  Patients with chronic neck pain show also respiratory dysfunctions.
  
  
  OBJECTIVE
  To investigate the effects of respiratory muscle endurance training (RMET) on chronic neck pain.
  
  
  METHODS
  In this pilot study (single-subject design: 3 baseline measurements, 4 measurements during RMET), 15 neck patients (49.3 ± 13.7 years; 13 females) conducted 20 sessions of home-based RMET using a SpiroTiger® (normocapnic hyperpnoea). Maximal voluntary ventilation (MVV), maximal inspiratory (Pimax) and expiratory (Pemax) pressure were measured before and after RMET. Neck flexor endurance, cervical and thoracic mobility, forward head posture, chest wall expansion and self-assessed neck disability [Neck Disability Index (NDI), Bournemouth questionnaire] were weekly assessed. Repeated measure ANOVA (Bonferroni correction) compared the first and last baseline and the last measurement after RMET.
  
  
  RESULTS
  RMET significantly increased MVV (p= 0.025), Pimax (p= 0.001) and Pemax (p< 0.001). During RMET, neck disability significantly decreased (NDI: p= 0.001; Bournemouth questionnaire: p= 0.002), while neck flexor endurance (p< 0.001) and chest wall expansion (p< 0.001) increased. The changes in respiratory and musculoskeletal parameters did not correlate.
  
  
  CONCLUSIONS
  RMET emerged from this pilot study as a feasible and effective therapy for reducing disability in patients with chronic neck pain. The underlying mechanisms, including blood gas analyses, need further investigation in a randomized controlled study.
authors.affiliation: Motor Control and Learning, Institute for Human Movement Sciences and Sports, ETH Zurich, Zurich, Switzerland.|Department of Chiropractic Medicine, University Hospital Balgrist, Zurich, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Wirth
authors.affiliation: Exercise Physiology Lab, Institute for Human Movement Sciences and Sports, ETH Zurich, Zurich, Switzerland.
authors.forename: T Duarte
authors.initials: TD
authors.lastname: Ferreira
authors.affiliation: Exercise Physiology Lab, Institute for Human Movement Sciences and Sports, ETH Zurich, Zurich, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Mittelholzer
authors.affiliation: Department of Chiropractic Medicine, University Hospital Balgrist, Zurich, Switzerland.
authors.forename: B K
authors.initials: BK
authors.lastname: Humphreys
authors.affiliation: Exercise Physiology Lab, Institute for Human Movement Sciences and Sports, ETH Zurich, Zurich, Switzerland.
authors.forename: U
authors.initials: U
authors.lastname: Boutellier
mesh_terms: D001945:Breathing Exercises; D059350:Chronic Pain / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000503:physiopathology / Q000628:therapy*; D010807:Physical Endurance / Q000502:physiology*; D010865:Pilot Projects; D012120:Respiration Disorders / Q000503:physiopathology / Q000628:therapy*; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000502:physiology*
keywords: Neck pain; respiratory dysfunction; respiratory muscle endurance training