Chiropractic + Naturopathic Doctor

Research Review Corner: July-August 2011

Shawn Thistle   

Features Research

Study Title: Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: Randomised controlled trial
Authors: Andersen LL et al.
Publication Information: Pain 2011; 152(2): 440-6.

Study Title: Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: Randomised controlled trial
Authors: Andersen LL et al.
Publication Information: Pain 2011; 152(2): 440-6.

BACKGROUND INFORMATION
We all know that chiropractic is an effective intervention for non-specific mechanical neck pain but for too many of our colleagues treatment of this condition involves only spinal manipulation. Although scientific evidence is generally in our corner for this condition (leaving aside the debate about manipulation versus mobilization, and assuming readers are aware that thoracic spine adjusting can be helpful for neck pain), some may not be aware that the evidence is also supportive of exercise for neck pain. In fact, as individual treatment options, manipulation, mobilization1 and exercise2 are all reasonable. But, the combination of manual therapy and exercise is recommended and represents a more complete treatment approach that engages and activates patients3.

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It is well known that compliance with exercise programs drives their efficacy, but that adherence, particularly to complex programs, is poor. This study investigated a simple approach to self-care, utilizing small amounts of progressive resistance training for (otherwise healthy) adults with neck and shoulder pain.

STUDY METHODS
In this study, 174 women and 24 men (average age: approximately 44 years old) working at least 30 hours per week and with frequent neck/shoulder pain were randomly assigned to resistance training with elastic tubing for two or 12 minutes per day five times per week, or to a control group receiving weekly information on general health. Subjects were excluded if they had a medical history of cardiovascular or cerebrovascular accident, fibromyalgia, rheumatoid arthritis, cervical disc prolapse, whiplash, other serious traumatic injury of the neck or shoulder, other serious chronic disease, pregnancy, worked fewer than 30 hours per week, or performed more than two hours per week of vigorous physical exercise. Potential participants were also excluded if the following were observed during the physical examination: blood pressure above 160/100, a positive foramen compression test; subacromial impingement syndrome; or pain of the shoulder, elbow, or wrist during resisted shoulder abduction resulting in severe discomfort for the participant.

The primary outcomes were changes in intensity of neck/shoulder pain (scale 0 to 10), examiner-verified tenderness of the neck/shoulder muscles (total tenderness score of 0 to 32), and isometric muscle strength at 10 weeks.

CONCLUSIONS AND PRACTICAL APPLICATIONS
This study showed that even a small amount of exercise (approximately two minutes/day) using minimal equipment (a Theraband) can result in reduced pain and tenderness and increased strength in adults with neck and shoulder pain. Not only does simple exercise engage patients in their own health, but also it has observable and measurable impact on symptoms and health that will only add to the benefit of the manual treatments we provide. The results of this study are encouraging and remind us all to activate our patients with exercise!


Dr. Shawn Thistle is the founder and president of Research Review Service Inc., an online, subscription-based service designed to help busy practitioners to integrate current, relevant scientific evidence into their practice. Shawn graduated from CMCC and holds an Honours Degree in Kinesiology from McMaster University. He also holds a certificate in Contemporary Medical Acupuncture from McMaster University, and is a Certified Active Release Techniques (ART®) Provider. For more information about the Research Review Service, visit www.researchreviewservice.com.


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