Time-wise change in neck pain in response to rehabilitation with specific resistance training: implications for exercise prescription

Purpose: To determine the time-wise effect of specific resistance training on neck pain among industrial technicians with frequent neck pain symptoms. Methods: Secondary analysis of a parallel-group cluster randomized controlled trial of 20 weeks performed at two large industrial production units in Copenhagen, Denmark. Women with neck pain >30 mm VAS (N = 131) were included in the present analysis. The training group (N = 77) performed specific resistance training for the neck/shoulder muscles three times a week, and the control group (N = 54) received advice to stay active. Participants of both groups registered neck pain intensity (0-100 mm VAS) once a week. Results: Neck pain intensity was 55 mm (SD 23) at baseline. There was a significant group by time interaction for neck pain (F-value 2.61, P< 0.001, DF = 19). Between-group differences in neck pain reached significance after 4 weeks (11 mm, 95% CI 2 to 20). The time-wise change in pain showed three phases; a rapid decrease in the training group compared with the control group during the initial 7 weeks, a slower decrease in pain during the following weeks (week 8-15), and a plateau during the last weeks (week 16-20). Adherence to training followed a two-phase pattern, i.e. weekly participation rate was between 70-86% during the initial 7 weeks, dropping towards 55-63% during the latter half of the training period. Conclusion: Four weeks of specific resistance training reduced neck pain significantly, but 15 weeks is required to achieve maximal pain reduction. The time-wise change in pain followed a three-phase pattern with a rapid effect during the initial 7 weeks followed by a slower but still positive effect, and finally a plateau from week 15 and onwards. Decreased participation rate may explain the decreased efficacy during the latter phase of the intervention.