Stretching and muscle-performance exercises for chronic nonspecific neck pain: who may benefit most?

Amira Daher, Gali Dar

Research output: Contribution to journalArticlepeer-review


Background: Although exercise is the mainstay of treatment for neck pain (NP), uncertainty remains over optimal decision-making concerning who may benefit most from such, particularly in the long term. Objective: To identify the subgroup of patients with nonspecific NP most likely to benefit from stretching and muscle-performance exercises. Methods: This was a secondary analysis of treatment outcomes of 70 patients (10 of whom dropped out) with a primary complaint of nonspecific NP in one treatment arm of a prospective, randomized, controlled trial. All patients performed the exercises, twice weekly for 6 weeks, and a home exercise program. Blinded outcome measurements were collected at baseline, after the 6-week program, and at a 6-month follow-up. Patients rated their perceived recovery on a 15-point global rating of change scale; a rating of “quite a bit better” (+5) or higher was defined as a successful outcome. Clinical predictor variables were developed via logistic regression analysis to classify patients with NP that may benefit from exercise-based treatment. Results: NP duration since onset≤6 months, no cervicogenic headache, and shoulder protraction were independent predictor variables. The pretest probability of success was 47% after the 6-week intervention and 40% at the 6-month follow-up. The corresponding posttest probabilities of success for participants with all three variables were 86% and 71%, respectively; such participants were likely to recover. Conclusion: The clinical predictor variables developed in this study may identify patients with nonspecific NP likely to benefit most from stretching and muscle-performance exercises in the short and long terms.

Original languageEnglish
Number of pages14
JournalPhysiotherapy Theory and Practice
Early online date3 May 2023
StateE-pub ahead of print - 3 May 2023

Bibliographical note

Publisher Copyright:
© 2023 Taylor & Francis Group, LLC.


  • Clinical prediction rules
  • cervicogenic headache
  • chronic nonspecific neck pain
  • muscle performance exercise
  • stretching exercise

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation


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