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
JournalPhysiotherapy Theory and Practice
StateAccepted/In press - 2023

Bibliographical note

Funding Information:
The authors would like to thank all the patients who participated in the study, as well as our colleagues from the Clalit Health Services Physical Therapy Outpatient Units of the Northern District, Haifa, and Western Galilee for their support throughout this study. This work was supported by National Insurance Institute of Israel [grant number: 12/2018]; Israel Physiotherapy Society [grant number: 06/2015]; and University of Haifa [grant number: 2015].

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


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

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation


Dive into the research topics of 'Stretching and muscle-performance exercises for chronic nonspecific neck pain: who may benefit most?'. Together they form a unique fingerprint.

Cite this