Exercises for mechanical neck disorders                        Gross et al (2015)
                                    Overview of the study
       Objectives: 
       •  To asses the effectiveness of exercise to improve pain, disability, function, 
          patient satisfaction, quality of life and global perceived effect in adults with 
          neck pain.
       Methods:
       •  Evidence current up to 21 May 2014
       •  Participants: Adults with neck pain categorized as mechanical neck 
          disorders, cervicogenic headache or neck disorders with radicular findings
       •  Intervention: Exercise therapy specified in the Therapeutic Exercise 
          Intervention Model to sub-classify exercise (Sahrmann 2002) prescribed or 
          performed in the treatment of neck pain
       •  Outcomes:
            o Primary: pain, function/disability, patient satisfaction and global 
               perceived effect
            o Secondary: No specified
      Exercises for mechanical neck disorders                             Gross et al (2015)
                                         Results & Conclusions
       •   27 trials (3005 participants) 
         Intervention                             Evidence                              Quality of 
                                                                                        evidence
                         Scapulothoracic and upper extremity strengthening had          Moderate
                         better improvements than controls for pain and function
                         Small to large effect combining cervical,                      Moderate
                         shoulder/scapulothoracic strengthening and stretching 
         Exercise for    Stretching added to manual therapy - no extra benefit             Low
          chronic NP     Endurance training combined to stretching or                   Very low-
                         strengthening exercises shows uncertain efficacy for pain      Moderate
                         and function
                         Neuromuscular exercises only when combined to physical           Low - 
                         and cognitive affective exercises improves pain, function      Moderate
                         and quality of life
      Exercises for mechanical neck disorders                               Gross et al (2015)
                                           Results & Conclusions
       •   27 trials (3005 participants) 
          Intervention                               Evidence                              Quality of 
                                                                                            evidence
                             Stabilization exercises combined to manual therapy, 
        Exercise for acute   when compared to no treatment, slightly improves                 Low
          radiculopathy      pain but not function at short-term, and neither pain 
                             nor function at intermediate-term
                             Self-SNAG exercises show to largely improve pain and             Low
                             function for CH compared to no treatment
          Cervicogenic 
         headache (CH)       Endurance training plus motor control neck exercises 
                             more effective than no treatment but no extra benefit         Moderate
                             than manual therapy for chronic NP
        Adverse events: six trials reported adverse events such as headache or worsening pain 
           in neck and shoulder 
        Moderate quality evidence supports the use of strengthening exercises, performed 
           alone or in combination with stretching for improving pain and function in chronic NP. 
           Cervicogenic headache and acute radiculopathy would also benefit from stabilization 
           exercises.