Effects of core stability exercise for patients with neck pain: A protocol for systematic review and meta-analysis

Yikang He, Wudong Sun, Xianghu Zhao, Ming Ma, Zengbin Zheng, Liang Xu, Yikang He, Wudong Sun, Xianghu Zhao, Ming Ma, Zengbin Zheng, Liang Xu

Abstract

Background: Neck pain is an important cause of disability. In spite of its high prevalence rate, treatment of the disorder is a challenging topic. Exercise therapy appears to be effective at decreasing pain and improving function for patients with NP in practice guidelines. Core stability exercise is becoming increasingly popular for NP. However, it is currently unknown whether core stability exercise produces more beneficial effects than general exercise in patients with NP. The aim of this study is to explore the therapeutic effect of core stability exercise for neck pain.

Methods: This review will only include randomized controlled trials (RCTs). Published articles from July 2009 to July 2019 will be identified using electronic searches. Search strategy will be performed in 3 English databases, 1 Chinese database, and the WHO International Clinical Trials Registry Platform. Two reviewers will screen, select studies, extract data, and assess quality independently. The methodological quality including the risk of bias of the included studies will be evaluated using a modified assessment form, which is based on Cochrane assessment tool and Physiotherapy Evidence Database scale. Review Manager Software (Revman5.3) will be used for heterogeneity assessment, generating funnel-plots, data synthesis, subgroup analysis, and sensitivity analysis. We will use GRADE system to evaluate the quality of our evidence.

Results: We will provide some more practical and targeted results investigating the effect of Core Stability Exercise (CSE) for Neck Pain (NP) in the current meta-analysis. Meanwhile, we will ascertain study progress of Core Stability Exercise for Neck Pain and find out defects or inadequacies of previous studies, so that future researchers could get beneficial guidance for more rigorous study.

Conclusion: The stronger evidence about Neck Pain's rehabilitative effect and safety will be provided for clinicians and policymakers.

Systematic review registration: PROSPERO CRD42017055711.

Ethics and dissemination: We do not apply for formal ethical approval from ethics committee because all of the study data in our review will be obtained in an anonymous way. Findings of this study are projected to be disseminated through peer-review publications.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow diagram of study selection. CBM = Chinese BioMedicial Literature Database, RCT = randomized controlled trial.
Figure 2
Figure 2
Modified assessment form. Y = yes (explicitly described in article and verified by communication); N = no (absent or unclear). Y scores 1, N scores 0. Three quality level: high (total scores 10-12), moderate (total scores 6–9), low (total scores 0–5).

References

    1. Borna L, Ahmadi A, Sarafzadeh J, et al. Comparison of cervical flexion relaxation phenomenon between forward head posture and healthy subjects [in Persian]. J Rehabil Med 2016;9:65–71.
    1. Falla D, O’Leary S, Farina D, et al. The change in deep cervical flexor activity after training is associated with the degree of pain reduction in patients with chronic neck pain. Clin J Pain 2012;28:628–34.
    1. Aydede M. Defending the IASP definition of pain. Monist 2017;100:439–64.
    1. Blanpied PR, Gross AR, Elliott JM, et al. Neck pain: revision 2017: clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Association. J Orthop Sports Phys Ther 2017;47:A1–83.
    1. Lynch S. The effects of an exercise intervention on forward head and rounded shoulder postures in elite swimmers. Br J Sport Med 2010;44:376–81.
    1. Oh HJ, Song GB. Effects of neurofeedback training on the cervical movement of adults with forward head posture. J Phys Ther Sci 2016;28:2894–7.
    1. Ruivo RM. Effects of a resistance and stretching training program on forward head and protracted shoulder posture in adolescents. J Manipulative Physiol Ther 2016;40:1–0.
    1. Peterson Kendall F, Kendall McCreary E, Provance PG, et al. Muscles: Testing and Function With Posture and Pain. 5th ed.Philadelphia, PA: Lippincott Williams & Wilkins; 2005.
    1. Silverman J, Rodriquez AA, Agre JC. Quantitative cervical flexor strength in healthy subjects and in subjects with mechanical neck pain. Arch Phys Med Rehabil 1991;72:679–81.
    1. Wolsko PM, Eisenberg DM, Davis RB, et al. Patterns and perceptions of care for treatment of back and neck pain: results of a national survey. Spine 2003;28:292–7.
    1. Akuthota V, Ferreiro A, Moore T, et al. Core stability exercise principles. Curr Sports Med Rep 2008;7:39–44.
    1. Gordon R, Bloxham S. A systematic review of the effects of exercise and physical activity on non-specific chronic low back pain. Healthcare 2016;4:22.Multidisciplinary Digital Publishing Institute.
    1. Courneya KS, Segal RJ, Mackey JR, et al. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol 2007;25:4396–404.
    1. Levine B, Kaplanek B, Jaffe WL. Pilates training for use in rehabilitation after total hip and knee arthroplasty: a preliminary report. Clin Orthop Relat Res 2009;467:1468–75.
    1. Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med 2006;36:189–98.
    1. Wang XQ, Zheng JJ, Yu ZW, et al. A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PloS One 2012;7:e52082.
    1. Dusunceli Y, Ozturk C, Atamaz F, et al. Efficacy of neck stabilization exercises for neck pain: a randomized controlled study. J Rehabil Med 2009;41:626–31.
    1. Griffiths C, Dziedzic K, Waterfield J, et al. Effectiveness of specific neck stabilization exercises or a general neck exercise program for chronic neck disorders: a randomized controlled trial. J Rheumatol 2009;36:390–7.
    1. Monticone M, Barbarino A, Testi C, et al. Symptomatic efficacy of stabilizing treatment versus laser therapy for sub-acute low back pain with positive tests for sacroiliac dysfunction: a randomised clinical controlled trial with 1 year follow-up. Eura Medicophys 2004;40:263–8.
    1. Haugen T, Haugvad L, Røstad V. Effects of core-stability training on performance and injuries in competitive athletes. Sportscience 2016;20:1–7.
    1. Almousa S, Lamprianidou E, Kitsoulis G. The effectiveness of stabilising exercises in pelvic girdle pain during pregnancy and after delivery: a systematic review. Physiother Re Int 2018;23:e1699.
    1. Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015;4:1.
    1. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009;339:b2535.
    1. Willardson JM. The effectiveness of resistance exercises performed on unstable equipment. Strength Cond J 2004;26:70–4.
    1. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097.
    1. Coulombe BJ, Games KE, Neil ER, et al. Core stability exercise versus general exercise for chronic low back pain. J Athl Train 2017;52:71–2.
    1. Salt E, Wright C, Kelly S, et al. A systematic literature review on the effectiveness of non-invasive therapy for cervicobrachial pain. Man Ther 2011;16:53–65.
    1. Hidalgo B, Hall T, Bossert J, et al. The efficacy of manual therapy and exercise for treating non-specific neck pain: a systematic review. J Back Musculoskelet Rehabil 2017;30:1149–69.

Source: PubMed

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