Long-term effects of diagonal active stretching versus static stretching for cervical neuromuscular dysfunction, disability and pain: An 8 weeks follow-up study

BACKGROUND: A high prevalence and incidence of neck and shoulder pain are common problems that require more attention from health service providers and researchers. Recent findings have indicated that the neck stretching is the one of the most effective physical therapy interventions. Although the recovery of the pain through the stretching exercise has been described in a previous study, functional advantages and changes of the neuromuscular control has not been suggested. Additionally, there was a lack of studies that considered methods of stretching. OBJECTIVE: The purpose of the present study was to examine the long-term effects of stretching methods for cervical neuromuscular dysfunction, disability and pain in a sample of sedentary workers with neck pain. METHODS: Twenty-four sedentary workers with neck pain participated in this study and were assigned to the following two groups: static stretching (SS), and diagonal active stretching (DS). Active cervical range of motion (ROM), pressure pain threshold (PPT), self reported questionnaire (Neck Disability Index, NDI), and the flexion - relaxation ratio (FRR) from the cervical erector spinae muscles were measured at pre-treatment, post-treatment (after 4 weeks) and follow-up (after 6 and 8 weeks). RESULTS: In both groups, the values obtained for the cervical ROM as flexion, extension, lateral flexion, were significantly increased in comparison to pre-treatment (p < 0.05). Significant increases of the left and right neck rotation, left and right FRR were only observed in the DS group (p <0.05). The NDI score of the SS group was significantly lower than that of the DS group (p < 0.05). CONCLUSIONS: Our findings suggest that both static and diagonal stretching exercises were effective for reducing disability of the neck and increasing cervical range of motion. Compared to the SS, in addition, present results suggest that changes of the activation patterns as FRR, and cervical rotational movement could be accomplished with the DS.