Effect Of Deep Cervical Muscles Combined With Scapular Stabilization Exercises On Chronic Nonspecific Neck Pain

Background: Chronic Nonspecific Neck Pain(CNNP)usually refers to neck pain with a course of more than three months and whose pathologic factors are not well defined.CNNP is the most common type of neck pain,and the incidence is increasing.Previous sports rehabilitation therapy focuses on cervical local training.Scapular Stabilization Exercise(SSE)emphasizes strengthening the strength and endurance of the muscles attached around the scapula as well as neuromuscular control.At present,SSE is mainly used to improve athletes’ sports performance,to treat subacromial impingement syndrome,rotator cuff injury,improve the shoulder motion of hemiplegia patients after stroke,relieve shoulder pain and improve round shoulder posture,Using SSE to deal with neck pain is still in the initial stage.In order to promote the development of the integration of physical medicine and physical health,kinesitherapy for chronic diseases should be actively explored,and the proportion of non-medical intervention including home rehabilitation training should be increased.Objective: This study aims to explore the effect of deep neck muscle training combined with SSE for neck pain,to compare the advantages and disadvantages of this comprehensive training program and traditional deep neck muscle training,in order to provide a new home training program for CNNP,to relieve the pain of patients,to improve their functional status and the quality of life.Methods: Randomized controlled study method was used,40 patients with CNNP who met the inclusion criteria were randomly divided into two groups according to the ratio of 1:1,respectively as the experimental group and the control group,for a period of 6 weeks of training intervention.The experimental group adopted the method of combining the deep cervical muscles training with SSE,while the control group only adopted the deep cervical muscles training,and the other intervention measures were consistent.Visual Analogue Score(VAS),neck disability index(NDI),cervical active range of motion(AROM),Forward Head Angle(FHA),Forward Shoulder Angle(FSA),and CKCUES-test standardized scores were assessed and evaluated before and after the intervention.The data of the two groups were statistically analyzed.Results:After six weeks of rehabilitation training,the results showed that:(1)there were significant differences in VAS score and NDI score between pre-intervention and post-intervention in both groups(p < 0.05).After intervention,the scores of the experimental group and the control group were significantly different(p< 0.05),and the VAS and NDI scores of the experimental group were better than those of the control group.(2)AROM: The cervical motion of the experimental group and the control group in all directions was statistically different between pre-intervention and post-intervention(p < 0.05),and the range of motion after intervention was greater than that before intervention;In the comparison between the two groups after intervention,there was a significant difference between the experimental group and the control group in the left and right rotation angles(p < 0.01),and the active angle of the left and right rotation of the cervical spine in the experimental group was significantly greater than that in the control group.(3)FHA and FSA:Both in two group,FHA was statistically different between before and after intervention.(p < 0.01),but there was no significant difference between the two groups after intervention(p >0.05);The FSA of the experimental group after intervention was smaller than that before intervention,and there was a very significant statistical difference(p < 0.01).(4)Standardized score of CKCUES-test: The standardized score of the experimental group after intervention was better than that before intervention,with a very significant statistical difference(p < 0.01),while the standardized score of the control group before and after intervention had no statistical difference(p> 0.05).Conclusions:(1)Both the deep cervical muscles training and SSE combined with the deep cervical muscles training can improve subjective pain,reduce dysfunction,increase the range of motion of the cervical spine in all directions,and improve head posture in patients with neck pain.(2)The exercise rehabilitation program with SSE is more effective in improving subjective pain,reducing dysfunction,increasing the range of motion of cervical rotation,reducing the round shoulder posture,and increasing the stability of upper limb during functional activities.