{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:40:20Z","timestamp":1788284420410,"version":"build-2803163510"},"reference-count":110,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,11,20]],"date-time":"2021-11-20T00:00:00Z","timestamp":1637366400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Specific neck exercises (SNE) targeting deep cervical flexors and extensors are commonly used for the treatment of nonspecific neck pain (NSNP). However, whether SNE are more effective than alternative exercise interventions (AEI) remains unclear. Furthermore, it has been postulated that SNE may be most effective when they are tailored and targeted to patients with evidence of motor control dysfunction, yet this notion also remains unproven. The objectives of this study were to compare the effectiveness of SNE with that of AEI for reducing pain and disability in people with NSNP and to assess whether the effectiveness of SNE is increased when the exercises are tailored and provided to patients with evidence of motor control dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For this systematic review with meta-analysis, Medline, Web of Science, Scopus, and Physiotherapy Evidence Database were searched. Eligibility criteria included randomized controlled trials evaluating the effectiveness of SNE against that of AEI in people with NSNP. Meta-analysis included subgroup analyses to determine the effect of exercise tailoring and participant selection criteria on the effectiveness of SNE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve studies were included. Meta-analysis revealed greater effectiveness of SNE in the short to medium term for reducing pain (pooled standardized mean difference [SMD] = \u22120.41; 95% CI = \u22120.76 to \u22120.06; P = .02) and disability (pooled SMD = \u22120.41; 95% CI = \u22120.78 to \u22120.04; P = .03) but no differences in the long term for pain (pooled SMD = \u22121.30; 95% CI = \u22123.35 to 0.75; P = .21) and disability (pooled SMD = \u22121.81; 95% CI = \u22124.29 to 0.67; P = .15), although evidence was limited for the latter. The effectiveness of SNE was not superior in studies that included only participants with motor control dysfunction or when exercises were tailored to each participant. Overall, the studies were of low quality. Grading of Recommendations Assessment, Development and Evaluation revealed low certainty, serious risk of bias, and inconsistency of findings for short- to medium-term effects and very low certainty, serious risk of bias, and very serious inconsistency for long-term effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The preferential use of SNE may be recommended to achieve better short- to medium-term outcomes, although the low quality of evidence affects the certainty of these findings. Currently used strategies for selecting patients and tailoring SNE are not supported by the evidence and therefore cannot be recommended for clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Impact<\/jats:title><jats:p>SNE are more effective than AEI for reducing pain and disability in patients with NSNP in the short to medium term, but overall evidence is of low quality, affecting the certainty of the findings. Tests of muscle dysfunction (mostly the craniocervical flexion test) currently used in studies to select patients and tailor SNE do not result in greater effectiveness of these exercises.<\/jats:p><\/jats:sec><jats:sec><jats:title>Lay Summary<\/jats:title><jats:p>Evidence suggests SNE are more effective than other forms of exercise, although evidence is overall of low quality. Use of the craniocervical flexion test in isolation to select participants and\/or tailor SNE cannot be recommended.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ptj\/pzab259","type":"journal-article","created":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T12:18:51Z","timestamp":1636114731000},"source":"Crossref","is-referenced-by-count":47,"title":["Effectiveness of Specific Neck Exercise for Nonspecific Neck Pain; Usefulness of Strategies for Patient Selection and Tailored Exercise\u2014A Systematic Review With Meta-Analysis"],"prefix":"10.1093","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8400-6463","authenticated-orcid":false,"given":"Iker","family":"Villanueva-Ruiz","sequence":"first","affiliation":[{"name":"Department of Physical Therapy , Faculty of Health Sciences, , Donostia-San Sebasti\u00e1n, Spain"},{"name":"University of Deusto , Faculty of Health Sciences, , Donostia-San Sebasti\u00e1n, Spain"},{"name":"Department of Preventive Medicine and Public Health , Faculty of Medicine and Nursing, University of the Basque Country UPV\/EHU, Leioa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Falla","sequence":"additional","affiliation":[{"name":"Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport , Exercise and Rehabilitation Sciences. College of Life and Environmental Sciences. University of Birmingham, Edgbaston, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3221-9747","authenticated-orcid":false,"given":"Ion","family":"Lascurain-Aguirrebe\u00f1a","sequence":"additional","affiliation":[{"name":"Physiotherapy , Department of Physiology, Faculty of Medicine and Nursing, , Leioa, Spain"},{"name":"University of the Basque Country UPV\/EHU , Department of Physiology, Faculty of Medicine and Nursing, , Leioa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,20]]},"reference":[{"issue":"368","key":"2023011806591985400_ref1","article-title":"Global, regional, and national burden of neck pain in the general population, 1990-2017: systematic analysis of the Global Burden of Disease Study 2017","author":"Safiri","year":"2020","journal-title":"BMJ."},{"key":"2023011806591985400_ref2","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S0140-6736(17)32154-2","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"390","author":"GBD-Disease and Injury Incidence and Prevalence Collaborators","year":"2017","journal-title":"Lancet"},{"key":"2023011806591985400_ref3","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.berh.2011.01.019","article-title":"The epidemiology of neck pain","volume":"24","author":"Hoy","year":"2010","journal-title":"Best Prac Res Clin Rheumatol."},{"key":"2023011806591985400_ref4","doi-asserted-by":"crossref","first-page":"S75","DOI":"10.1097\/BRS.0b013e31816445be","article-title":"Course and prognostic factors for neck pain in the general population: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders","volume":"33","author":"Carroll","year":"2008","journal-title":"Spine."},{"key":"2023011806591985400_ref5","doi-asserted-by":"crossref","first-page":"A1","DOI":"10.2519\/jospt.2008.0303","article-title":"Neck pain: clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopedic Section of the American Physical Therapy Association","volume":"38","author":"Childs","year":"2008","journal-title":"J Orthop Sports Phys Ther."},{"key":"2023011806591985400_ref6","doi-asserted-by":"crossref","first-page":"E459","DOI":"10.1097\/01.brs.0000174279.44855.02","article-title":"Predictors of outcome in neck and shoulder symptoms: a cohort study in general practice","volume":"30","author":"Bot","year":"2005","journal-title":"Spine."},{"key":"2023011806591985400_ref7","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1002\/jmri.26567","article-title":"Cervical spine findings on MRI in people with neck pain compared with pain-free controls: a systematic review and meta-analysis","volume":"49","author":"Farrell","year":"2019","journal-title":"J Magn Reson Imaging."},{"key":"2023011806591985400_ref8","doi-asserted-by":"crossref","first-page":"A1","DOI":"10.2519\/jospt.2017.0302","article-title":"Neck pain: revision 2017","volume":"47","author":"Blanpied","year":"2017","journal-title":"J Orthop Sports Phys Ther."},{"key":"2023011806591985400_ref9","doi-asserted-by":"crossref","first-page":"A1","DOI":"10.2519\/jospt.2008.0303","article-title":"Neck pain: clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopedic Section of the American Physical Therapy Association","volume":"38","author":"Childs","year":"2008","journal-title":"J Orthop Sports Phys Ther."},{"key":"2023011806591985400_ref10","doi-asserted-by":"crossref","first-page":"2000","DOI":"10.1007\/s00586-016-4467-7","article-title":"Management of neck pain and associated disorders: a clinical practice guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration","volume":"25","author":"C\u00f4t\u00e9","year":"2016","journal-title":"Eur Spine J."},{"key":"2023011806591985400_ref11","doi-asserted-by":"crossref","first-page":"S227","DOI":"10.1016\/j.jmpt.2008.11.023","article-title":"Clinical practice implications of the bone and joint decade 2000\u20132010 Task Force on Neck Pain and Its Associated Disorders: from concepts and findings to recommendations","volume":"32","author":"Guzman","year":"2009","journal-title":"J Manip Physiol Ther."},{"key":"2023011806591985400_ref12","doi-asserted-by":"crossref","first-page":"2242","DOI":"10.1007\/s00586-017-5121-8","article-title":"National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy","volume":"26","author":"Kjaer","year":"2017","journal-title":"Eur Spine J."},{"key":"2023011806591985400_ref13","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1093\/ptj\/pzx118","article-title":"Clinical practice guideline for physical therapy assessment and treatment in patients with nonspecific neck pain","volume":"98","author":"Bier","year":"2018","journal-title":"Phys Ther."},{"key":"2023011806591985400_ref14","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/s12891-019-2441-3","article-title":"Comparison of CPG\u2019s for the diagnosis, prognosis and management of non-specific neck pain: a systematic review","volume":"20","author":"Parikh","year":"2019","journal-title":"BMC Musculoskel Disord."},{"issue":"12","key":"2023011806591985400_ref15","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/1471-2474-12-14","article-title":"Protocol for shoulder function training reducing musculoskeletal pain in shoulder and neck: a randomized controlled trial","volume":"14","author":"Andersen","year":"2011","journal-title":"BMC Musculoskelet Disord."},{"key":"2023011806591985400_ref16","doi-asserted-by":"crossref","first-page":"3322","DOI":"10.1519\/JSC.0b013e31828f12c6","article-title":"Dose-response of strengthening exercise for treatment of severe neck pain in women","volume":"27","author":"Andersen","year":"2013","journal-title":"J Strength Cond Res."},{"key":"2023011806591985400_ref17","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.pain.2010.11.016","article-title":"Effectiveness of small daily amounts of progressive resistance training for frequent neck\/shoulder pain: randomised controlled trial","volume":"152","author":"Andersen","year":"2011","journal-title":"Pain."},{"key":"2023011806591985400_ref18","doi-asserted-by":"crossref","first-page":"187324","DOI":"10.1155\/2014\/187324","article-title":"High-intensity strength training improves function of chronically painful muscles: case-control and RCT studies","volume":"2014","author":"Andersen","year":"2014","journal-title":"Biomed Res Int."},{"key":"2023011806591985400_ref19","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/s00420-010-0568-5","article-title":"Myofeedback training and intensive muscular strength training to decrease pain and improve work ability among female workers on long-term sick leave with neck pain: a randomized controlled trial","volume":"84","author":"Dellve","year":"2011","journal-title":"Int Arch Occup Environ Health."},{"key":"2023011806591985400_ref20","doi-asserted-by":"crossref","DOI":"10.1155\/2014\/693013","article-title":"Effect of training supervision on effectiveness of strength training for reducing neck\/shoulder pain and headache in office workers: cluster randomized controlled trial","volume":"2014","author":"Gram","year":"2014","journal-title":"Biomed Res Int."},{"key":"2023011806591985400_ref21","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1053\/apmr.2000.7582","article-title":"Rehabilitation of neck-shoulder pain in women industrial workers: a randomized trial comparing isometric shoulder endurance training with isometric shoulder strength training","volume":"81","author":"Hagberg","year":"2000","journal-title":"Arch Phys Med Rehabil."},{"key":"2023011806591985400_ref22","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1177\/0269215507087486","article-title":"Strength training and stretching versus stretching only in the treatment of patients with chronic neck pain: a randomized one-year follow-up study","volume":"22","author":"H\u00e4kkinen","year":"2008","journal-title":"Clin Rehabil."},{"key":"2023011806591985400_ref23","doi-asserted-by":"crossref","first-page":"196","DOI":"10.5271\/sjweh.3136","article-title":"Kettlebell training for musculoskeletal and cardiovascular health: a randomized controlled trial","volume":"37","author":"Jay","year":"2011","journal-title":"Scand J Work Environ Health."},{"issue":"10","key":"2023011806591985400_ref24","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1186\/1471-2474-10-101","article-title":"Short-term effects of implemented high intensity shoulder elevation during computer work","volume":"10","author":"Larsen","year":"2009","journal-title":"BMC Musculoskelet Disord."},{"key":"2023011806591985400_ref25","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1007\/s00420-017-1230-2","article-title":"Comparison of the effectiveness of resistance training in women with chronic computer-related neck pain: a randomized controlled study","volume":"90","author":"Li","year":"2017","journal-title":"Int Arch Occup Environ Health."},{"key":"2023011806591985400_ref26","doi-asserted-by":"crossref","first-page":"845851","DOI":"10.1155\/2014\/845851","article-title":"Lasting effects of workplace strength training for neck\/shoulder\/arm pain among laboratory technicians: natural experiment with 3-year follow-up","volume":"2014","author":"Mortensen","year":"2014","journal-title":"Biomed Res Int."},{"issue":"14","key":"2023011806591985400_ref27","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1186\/1471-2474-14-287","article-title":"Implementation of specific strength training among industrial laboratory technicians: long-term effects on back, neck and upper extremity pain","author":"Pedersen","year":"2013","journal-title":"BMC Musculoskelet Disord."},{"key":"2023011806591985400_ref28","first-page":"617","article-title":"Effect of strength training in addition to general exercise in the rehabilitation of patients with non-specific neck pain. A randomized clinical trial","volume":"50","author":"Rolving","year":"2014","journal-title":"Eur J Phys Rehabil Med"},{"issue":"8","key":"2023011806591985400_ref29","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/1477-7525-8-48","article-title":"Effect of neck strength training on health-related quality of life in females with chronic neck pain: a randomized controlled 1-year follow-up study","author":"Salo","year":"2010","journal-title":"Health Qual Life Outcomes."},{"key":"2023011806591985400_ref30","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.jmpt.2013.08.011","article-title":"Effectiveness of global postural reeducation compared to segmental exercises on function, pain, and quality of life of patients with scapular dyskinesis associated with neck pain: a preliminary clinical trial","volume":"37","author":"de Amorim","year":"2014","journal-title":"J Manip Physiol Ther."},{"key":"2023011806591985400_ref31","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.math.2011.12.005","article-title":"Can a functional postural exercise improve performance in the cranio-cervical flexion test? A preliminary study","volume":"17","author":"Beer","year":"2012","journal-title":"Man Ther."},{"key":"2023011806591985400_ref32","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1590\/S1807-59322008000600010","article-title":"Effect of global posture reeducation and of static stretching on pain, range of motion, and quality of life in women with chronic neck pain: a randomized clinical trial","volume":"63","author":"Cunha","year":"2008","journal-title":"Clinics (Sao Paulo)."},{"key":"2023011806591985400_ref33","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.jbmt.2016.07.008","article-title":"Efficacy of kinesiology tape versus postural correction exercises on neck disability and axioscapular muscles fatigue in mechanical neck dysfunction: a randomized blinded clinical trial","volume":"21","author":"El-Abd","year":"2017","journal-title":"J Bodyw Mov Ther."},{"key":"2023011806591985400_ref34","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.2522\/ptj.20150501","article-title":"Effectiveness of global postural re-education in patients with chronic nonspecific neck pain: randomized controlled trial","volume":"96","author":"Pillastrini","year":"2016","journal-title":"Phys Ther."},{"key":"2023011806591985400_ref35","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1007\/s10926-013-9441-1","article-title":"Effect of scapular function training on chronic pain in the neck\/shoulder region: a randomized controlled trial","volume":"24","author":"Andersen","year":"2014","journal-title":"J Occup Rehabil."},{"key":"2023011806591985400_ref36","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.math.2015.07.003","article-title":"Cervical and scapulothoracic stabilization exercises with and without connective tissue massage for chronic mechanical neck pain: a prospective, randomised controlled trial","volume":"21","author":"Celenay","year":"2016","journal-title":"Man Ther"},{"key":"2023011806591985400_ref37","doi-asserted-by":"crossref","first-page":"99","DOI":"10.3109\/09593985.2014.963904","article-title":"Effectiveness of mobilization therapy and exercises in mechanical neck pain","volume":"31","author":"Ganesh","year":"2015","journal-title":"Physiother Theory Pract."},{"key":"2023011806591985400_ref38","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1002\/msc.1132","article-title":"Scapulothoracic muscle strength changes following a single session of manual therapy and an exercise programme in subjects with neck pain","volume":"14","author":"Petersen","year":"2016","journal-title":"Musculoskeletal Care."},{"key":"2023011806591985400_ref39","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.ptsp.2018.08.011","article-title":"Comparison of the effects of sensorimotor training programs on pain, electromyography and kinematics in patients with scapular downward rotation syndrome","volume":"34","author":"Derakhshani","year":"2018","journal-title":"Phys Ther Sport"},{"key":"2023011806591985400_ref40","first-page":"130","article-title":"Effect of proprioceptive training on balance in patients with chronic neck pain","volume":"30","author":"Duray","year":"2018","journal-title":"Agri."},{"key":"2023011806591985400_ref41","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1002\/jor.20220","article-title":"Retraining cervical joint position sense: the effect of two exercise regimes","volume":"25","author":"Jull","year":"2007","journal-title":"J Orthop Res."},{"key":"2023011806591985400_ref42","doi-asserted-by":"crossref","first-page":"27","DOI":"10.3233\/WOR-2010-1004","article-title":"Effects of intermittent stretching exercises at work on musculoskeletal pain associated with the use of a personal computer and the influence of media on outcomes","volume":"36","author":"Marangoni","year":"2010","journal-title":"Work."},{"key":"2023011806591985400_ref43","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1177\/0269215515575747","article-title":"The effectiveness of a neck and shoulder stretching exercise program among office workers with neck pain: a randomized controlled trial","volume":"30","author":"Tunwattanapong","year":"2016","journal-title":"Clin Rehabil."},{"key":"2023011806591985400_ref44","doi-asserted-by":"crossref","first-page":"126","DOI":"10.2340\/16501977-0015","article-title":"Stretching exercises vs manual therapy in treatment of chronic neck pain: a randomized, controlled cross-over trial","volume":"39","author":"Ylinen","year":"2007","journal-title":"J Rehabil Med."},{"key":"2023011806591985400_ref45","doi-asserted-by":"crossref","first-page":"2799","DOI":"10.1016\/j.jbiomech.2008.07.005","article-title":"Cervical helical axis characteristics and its center of rotation during active head and upper arm movements-comparisons of whiplash-associated disorders, non-specific neck pain and asymptomatic individuals","volume":"41","author":"Grip","year":"2008","journal-title":"J Biomech."},{"key":"2023011806591985400_ref46","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.math.2006.10.002","article-title":"Sensorimotor disturbances in chronic neck pain--range of motion, peak velocity, smoothness of movement, and repositioning acuity","volume":"13","author":"Sj\u00f6lander","year":"2008","journal-title":"Man Ther."},{"issue":"9","key":"2023011806591985400_ref47","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/1471-2474-9-90","article-title":"Altered motor control patterns in whiplash and chronic neck pain","author":"Woodhouse","year":"2008","journal-title":"BMC Musculoskelet Disord."},{"key":"2023011806591985400_ref48","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/j.clinph.2009.12.029","article-title":"Effect of pain on the modulation in discharge rate of sternocleidomastoid motor units with force direction","volume":"121","author":"Falla","year":"2010","journal-title":"Clin Neurophysiol."},{"key":"2023011806591985400_ref49","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.math.2010.07.006","article-title":"Association between neck muscle coactivation, pain, and strength in women with neck pain","volume":"16","author":"Lindstr\u00f8m","year":"2011","journal-title":"Man Ther."},{"issue":"49","key":"2023011806591985400_ref50","article-title":"Women with mechanical neck pain exhibit increased activation of their superficial neck extensors when performing the cranio-cervical flexion test","author":"Bonilla-Barba","year":"2020","journal-title":"Musculosc Sci Pract."},{"key":"2023011806591985400_ref51","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s00221-011-2629-8","article-title":"The relative timing of trunk muscle activation is retained in response to unanticipated postural-perturbations during acute low back pain","volume":"210","author":"Boudreau","year":"2011","journal-title":"Exp Brain Res."},{"key":"2023011806591985400_ref52","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s00221-003-1814-9","article-title":"Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain","volume":"157","author":"Falla","year":"2004","journal-title":"Exp Brain Res."},{"key":"2023011806591985400_ref53","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1016\/S0003-9993(96)90008-8","article-title":"Neck flexor muscle strength, efficiency, and relaxation times in normal subjects and subjects with unilateral neck pain and headache","volume":"77","author":"Barton","year":"1996","journal-title":"Arch Phys Med Rehabil."},{"key":"2023011806591985400_ref54","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.math.2010.12.005","article-title":"Endurance and fatigue characteristics of the neck flexor and extensor muscles during isometric tests in patients with postural neck pain","volume":"16","author":"Edmondston","year":"2011","journal-title":"Man Ther."},{"key":"2023011806591985400_ref55","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.math.2006.02.010","article-title":"Cranio-cervical flexor muscle impairment at maximal, moderate, and low loads is a feature of neck pain","volume":"12","author":"O\u2019Leary","year":"2007","journal-title":"Man Ther."},{"key":"2023011806591985400_ref56","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1186\/s12891-018-2324-z","article-title":"Effects of deep cervical flexor training on impaired physiological functions associated with chronic neck pain: a systematic review","volume":"19","author":"Blomgren","year":"2018","journal-title":"BMC Musculoskelet Dis."},{"key":"2023011806591985400_ref57","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/j.math.2009.05.004","article-title":"The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain","volume":"14","author":"Jull","year":"2009","journal-title":"Man Ther."},{"key":"2023011806591985400_ref58","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.math.2013.05.011","article-title":"Immediate effects of active cranio-cervical flexion exercise versus passive mobilisation of the upper cervical spine on pain and performance on the cranio-cervical flexion test","volume":"19","author":"Lluch","year":"2014","journal-title":"Man Ther."},{"key":"2023011806591985400_ref59","author":"Jull","year":"2018"},{"key":"2023011806591985400_ref60","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.msksp.2019.04.010","article-title":"Motor control using cranio-cervical flexion exercises versus other treatments for non-specific chronic neck pain: a systematic review and meta-analysis","volume":"42","author":"Martin-Gomez","year":"2019","journal-title":"Musculoskel Sci Pract."},{"key":"2023011806591985400_ref61","article-title":"Comparative effectiveness of physical exercise interventions for chronic non-specific neck pain: a systematic review with network meta-analysis of 40 randomised controlled trials","author":"Zoete","year":"2020","journal-title":"Br J Sports Med."},{"key":"2023011806591985400_ref62","article-title":"Prescription of exercises for the treatment of chronic pain along the continuum of nociplastic pain: a systematic review with meta-analysis","author":"Franco","year":"2020","journal-title":"Euro J Pain"},{"key":"2023011806591985400_ref63","article-title":"Motor control training of deep neck flexors with pressure biofeedback improves pain and disability in patients with neck pain: a systematic review and meta-analysis","volume":"24","author":"Tsiringakis","year":"2020","journal-title":"Musculoskel Sci Prac."},{"key":"2023011806591985400_ref64","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1002\/j.1532-2149.2013.00321.x","article-title":"Effectiveness of an 8-week exercise programme on pain and specificity of neck muscle activity in patients with chronic neck pain: a randomized controlled study","volume":"17","author":"Falla","year":"2013","journal-title":"Eur J Pain."},{"key":"2023011806591985400_ref65","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.MR000012.pub3","article-title":"Randomisation to protect against selection bias in healthcare trials","author":"Odgaard-Jensen","year":"2011","journal-title":"Cochrane Database of Systematic Reviews."},{"key":"2023011806591985400_ref66","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1179\/2042618613Y.0000000047","article-title":"The influence of home exercise programs for patients with non-specific or specific neck pain: a systematic review of the literature","volume":"24","author":"Zronek","year":"2016","journal-title":"J Man Manip Ther."},{"key":"2023011806591985400_ref67","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0234511","article-title":"Effectiveness and optimal dosage of exercise training for chronic non-specific neck pain: a systematic review with a narrative synthesis","volume":"15","author":"Price","year":"2020","journal-title":"PLoS ONE."},{"key":"2023011806591985400_ref68","doi-asserted-by":"crossref","DOI":"10.1016\/j.physio.2021.05.010","article-title":"Adherence is a key factor for interpreting the results of exercise interventions: a debate article","author":"Nagpal","year":"2021","journal-title":"Physiotherapy."},{"key":"2023011806591985400_ref69","first-page":"36","article-title":"The Italian Society of Physical and Rehabilitation Medicine (SIMFER) recommendations for neck pain","volume":"35","author":"Monticone","year":"2013","journal-title":"G Ital Med Lav Ergon."},{"key":"2023011806591985400_ref70","first-page":"132","article-title":"Effectiveness of physiotherapy interventions plus extrinsic feedback for neck disorders: a systematic review with meta-analysis","volume":"29","author":"Araujo","year":"2017","journal-title":"Muscul Sci Prac."},{"key":"2023011806591985400_ref71","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2013\/567175","article-title":"Evidence of physiotherapy interventions for patients with chronic neck pain: a systematic review of randomised controlled trials","volume":"2013","author":"Damgaard","year":"2013","journal-title":"ISRN Pain."},{"key":"2023011806591985400_ref72","first-page":"1083","article-title":"Conservative management of mechanical neck disorders: a systematic review","volume":"34","author":"Gross","year":"2007","journal-title":"J Rheumatol"},{"key":"2023011806591985400_ref73","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.3233\/BMR-169615","article-title":"The efficacy of manual therapy and exercise for treating non-specific neck pain: a systematic review","volume":"30","author":"Hidalgo","year":"2018 6","journal-title":"BMR."},{"key":"2023011806591985400_ref74","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/S1836-9553(10)70037-0","article-title":"Conservative interventions provide short-term relief for non-specific neck pain: a systematic review","volume":"56","author":"Leaver","year":"2010","journal-title":"J Physiother."},{"key":"2023011806591985400_ref75","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1186\/1471-2474-15-382","article-title":"Effects of proprioceptive exercises on pain and function in chronic neck\u2014and low back pain rehabilitation: a systematic literature review","volume":"15","author":"McCaskey","year":"2014","journal-title":"BMC Musculoskelet Dis"},{"key":"2023011806591985400_ref76","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1136\/bjsports-2015-095410","article-title":"Are group-based and individual physiotherapy exercise programmes equally effective for musculoskeletal conditions? A systematic review and meta-analysis","volume":"51","author":"O\u2019Keeffe","year":"2017","journal-title":"Br J Sports Med."},{"key":"2023011806591985400_ref77","article-title":"Evidence-based treatment recommendations for neck and low back pain across Europe: a systematic review of guidelines","author":"Corp","year":"2020","journal-title":"Euro J Pain"},{"key":"2023011806591985400_ref78","first-page":"459","article-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen","year":"2013"},{"key":"2023011806591985400_ref79","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003 4","journal-title":"BMJ."},{"key":"2023011806591985400_ref80","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1097\/BRS.0000000000001151","article-title":"Mechanism of action of spinal mobilizations: a systematic review","volume":"41","author":"Lascurain-Aguirrebe\u00f1a","year":"2016","journal-title":"Spine."},{"key":"2023011806591985400_ref81","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1097\/BRS.0b013e3181b1c99f","article-title":"Editorial Board, Cochrane Back Review Group. 2009 Updated method guidelines for systematic reviews in the Cochrane Back Review Group","volume":"34","author":"Furlan","year":"2009","journal-title":"Spine."},{"key":"2023011806591985400_ref82","article-title":"Patient involvement with home-based exercise programs: can connected health interventions influence adherence?","author":"Argent","year":"1, 2018","journal-title":"JMIR Mhealth Uhealth."},{"key":"2023011806591985400_ref83","doi-asserted-by":"crossref","first-page":"48","DOI":"10.2340\/16501977-2034","article-title":"Comparison of cranio-cervical flexion training versus cervical proprioception training in patients with chronic neck pain: a randomized controlled clinical trial","volume":"48","author":"Gallego Izquierdo","year":"2016","journal-title":"J Rehabil Med."},{"key":"2023011806591985400_ref84","first-page":"1","article-title":"Does deep cervical flexor muscle training affect pain pressure thresholds of myofascial trigger points in patients with chronic neck pain? A prospective randomized controlled trial","volume":"2016","author":"Bobos","year":"2016","journal-title":"Rehab Res Prac."},{"key":"2023011806591985400_ref85","first-page":"2261","article-title":"Effect of deep cervical flexor training vs. conventional isometric training on forward head posture, pain, neck disability index in dentists suffering from chronic neck pain","volume":"7","author":"Gupta","year":"2013","journal-title":"J Clin Diagn Res."},{"key":"2023011806591985400_ref86","doi-asserted-by":"crossref","first-page":"915","DOI":"10.2147\/JPR.S190125","article-title":"Effect of specific deep cervical muscle exercises on functional disability, pain intensity, craniovertebral angle, and neck-muscle strength in chronic mechanical neck pain: a randomized controlled trial","volume":"12","author":"Suvarnnato","year":"2019","journal-title":"JPR."},{"key":"2023011806591985400_ref87","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.jbmt.2017.06.004","article-title":"Long-term effect of direction-movement control training on female patients with chronic neck pain","volume":"22","author":"Khosrokiani","year":"2018","journal-title":"J Bodyw Mov Ther."},{"key":"2023011806591985400_ref88","doi-asserted-by":"crossref","first-page":"211","DOI":"10.3233\/BMR-160735","article-title":"The clinical and EMG assessment of the effects of stabilization exercise on nonspecific chronic neck pain: a randomized controlled trial","volume":"30","author":"Ghaderi","year":"2017","journal-title":"J Back Musculoskelet Rehabil."},{"key":"2023011806591985400_ref89","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1016\/j.apmr.2012.02.018","article-title":"Training mode-dependent changes in motor performance in neck pain","volume":"93","author":"O\u2019Leary","year":"2012","journal-title":"Arch Phys Med Rehabil"},{"key":"2023011806591985400_ref90","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1589\/jpts.28.269","article-title":"Clinical effects of deep cervical flexor muscle activation in patients with chronic neck pain","volume":"28","author":"Kim","year":"2016","journal-title":"J Phys Ther Sci."},{"key":"2023011806591985400_ref91","first-page":"916","article-title":"Effects of the craniocervical flexion and isometric neck exercise compared in patients with chronic neck pain: a randomized controlled trial. Physiother","volume":"34","author":"Chung","year":"2018","journal-title":"Theory Pract."},{"key":"2023011806591985400_ref92","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1589\/jpts.25.1157","article-title":"Effects of strength and endurance training of superficial and deep neck muscles on muscle activities and pain levels of females with chronic neck pain","volume":"25","author":"Borisut","year":"2013","journal-title":"J Phys Ther Sci."},{"key":"2023011806591985400_ref93","doi-asserted-by":"crossref","first-page":"833","DOI":"10.3233\/BMR-150593","article-title":"The effect of different exercise programs on cervical flexor muscles dimensions in patients with chronic neck pain","volume":"28","author":"Javanshir","year":"2015","journal-title":"J Back Musculoskelet Rehabil."},{"key":"2023011806591985400_ref94","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/j.math.2009.05.004","article-title":"The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain","volume":"14","author":"Jull","year":"2009","journal-title":"Manual Therapy."},{"key":"2023011806591985400_ref95","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.math.2007.07.001","article-title":"Training the cervical muscles with prescribed motor tasks does not change muscle activation during a functional activity","volume":"13","author":"Falla","year":"2008","journal-title":"Man Ther."},{"key":"2023011806591985400_ref96","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/j.math.2015.01.007","article-title":"Inter-and intra-tester reliability of a battery of cervical movement control dysfunction tests","volume":"20","author":"Segarra","year":"2015","journal-title":"Man Ther."},{"key":"2023011806591985400_ref97","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.clinbiomech.2018.05.010","article-title":"Differences in neck surface electromyography, kinematics and pain occurrence during physiological neck movements between neck pain and asymptomatic participants. A cross-sectional study","volume":"57","author":"Lascurain-Aguirrebe\u00f1a","year":"2018","journal-title":"Clin Biomech (Bristol, Avon)"},{"key":"2023011806591985400_ref98","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1093\/ptj\/83.8.713","article-title":"Reliability of the PEDro scale for rating quality of randomized controlled trials","volume":"83","author":"Maher","year":"2003","journal-title":"Phys Ther."},{"key":"2023011806591985400_ref99","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0132634","article-title":"PEDro or Cochrane to assess the quality of clinical trials? A meta-epidemiological study","volume":"10","author":"Armijo-Olivo","year":"2015 10","journal-title":"PLOS ONE."},{"key":"2023011806591985400_ref100","article-title":"best evidence rehabilitation for chronic pain part 4: neck pain","author":"Sterling","year":"15, 2019","journal-title":"J Clin Med."},{"key":"2023011806591985400_ref101","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.msksp.2017.07.005","article-title":"Manual therapy, exercise therapy or combined treatment in the management of adult neck pain\u2013a systematic review and meta-analysis","volume":"31","author":"Fredin","year":"2017","journal-title":"Musculoskel Sci Prac."},{"key":"2023011806591985400_ref102","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1097\/PHM.0000000000000721","article-title":"The effect of different exercise programs on size and function of deep cervical flexor muscles in patients with chronic nonspecific neck pain: a systematic review of randomized controlled trials","volume":"96","author":"Arimi","year":"2017","journal-title":"Am J Phys Med Rehab."},{"key":"2023011806591985400_ref103","article-title":"Exercises for mechanical neck disorders. Cochrane Back and Neck Group, editor","author":"Gross","year":"28, 2015","journal-title":"Cochrane Database of Systematic Reviews."},{"key":"2023011806591985400_ref104","doi-asserted-by":"crossref","first-page":"pzaa223","DOI":"10.1093\/ptj\/pzaa223","article-title":"Enhanced pronociceptive and disrupted antinociceptive mechanisms in nonspecific chronic neck pain","volume":"101","author":"Zabala-Mata","year":"2021","journal-title":"Phys Ther."},{"key":"2023011806591985400_ref105","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.b2535","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","author":"Moher","year":"2009","journal-title":"BMJ"},{"key":"2023011806591985400_ref106","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.math.2006.06.003","article-title":"Recruitment of the deep cervical flexor muscles during a postural-correction exercise performed in sitting","volume":"12","author":"Falla","year":"2007","journal-title":"Manual Therapy."},{"key":"2023011806591985400_ref107","volume-title":"Enhancing low-back health through stabilization exercise a daily routine for enhancing low-back health","author":"Mcgill","year":"2003"},{"key":"2023011806591985400_ref108","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/0003-9993(94)90115-5","article-title":"Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomized controlled study","volume":"75","author":"Revel","year":"1994","journal-title":"Arch Phys Med Rehabil."},{"key":"2023011806591985400_ref109","first-page":"288","article-title":"Cervicocephalic kinesthetic sensibility in patients with cervical pain","volume":"72","author":"Revel","year":"1991","journal-title":"Arch Phys Med Rehabil."},{"key":"2023011806591985400_ref110","doi-asserted-by":"crossref","first-page":"275","DOI":"10.2519\/jospt.1992.16.6.275","article-title":"Progressive resistance neck exercises using a compressible ball coupled with an air pressure gauge","volume":"16","author":"Axen","year":"1992","journal-title":"J Orthop Sports Phys Ther."}],"container-title":["Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ptj\/advance-article-pdf\/doi\/10.1093\/ptj\/pzab259\/41188946\/pzab259.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ptj\/article-pdf\/102\/2\/pzab259\/48750918\/pzab259.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ptj\/article-pdf\/102\/2\/pzab259\/48750918\/pzab259.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,12]],"date-time":"2023-11-12T08:52:35Z","timestamp":1699779155000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ptj\/article\/doi\/10.1093\/ptj\/pzab259\/6423600"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,20]]},"references-count":110,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ptj\/pzab259","relation":{},"ISSN":["0031-9023","1538-6724"],"issn-type":[{"value":"0031-9023","type":"print"},{"value":"1538-6724","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,2,1]]},"published":{"date-parts":[[2021,11,20]]},"article-number":"pzab259"}}