Effects of breathing re-education on endurance, strength of deep neck flexors and pulmonary function in patients with chronic neck pain: A randomised controlled trial.

Background: People with chronic neck pain show decreased endurance and strength of cervical muscles with compromised respiratory function. There is little evidence that improvement in breathing function of people with neck pain can help in enhancing cervical muscle strength and pulmonary function. The objective of this our clinical trial was to examine the effects of breathing re-education combined with physiotherapy on endurance and strength of deep neck flexors, and pulmonary function in patients with chronic neck pain.

Methods/design: In this double blind randomised clinical trial, 30 patients with chronic neck pain (25-50 years old) were randomly allocated to two groups. Group A, physiotherapy (n = 15), and Group B, breathing re-education (n = 15). The duration of intervention was eight weeks with treatment five days a week. The endurance was measured with the craniocervical flexion test, strength with a handheld dynamometer (Baseline USA) and pulmonary functions with the Spiro lab 4 (USA) at baseline, at week four and at week eight of the intervention.

Discussion: There was a significant between group improvement in the strength of deep neck flexors and forced vital capacity (FVC) in Group B p = 0.0001 and p = 0.0200 (p ˂ 0.05) respectively. Intergroup comparisons showed no significant differences for endurance, cervical extensor strength, Forced Expiratory Volume in one second (FEV1), and FEV1/FVC percentage.

Conclusion: Our study concluded that breathing re-education combined with other physiotherapy management is effective for improving the strength of neck flexors and increasing FVC in people with chronic neck pain.

Clinical implication: Breathing re-education may be part of physiotherapy management in patients with chronic neck pain.

Trial registration: Iranian Registry of Clinical Trials, IRCT20200226046623N1, https://www.irct.ir/trial/46240.