Institutional members access full text with Ovid®

Share this article on:

Isometric Exercise for the Cervical Extensors Can Help Restore Physiological Lordosis and Reduce Neck Pain: A Randomized Controlled Trial

Alpayci, Mahmut MD; İlter, Server MD

American Journal of Physical Medicine & Rehabilitation: September 2017 - Volume 96 - Issue 9 - p 621–626
doi: 10.1097/PHM.0000000000000698
Original Research Articles

Objective The aim of this study was to investigate whether isometric neck extension exercise restores physiological cervical lordosis and reduces pain.

Design Sixty-five patients with loss of cervical lordosis were randomly assigned to exercise (27 women, 7 men; mean age, 32.82 ± 8.83 yrs) and control (26 women, 5 men; mean age, 33.48 ± 9.67 yrs) groups. Both groups received nonsteroidal anti-inflammatory drugs for 10 days. The exercise group received additional therapy as a home exercise program, which consisted of isometric neck extension for 3 mos. Neck pain severity and cervical lordosis were measured at baseline and at 3 mos after baseline.

Results Compared with baseline levels, cervical lordosis angle was significantly improved in the exercise group (P < 0.001) but not in the control group (P = 0.371) at the end of 3 mos. Moreover, the exercise group was significantly superior to the control group considering the number of patients in whom cervical lordosis angle returned to physiological conditions (85.2% vs. 22.5%; P < 0.001). At the end of 3 mos, pain intensity was significantly reduced in both groups compared with baseline levels (for all, P < 0.001). Nevertheless, considering the change from baseline to month 3, the reduction in pain was about twice in the exercise group compared with the control group (P < 0.001).

Conclusions Isometric neck extension exercise improves cervical lordosis and pain.

From the Yuzuncu Yil University Hospital, Department of Physical Medicine and Rehabilitation, Van, Turkey.

All correspondence and requests for reprints should be addressed to: Mahmut Alpayci, MD, Yuzuncu Yil University Hospital, Department of Physical Medicine and Rehabilitation, Van, 65100, Turkey.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.