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Neck Muscle Strength and Mobility of the Cervical Spine as Predictors of Neck Pain: A Prospective 6-Year Study

Salo, Petri DSc*; Ylinen, Jari PhD, MD*; Kautiainen, Hannu BA; Häkkinen, Keijo PhD; Häkkinen, Arja PhD*,§

doi: 10.1097/BRS.0b013e31823b405e
Cervical Spine

Study Design. Follow-up study.

Objective. To study whether neck muscle strength or cervical spine mobility values could serve as predictors for future neck pain among originally pain-free working-age subjects during a long period.

Summary of Background Data. Neck pain has been associated with weaker neck muscle strength and lower cervical spine mobility in several studies. However, causality between physical capacity and neck pain has not been shown.

Methods. Isometric neck muscle strength and passive range of motion of the cervical spine of 220 healthy female volunteers, aged 20 to 59 years, were measured. A postal survey was conducted 6 years later to determine whether any volunteers had experienced neck pain. The receiver operator characteristics curve was used to study how well the neck strength and mobility values in different movement planes at baseline served as predictors of future neck pain.

Results. Of the 192 (87%) responders, 37 (19%) reported neck pain for 7 days during the past year. In predicting neck pain, areas under the receiver operator characteristics curves (95% confidence intervals) in different movement planes were 0.52 to 0.56 (0.41–0.66) for isometric neck strength and 0.54 to 0.56 (0.44–0.76) for passive mobility of the cervical spine.

Conclusion. The results suggest that neither isometric neck muscle strength nor passive mobility of cervical spine has predictive value for later occurrences of neck pain in pain-free working-age women. Thus, screening healthy subjects for weaker neck muscle strength or decreased mobility of the cervical spine may not be recommended for preventive purposes.

In this 6-year prospective study, the predictive value of physical capacity measures for future neck pain was assessed among 220 healthy female volunteers. Neither isometric neck muscle strength nor passive mobility of the cervical spine seemed to have predictive value for later occurrences of neck pain.

*Department of Physical and Rehabilitation Medicine, Central Finland Health Care District, Jyväskylä, Finland;

Rheumatism Foundation, Heinola, Finland;

Department of Biology of Physical Activity, University of Jyväskylä, Finland; and

§Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.

Address correspondence and reprint requests to Petri Salo, DSc, Department of Physical and Rehabilitation Medicine, Central Finland Health Care District, Keskussairaalantie 19, FI-40620 Jyväskylä, Finland; E-mail:

Acknowledgment date: March 22, 2011. First revision date: September 29, 2011. Acceptance date: October 1, 2011.

The manuscript submitted does not contain information about medical device(s)/drug(s).

The Ministry of Education and the Central Finland Health Care District funds were received to support this work.

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

© 2012 Lippincott Williams & Wilkins, Inc.