67% of people will suffer neck pain at some point in their lives. Abnormal muscle recruitment patterns may lead to a cycle of impaired movement patterns, which result in neck pain becomig chronic. Spinal manipu- lation combined with exercise has been shown to decrease pain and disability in patients with chronic low back pain and this improvement can be partially attributed to improved neuromuscular activation patterns. The purpose of this pilot study was to apply this model from the back to the neck and also to determine whether similar changes in neuromuscular activation occurred in chronic neck pain patients.
This pilot study was a randomized controlled trial comparing chiropractic care combined with exercise versus exercise only for participants with chronic neck pain. Group 1 received 4 weeks of chiropractic care, and Group 2 waited 4 weeks before both groups participated in an 8-week exercise intervention. The following outcome measures were assessed in week 1 (baseline), week 4 and at week 12: Neck Disability Index (NDI); Visual Analogue Scale; Neck flexion-relaxation (FR) response and feed forward activation times.
1) To determine whether a 4-week period of chiropractic care improves the ability of patients to respond to an 8-week period of exercise rehabilitation on indices of disability, and neuromuscular function.

2) To determine effect sizes for any changes in neuromuscular activation patterns.
There was a significant reduction observed in functional disability and pain levels in both groups. There were medium effect size changes in feed forward activation for both groups and for the FR response in the exercise group.
Chiropractic care combined with exercise and exercise alone are both effective at reducing functional disability and pain in chronic non-specific neck pain patients, which may be related to improved neuromuscular measures.

Grant Value: $36,030.82
Chief Investigator: Dr Bernadette Murphy – University of Auckland
Status: Complete