Chronic Neck Pain and Exercise Interventions: Frequency, Intensity, Time, and Type Principle

The aim of this study was to identify the most effective components in an active exercise physiotherapy treatment intervention for chronic neck pain based on the frequency, intensity, time, and type (FITT) exercise method of tailoring physical activity recommendations to the individual needs and objectives of patients. Databases, including the Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health, MEDLINE, SPORTDiscus, Biomedical Reference Collection, and Academic Search Premier, were searched for relevant articles. Quantitative design studies that included active exercise as part of a multimodal or stand-alone approach were selected. Only studies scoring ≥6 on the Physiotherapy Evidence Database Scale were included in the review due to this reflecting a good level of evidence. Study methodologies and relevant outcome measures, including isometric strength, Neck Disability Index scores, and pain scores, were taken from relevant articles and grouped together for appraisal and synthesis. Evidence from selected articles was synthesized according to the FITT exercise principal to determine the most effective exercise type, frequency, and intensity in the treatment of chronic neck pain.

The study found physiotherapy interventions using a multimodal approach seem to produce more beneficial outcomes in terms of increased strength, improved function, and health-related quality of life and lower pain scores. Active strengthening exercises seem to be beneficial for all of these outcomes; the inclusion of additional stretching and aerobic exercise components appear to increase the benefits of an exercise intervention.