Immediate neck hypoalgesic effects of craniocervical flexion exercises and cervical retraction exercises among individuals with non-acute neck pain and a directional preference for retraction or extension: preliminary pretest-posttest randomized experimental design.
Hiroshi Takasaki, Chisato Yamasaki
PMID 37052492WHAT IT FOUND
A single 9-minute session of either craniocervical flexion or cervical retraction exercise made the neck less tender to pressure, with no significant difference between them.
Retraction gave more range-of-motion gain in these 19 young people whose symptoms eased with retraction or extension.
Key findings
01Pressure pain threshold rose from before to immediately after the exercise at both neck levels in both groups (pre-post p = 0.048 at C2 and p < 0.001 at C5/6), but the difference between the two exercises was not statistically significant (p = 0.194 at C2 and p = 0.146 at C5/6).
02Neck range of motion improved more after cervical retraction than after craniocervical flexion. This was the only outcome with a statistically significant difference between the groups (p = 0.014), with a large effect size (g = 1.259).
03Current pain intensity fell by half in both groups after the 9 minutes of exercise, from 2.9 to 1.4 out of 10 with craniocervical flexion and 3.6 to 1.8 with retraction, and symptoms were reported over fewer body areas in both groups. Neither differed significantly between the two exercises (p = 0.558 and p = 0.146).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only 19 people were analysed, all university students and mostly women, recruited by convenience. The authors themselves call the results preliminary and say a larger cohort is needed. There was no control group, so the improvements could reflect time, the testing itself or simply being handled. Medication use was neither recorded nor controlled, so it may also have influenced the results. Each person exercised once for nine minutes and was measured straight afterwards, so the study says nothing about whether any effect lasts hours, days or longer. The main comparison between the two exercises was not statistically significant, and the sample was sized from an earlier study of only 18 people, so a real difference between the exercises may simply have been missed. The groups differed before treatment: the retraction group reported more pain at baseline (21.0 versus 14.9 on a 0 to 40 scale) and had much longer symptom duration (49.7 versus 20.1 months). The therapist who delivered both exercises was the study's first author and also carried out the directional-preference classification afterwards. Only the outcome assessors were kept blind to which exercise had been given.
Declared interests
The paper's only funding statement is that the article processing fee was supported by the International MDT Research Foundation. MDT is the mechanical diagnosis and therapy system that supplied the cervical retraction exercise tested here. No other funding and no individual author declarations appear in the text.
The easy way to misread this
Do not conclude that cervical retraction is a better exercise than craniocervical flexion for neck pain. The difference between the two on the main measure, pressure pain threshold, was not statistically significant at either neck level, and the study had 19 participants, no control group and a single nine-minute session. The one significant between-group result was for neck range of motion, not for pain.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →