Motor control training of deep neck flexors with pressure biofeedback improves pain and disability in patients with neck pain: A systematic review and meta-analysis

Abstract

Background: The effects of motor control training with pressure biofeedback on neck pain and disability of patients with neck pain is a field that has drawn a lot of research interest. Therefore, the aim of this study was to conduct, for the first time, a systematic review and meta-analysis for examining whether motor control training of deep neck flexors with pressure biofeedback improves pain and disability in patients with neck pain. Methods: The systematic review and meta-analysis were performed according to PRISMA guidelines. The databases PubMED, MEDLINE, EBSCOhost, Google scholar, SportDiscus, COCHRANE and EMBASE were searched for studies related to the research question. PEDro scale was used for examining methodological quality. A random effects model was used for data meta-analysis. Results: Seventeen studies were included for qualitative synthesis and 10 were selected for further quantitative synthesis. Motor control training of deep neck flexors with pressure biofeedback was found to have equal or better effectiveness on neck pain intensity and disability in comparison to other control interventions. The meta-analyses show that motor control training of deep neck flexors with pressure biofeedback is more effective than strength-endurance training of cervical muscles for improving pain (Hedges’ g = 0.323, 95% CI 0.04–0.60, I2 = 50.94%) and disability (Hedges g = 0.401, 95% CI 0.12–0.68, I2 = 53.44%) in patients with neck pain. Conclusions: Motor control training of deep neck flexors with pressure biofeedback is an effective intervention for improving pain intensity and disability in patients with neck pain and preferable to strength-endurance training of cervical muscles. © 2020 Elsevier Ltd