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In Reply: I agree with Dr Nadler that patient education is the key factor to obtaining good results in rehabilitation. Isometric neck strength training often requires several teaching sessions so that the proper body posture is maintained during the exercise and that the load of the elastic band is high enough. The control patients were taught stretching exercises only once before they received printed advice. Thus, we compared commonly used patient instruction for stretching and 2 muscle training methods.

I disagree, however, that increased education in the control group would have improved its outcome. These patients had fewer exercises to learn and most were already familiar with stretching exercises. For instance, Takala et al¹ found that stretching exercises did not improve neck pain even when performed regularly in supervised groups.

Isometric testing has been commonly used in studies of neck pain because it is an appropriate, safe, and more repeatable . . . [Full Text of this Article]

Jari Ylinen, MD
Department of Physical and Rehabilitation Medicine
Jyväskylä Central Hospital
Jyväskylä, Finland

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Isometric Training to Treat Chronic Neck Pain
Scott F. Nadler
JAMA. 2003;290(8):1027.
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