The effects of Stabilization Exercises and Maximum Isometric Exercises on Fear Avoidance of Belief in Chronic Non-Specific Neck Pain

There is an increasing evidence that show fear of pain and fear of re-injury are fundamental mechanisms in progress of pain and disability in the patients. Cervical stabilization training is a method of exercise which is designed to improved the mechanisms by which the cervical spine maintains a stable, injury-free state. The aim of this study was to compare effectiveness of stabilization exercises with maximum Isometric exercises on fear avoidance belief in Chronic Non-Specific Neck Pain. In clinical trail study fifty patients with chronic neck pain were recruited. Subjects were randomly assigned to either a stabilization (n=25) or a maximum isometric exercise group (n=25). Before and after intervention (4,8,12 weeks) pain was assessed with visual analog scale (ordinal), disability (ordinal) with Neck Stability Index (NDI), Fear Avoidance of Belief with Fear Avoidance of Belief Questionnaire (FABQ. A 48 session exercise program which 8 weeks. six session per week, and per session was performed for both groups. Repeated measurement of analysis variance, Independent t-test and paired t-test were used for comparison between pretreatment and post treatment test results between groups and within groups, respectively. The mean neck pain decreased from 7/16±1/57 in first session to 0/92±0/70 in 12 session in the stabilization group and from 7/12±1/67 in first session to 1/28±0/94in 12 session in maximum isometric group (p=0/482). The mean disability (NDI) decreased from 22/60±3/20 in first session to 11/16±0/90 in 12 session in the stabilization group and from 21/88±2/76 in first session to 14/96±1/48 in 12 session in maximum isometric group (p<0/001). The mean FABQ-W decreased from 35/08±4/48 in first session to 9/08±1/44 in 12 session in the stabilization group and from 34/76±4/63 in first session to 17/44±2/18 in 12 session in maximum isometric group (P<0/001). The mean FABQ-PA decreased from 20/12±2/26 in first session to 9/26±1/01 in 12 session in the stabilization group and from 20/08±2/23 in first session to 11/16±1/14 in 12 session in maximum isometric group (p= 0/938). Decreased all variables in the stabilization group was more useful than maximum isometric group (p<0/05). This study showed that neck specific stabilization exercises and maximum isometric exercises decrease pain, disability, fear of pain and fear of re-injury. Also specific stabilization exercises was more useful than maximum isometric procedure.