Efficacy of Mckenzie and Isometric Strengthening Exercises to Improve ROM in Patients with Non-Specific Neck Pain-A Systematic Review

Abstract

Non-specific neck pain is a prevalent musculoskeletal disorder that often results in reduced cervical range of motion (ROM) and impaired quality of life. McKenzie exercises and isometric strengthening exercises are two widely adopted physiotherapeutic approaches. Objective: To systematically review the existing literature and evaluate the efficacy of McKenzie and isometric strengthening exercises in improving ROM among patients with non-specific neck pain. Methods: This randomized controlled trial aimed to compare the efficacy of McKenzie exercises, isometric strengthening, their combination, and standard care in improving cervical range of motion (ROM), reducing pain, and minimizing disability in individuals with NSNP. 40 participants with 20-50 years were randomly assigned to four groups. Assessments using a goniometer (ROM), Visual Analogue Scale (VAS), and Neck Disability Index (NDI) were recorded at baseline and after four weeks.

Introduction

Non-specific neck pain is a prevalent musculoskeletal condition affecting daily activities and potentially leading to disability. It typically involves mechanical pain between the occiput and upper thoracic spine without a specific cause. About 70% of adults experience neck pain in their lifetime, with a higher prevalence in women. Causes include muscle strain, poor posture, sedentary lifestyle, minor injuries, and repetitive movements. Symptoms can include stiffness, limited range of motion (ROM), headaches, dizziness, and brachialgia.

Risk factors range from psychological issues, genetics, sleep problems, smoking, obesity, trauma, and occupational hazards, especially in office workers, manual laborers, and athletes in contact sports. Treatment options include manual therapy, electrotherapy, medications, and various exercise regimes.

The McKenzie Method (Mechanical Diagnosis and Therapy) is a recognized exercise approach focusing on repeated movements to improve ROM and reduce symptoms. Isometric strengthening exercises help reduce muscle spasms, strengthen neck muscles, and improve endurance.

Despite multiple therapies, no consensus exists on the most effective intervention for improving cervical ROM in non-specific neck pain. This study aims to evaluate the effectiveness of McKenzie exercises, isometric strengthening exercises, and their combination in improving cervical ROM.

A systematic review and randomized controlled trials suggest that both McKenzie and isometric exercises individually improve pain, disability, and ROM, but their combination yields superior outcomes. The combined approach provides biomechanical and neuromuscular benefits by addressing symptom centralization and muscle stabilization.

Limitations of existing research include short study durations, small sample sizes, and lack of long-term follow-up, highlighting the need for further research.

Conclusion

The combination of McKenzie and isometric strengthening exercises is more effective in improving cervical ROM, reducing pain, and minimizing disability in patients with non-specific neck pain than either modality alone or standard care. Clinicians are encouraged to adopt an integrative approach for optimal rehabilitation outcomes in non-specific neck pain patients.Future research should focus on larger sample sizes and long-term outcomes to establish definitive clinical guidelines.

References

[1] Reham Hussein Diab,Rania Hakem Hamed,Ibrahem Mustafa Mustafa.Efficacy of Mckenzie Protocol on Non-specific neck pain.International Journal of Physical Education ,Sports and Health 2024;11(2):228-238,doi:01.04.2024 [2] Hayat M.,Kalsoom K ,Pria A,Ijaz R et al.(2023).Comparison of Treatment outcome of the Effectiveness of Isometric Exercises as compared to General Exercises with Cervical spine mobilization in the management of chronic non specific neck pain,British Journal of Multidisciplinary and Advanced Studies:Health and Medical Sciences 4(6),63-72.doi:https://doi.org/10.37745/bjmas.2022.0380 [3] Hassan W ,Malik S,Gondal J et.al(2016).Comparison of effectiveness of isometric exercises with or without stretchingbexercises in non specific cervical pain.International Journal of Physiotherapy,3(3),371-375.doi.18.05.2016,10.15621/ijphy/2016/v3i3/100848

Copyright

Copyright © 2025 Bhagyasree Datta. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.