387: Exercise prescription for chronic neck pain: a narrative synthesis of a systematic review

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary musculoskeletal pain, Non-pharmacological treatments, Physiotherapy (e.g. exercise, rehab)

Background and Aims: Chronic neck pain (CNP) is a prevalent condition often associated with persistent pain, disability, and reduced quality of life. Physical activity is recommended as core component for managing chronic pain; However, most research focuses on supervised, on-site exercises, with limited attention to the impact of exercise prescription alone. Prescription of physical activity (PPA) represents a clinical strategy that may influence outcomes while improving care. Currently, no systematic reviews have specifically examined how exercise is prescribed or how prescription-based interventions differ from supervised delivery. This review aimed to synthesize exercise prescription characteristics in trials involving individuals with CNP.

Methods: A systematic review (PROSPERO CRD42024594589) was performed according to PRISMA guidelines. Electronic searches were conducted in MEDLINE, Embase, Scopus, CENTRAL, and CINAHL databases. Studies investigating exercise-based interventions for adults with CNP were included. Two reviewers independently screened studies and extracted descriptive data (COVIDENCE). A narrative synthesis was performed to summarize exercise prescription characteristics across studies using predefined domains, including prescribing professional, general, and specific exercise type, prescription tools, and monitoring strategies. The completeness of exercise intervention reporting was assessed using the Consensus on Exercise Reporting Template (CERT).

Results: Seventeen studies were included. Exercise was most commonly prescribed by physiotherapists (59%). Most interventions were based on general neck exercises (47%), while fewer studies used stretching-based approaches (24%) or combined general physical activity with neck-specific components (29%). Most studies used written materials to support exercise delivery (65%), while 35% included one-time in-person instruction session. Video-based tools were used in 24% of the interventions, and only 12% incorporated remote or digital support strategies. Adherence was primarily monitored through diaries or logbooks (47%). Considerable heterogeneity and incomplete reporting of key prescription elements were observed across studies based on CERT guidelines.

Conclusions: This narrative primary analysis highlights that exercise prescription strategies for individuals with CNP are heterogeneous and frequently lack comprehensive reporting of key components, such as progression criteria, individualization, monitoring, and adherence strategies. Although physiotherapists most commonly prescribe exercise and written materials are widely used, substantial variability exists in delivery methods and monitoring approaches. Greater standardization and transparency in describing exercise prescription characteristics are needed to strengthen the methodological rigor of non-pharmacological interventions for CNP management. Future analyses of this review will compare the effectiveness of exercise prescription alone with supervised or multimodal therapeutic approaches.

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Özden Yaşarer, Hürriyet Gürsel Yilmaz & Halis Doğan (07 Apr 2023): Comparison of two different delivery methods of home-based exercise on neck pain, Somatosensory & Motor Research, DOI: 10.1080/08990220.2023.2194389

Presenting Author: Luiz Felipe Tavares
Submitting Author: Luiz Felipe Tavares

Senior Author: Susan Armijo-Olivo

IASP 2026 Global Year theme of Neuropathic Pain: No

• Vladimir Aron: MSc - UC Louvain
• Bárbara Carrasco Gubernatis: BPhysio - Hochschule Osnabrueck
• Henrik Bjarke Vaegter: PhD - University of Southern Denmark
• Susan Armijo-Olivo: PhD - University of Applied Sciences Osnabruck