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There is a need for specificity when prescribing


   therapeutic exercise in the management of people with
neck pain due to the general exercise (i.e.strengthening



 
 
and stretching superficial neck muscles) showed no im-
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  The deep neck and girdle muscles are function-
 ally more important to provide cervical joints support and
Previous protocols such as radiological imaging, control. The specific therapeutic exercise program should
classification systems are not helpful for diagnosis and - Target and activate the deep neck and girdle muscles
management in patients with neck pain. - Retraining tonic endurance capacity of deep neck and
The new models of diagnosis are to consider girdle muscles
neck disorders as a pain syndrome. Physiotherapy should - Retrain the patterns of activation of deep and
investigate the processes involved:- superficial neck and girdle muscles
1)musculoskeletal system - Co-contraction exercise (deep flexors and extensors)
2)pain (sensory) system - Re-educate the use of muscles in posture and
3)psychological system. functional tasks
- Address strength and endurance for functional
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 requirements
Physiotherapists should investigate the following function; - Designed to focus on the muscle control aspects and
- Range of motion aims to improve control of the deep postural muscles
- Muscle function - Low load exercise is used to train the co-ordination
- Postural control system between the layers o the neck muscles
Measurable impairments: -Based on biomechanical, physiological and clinical
- Cranio-cervical flexion test evidence of impairments in these muscles in neck
- EMG pain patients.
There are several practice sessions on the use
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  of neck stabilizers on cranio-cervical flexion test, which is
Sensory changes are like reflecting disturbances in central developed by the speaker (Professor Jull). The practical
neurobiological processing of pain. Evidence is shown that sessions are included the assessment of lumbar and
patients with chronic whiplash had hyperalgesia which shoulder girdle dysfunctions, therapeutic exercise for neck
indicated the abnormal physiology in the way the nervous flexors and extensors, and balance control.
system processess pain signals.
Quantitative sensory tests
- Heat&cold tests
- Pressure pain thresholds
- Brachial plexus provocation test

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Neck afferents are vital for postural control. Cervical
afferents are important for knowledge of head position in
relation to the body, controlling posture, and eye-head
coordination.
Quantitative postural control tests
- Cervical joint position error
- Altered smooth pursuit eye movement with nock
torsion(SPNT)