STUDY DESIGN: A multivariate repeated measures independent-group study design.OBJECTIVES: To compare the effect of a craniocervical flexion exercise (CCFEx) program to that of a conventional cervical flexion exercise (CFEx) program in training isometric craniocervical flexor muscle performance. BACKGROUND: The craniocervical flexor muscles are important muscles of the cervical spine, as they have been shown to be impaired in persons with chronic neck pain. While both CCFEx and CFEx protocols have been advocated to train craniocervical flexor muscle performance, at present there is no consensus as to the most effective method. METHODS AND MEASURES: Fifty females with chronic mild neck pain and disability status were randomly allocated into a 6-week program of either CCFEx (n = 27) or CFEx (n = 23). Isometric dynamometry measurements of craniocervical flexor muscle performance (maximal voluntary contraction, endurance at 50% of maximal voluntary contraction) were recorded before and following the exercise program. Changes in craniocervical flexor muscle performance (pretraining-posttraining) within and between exercise groups were analyzed with analysis of variance models. RESULTS: Both exercise interventions significantly improved isometric craniocervical flexor muscle performance (P<.02). No significant differences in improvement of muscle performance were observed between the 2 exercise interventions.CONCLUSION: It appears that isometric craniocervical flexor muscle performance can be trained with either a CCFEx protocol or a conventional CFEx protocol in patients with mild neck pain and disability.  

J Orthop Sports Phys Ther. 2007;37(1):3-9. doi:10.2519/jospt.2007.2237 

KEY WORDS: cervical spine, craniocervical flexion, neck pain, rehabilitation