Long-term effects of therapeutic exercise on nonspecific chronic neck pain: a literature review.

[Purpose] Nonspecific neck pain is a common musculoskeletal disease. Therapeutic exercise has been shown to improve pain and disability in short-term and midterm follow-ups. This study performed a literature review of the long-term effects of therapeutic exercise on subjects with nonspecific chronic neck pain. [Subjects and Methods] The databases of the CINAHL, MEDLINE, PEDro and PubMed were used. Randomized controlled trials (RCT) published from January 2000 to January 2014 and explicitly including a one-year follow-up were identified. [Results] Only six articles were included in this review. They had scores of 5 to 8 points on the PEDro scale, and the level of evidence was grade I. The study results show that the main exercises used were cervical strengthening and endurance training exercise. Short-term exercises (10 to 12 weeks) helped to improve the body function, structure, activity and participation immediately after the intervention, but not at the long-term follow-up. On the other hand, long-term interventions (1 year) resulted in improvements in body function and structure at the 3 year follow-up. [Conclusion] The results of the six high-quality studies suggest that long-term exercise have long-term benefits for patients with nonspecific neck pain in terms of body function and structure.

Spatial variation of soil properties impacted by aquaculture effluent in a small-scale mangrove.

Small-scale mangroves serve ecological functions similar to large-scale mangroves regarding biological conservation, environmental purification, and supporting biogeochemical processes. The rising aquaculture neighboring mangroves results in their serving as an important sink for massive nutrients and pollutants from aquaculture effluent. We assessed how long-term aquaculture effluent discharge influenced the soil properties of a mangrove-tidal flat continuum using field survey and geostatistics. Common soil physical-chemical properties presented significant spatial variability. Continued aquaculture effluent discharge caused a significant cumulation of soil total organic carbon (SOC) (64.13 g·kg-1), total nitrogen (TN) (2.44 g·kg-1) and total phosphorus (TP) (1.12 g·kg-1) in the mangrove soil, which were as 2-3 times as those on the mudflat. Most of the soil properties changed significantly with increasing distance from the effluent outlet along a tidal channel, and the maximum concentrations of SOC, TN and TP all occurred at 50 m away from the outlet. The results of principal component analysis indicated that aquaculture effluent significantly affected the spatial pattern of soil properties along the mangrove-tidal flat continuum. Continued aquaculture effluent input rendered extensive accumulation of SOC, TN and TP in the mangroves. The spatial heterogeneity of mangrove is the key driver to process the nutrient input spatially differently.

Changes of postural control and muscle activation pattern in response to external perturbations after neck flexor fatigue in young subjects with and without chronic neck pain.

PURPOSE: Previous studies have identified sensorimotor disturbances and greater fatigability of neck muscles in patients with neck pain. The purpose of this study was to investigate the effect of neck pain and neck flexor fatigue on standing balance following postural perturbations. METHODS: Twenty patients with chronic neck pain (CNP) (24.7±3.6 year-old) and 20 age-matched asymptomatic subjects (22.1±2.2 year-old) were recruited. Subjects stood barefoot on a force plate and experienced backward perturbations before and after neck flexor fatigue. Center of pressure, electromyography of cervical and lumbar muscles, and head/trunk accelerations were recorded. Two-way ANOVA (pain×fatigue) was used for statistical analysis. RESULTS: CNP group showed larger body sway during quiet standing but not during perturbed standing compared with asymptomatic adults. In both groups, neck flexor fatigue resulted in greater body sway during the quiet standing but smaller body sway during perturbed standing, increased neck muscle activations and decreased lumbar muscle activations, as well as increased time to maximal head acceleration. CONCLUSIONS: Disturbed balance control was observed in CNP patients during the quiet standing. However, a rigid strategy was used to minimize the postural sway and to protect the head against backward perturbations in both CNP and asymptomatic young adults after neck flexor fatigue. The results facilitate the understanding of how the subjects with chronic neck pain and with neck muscle fatigue deal with the challenging condition. Further studies are needed to verify if such phenomenon could be changed after the intervention of specific flexor muscle retraining and balance control exercises.