تأثیر تمرینات ثبات دهنده و تمرینات ایزومتریک حداکثری بر دیدگاه‌های اجتنابی ناشی از درد در بیماران گردن درد مزمن غیر اختصاصی

Objective: There is an increasing evidence that show fear of pain and fear of re-injury are fundamental mechanisms in progress of pain and disability in the patients. Cervical stabilization training is a method of exercise which is designed to improved the mechanisms by which the cervical spine maintains a stable, injury-free state . The aim of this study was to compare effectiveness of stabilization exercises with maximum Isometric exercises on fear avoidance belief in Chronic Non-Specific Neck Pain . Materials & Methods: In clinical trail study fifty patients with chronic neck pain were recruited. Subjects were randomly assigned to either a stabilization (n=25) or a maximum isometric exercise group (n=25). Before and after intervention ( 4,8,12 weeks) pain was assessed with visual analog scale (ordinal) , disability (ordinal ) with Neck Stability Index (NDI) , Fear Avoidance of Belief with Fear Avoidance of Belief Questionnaire (FABQ . A 48 session exercise program which 8 weeks . six session per week , and per session was performed for both groups. Repeated measurement of analysis variance , Independent t-test and paired t-test were used for comparison between pretreatment and post treatment test results between groups and within groups, respectively. Results: The mean neck pain decreased from 7.16±1.57 in first session to 0.92±0.70 in 12 session in the stabilization group and from 7.12±1.67 in first session to 1.28±0.94in 12 session in maximum isometric group (p=0.482) . The mean disability (NDI) decreased from 22/60±3/20 in first session to 11.16±0.90 in 12 session in the stabilization group and from 21.88±2.76 in first session to 14.96±1.48 in 12 session in maximum isometric group (p<0.001 ) . The mean FABQ-W decreased from 35.08±4.48 in first session to 9.08±1.44 in 12 session in the stabilization group and from 34.76±4.63 in first session to 17.44±2.18 in 12 session in maximum isometric group (P<0.001) . The mean FABQ-PA decreased from 20.12±2.26 in first session to 9.26±1.01 in 12 session in the stabilization group and from 20.08±2.23 in first session to 11.16±1.14 in 12 session in maximum isometric group (P=0.938) . Decreased all variables in the stabilization group was more useful than maximum isometric group (P<0.05) . Conclusion: This study showed that neck specific stabilization exercises and maximum isometric exercises decrease pain, disability, fear of pain and fear of re-injury . Also specific stabilization exercises was more useful than maximum isometric procedure .