PDF(Pubmed)
Abstract：
Chronic non-specific neck pain is highly prevalent, resulting in significant disability. Despite exercise being a mainstay treatment, guidance on optimal exercise and dosage variables is lacking. Combining submaximal effort deep cervical muscles exercise (motor control) and superficial cervical muscles exercise (segmental) reduces chronic non-specific neck pain, but evaluation of optimal exercise and dosage variables is prevented by clinical heterogeneity.
To gain consensus on important motor control and segmental exercise and dosage variables for chronic non-specific neck pain.
An international 3-round e-Delphi study, was conducted with experts in neck pain management (academic and clinical). In round 1, exercise and dosage variables were obtained from expert opinion and clinical trial data, then analysed thematically (two independent researchers) to develop themes and statements. In rounds 2 and 3, participants rated their agreement with statements (1-5 Likert scale). Statement consensus was evaluated using progressively increased a priori criteria using descriptive statistics.
Thirty-seven experts participated (10 countries). Twenty-nine responded to round 1 (79%), 26 round 2 (70%) and 24 round 3 (65%). Round 1 generated 79 statements outlining the interacting components of exercise prescription. Following rounds 2 and 3, consensus was achieved for 46 important components of exercise and dosage prescription across 5 themes (clinical reasoning, dosage variables, exercise variables, evaluation criteria and progression) and 2 subthemes (progression criteria and progression variables). Excellent agreement and qualitative data supports exercise prescription complexity and the need for individualised, acceptable, and feasible exercise. Only 37% of important exercise components were generated from clinical trial data. Agreement was highest (88%-96%) for 3 dosage variables: intensity of effort, frequency, and repetitions.
Multiple exercise and dosage variables are important, resulting in complex and individualised exercise prescription not found in clinical trials. Future research should use these important variables to prescribe an evidence-informed approach to exercise.
To gain consensus on important motor control and segmental exercise and dosage variables for chronic non-specific neck pain.
An international 3-round e-Delphi study, was conducted with experts in neck pain management (academic and clinical). In round 1, exercise and dosage variables were obtained from expert opinion and clinical trial data, then analysed thematically (two independent researchers) to develop themes and statements. In rounds 2 and 3, participants rated their agreement with statements (1-5 Likert scale). Statement consensus was evaluated using progressively increased a priori criteria using descriptive statistics.
Thirty-seven experts participated (10 countries). Twenty-nine responded to round 1 (79%), 26 round 2 (70%) and 24 round 3 (65%). Round 1 generated 79 statements outlining the interacting components of exercise prescription. Following rounds 2 and 3, consensus was achieved for 46 important components of exercise and dosage prescription across 5 themes (clinical reasoning, dosage variables, exercise variables, evaluation criteria and progression) and 2 subthemes (progression criteria and progression variables). Excellent agreement and qualitative data supports exercise prescription complexity and the need for individualised, acceptable, and feasible exercise. Only 37% of important exercise components were generated from clinical trial data. Agreement was highest (88%-96%) for 3 dosage variables: intensity of effort, frequency, and repetitions.
Multiple exercise and dosage variables are important, resulting in complex and individualised exercise prescription not found in clinical trials. Future research should use these important variables to prescribe an evidence-informed approach to exercise.
摘要：
慢性非特异性颈痛非常普遍，造成严重残疾。尽管运动是一种主要治疗方法，缺乏关于最佳运动和剂量变量的指导。结合次最大努力深颈部肌肉锻炼（运动控制）和浅颈部肌肉锻炼（节段性）减少慢性非特异性颈部疼痛，但是临床异质性阻止了对最佳运动和剂量变量的评估。
就慢性非特异性颈痛的重要运动控制和分段运动和剂量变量达成共识。
国际三轮e-Delphi研究，由颈部疼痛管理专家（学术和临床）进行。在第1轮中，从专家意见和临床试验数据中获得运动和剂量变量，然后进行主题分析（两名独立研究人员）以制定主题和陈述。在第2轮和第3轮中，参与者对他们与陈述的一致性进行了评分（1-5李克特量表）。使用描述性统计，使用逐步增加的先验标准评估陈述共识。
37名专家参加了会议（10个国家）。二十九人回应第一轮(79%)，26轮2（70％）和24轮3（65％）。第1轮生成了79条陈述，概述了运动处方的相互作用组成部分。在第2轮和第3轮之后，在5个主题（临床推理，剂量变量，运动变量，评估标准和进展)和2个子主题(进展标准和进展变量)。优秀的协议和定性数据支持运动处方的复杂性和个性化的需要，可接受,可行的锻炼。只有37%的重要运动成分来自临床试验数据。3个剂量变量的一致性最高(88%-96%)：努力强度，频率,和重复。
多种运动和剂量变量很重要，导致临床试验中未发现复杂和个性化的运动处方。未来的研究应该使用这些重要的变量来规定一种基于证据的锻炼方法。
就慢性非特异性颈痛的重要运动控制和分段运动和剂量变量达成共识。
国际三轮e-Delphi研究，由颈部疼痛管理专家（学术和临床）进行。在第1轮中，从专家意见和临床试验数据中获得运动和剂量变量，然后进行主题分析（两名独立研究人员）以制定主题和陈述。在第2轮和第3轮中，参与者对他们与陈述的一致性进行了评分（1-5李克特量表）。使用描述性统计，使用逐步增加的先验标准评估陈述共识。
37名专家参加了会议（10个国家）。二十九人回应第一轮(79%)，26轮2（70％）和24轮3（65％）。第1轮生成了79条陈述，概述了运动处方的相互作用组成部分。在第2轮和第3轮之后，在5个主题（临床推理，剂量变量，运动变量，评估标准和进展)和2个子主题(进展标准和进展变量)。优秀的协议和定性数据支持运动处方的复杂性和个性化的需要，可接受,可行的锻炼。只有37%的重要运动成分来自临床试验数据。3个剂量变量的一致性最高(88%-96%)：努力强度，频率,和重复。
多种运动和剂量变量很重要，导致临床试验中未发现复杂和个性化的运动处方。未来的研究应该使用这些重要的变量来规定一种基于证据的锻炼方法。
