Investigation of physical fitness, daily physical activity, body composition and quality of life in patients with chronic neck pain

Neck pain is a common condition throughout the world, and it appears to be increasing in both the general population and in specific occupational groups. The purpose of this study was to investigate maximal aerobic capacity (VO2max), muscle strength, trunk flexibility, daily physical activity, pulmonary function, body composition, quality of life, anxiety and depression, as well as other disease-related changes in patients with chronic neck pain, and to compare them with healthy controls. Patients who had neck pain for at least the previous 3 months, at least 5 days/week, and no exercise-related risks were included in this study. Chronic neck pain diagnosis was confirmed in the Physical Therapy and Rehabilitation department. Eighty patients (40 male, 40 female) with chronic neck pain and 80 (40 male, 40 female) healthy controls were included in this study. Maximal aerobic capacity was estimated with Astrand submaximal exercise protocol. Handgrip strength and back-leg strength were measured with dynamometers; trunk flexibility was measured with flexion meter; daily physical activity was monitored with a metabolic holter; pulmonary function tests were obtained with a portable spirometer. Body composition parameters were determined with a bioelectrical impedance analysis system. Pain pressure thresholds (PPT) were measured with a mechanical pressure algometer. Skinfold thickness was measured with a skinfold caliper, and waist, abdomen and hip circumference measurements were taken with a tape measure. Neck disability index (NDI), Beck anxiety inventory (BAI), Beck depression inventory (BDI), Pittsburg sleep quality index (PSQI), and SF-36 quality of life questionnaires were applied to all participants. The data were analyzed using the SPSS version 18.0 software. Age, body mass index, skinfold thicknesses, waist, abdomen and hip circumferences, waist-hip ratio, trunk flexibility, daily total energy expenditure value, daily step number, daily moderate activity time, daily vigorous activity time, daily very vigorous activity time, daily active energy expenditure value and PFT values were not significantly different between the patients and the controls in both genders. We found that handgrip and back-leg strengths and suboccipital and paraspinal-C7 PPTs and health-related quality of life were lower, and PSQI, BAI and BDI were higher, in female patients with chronic neck pain, compared to healthy controls; whereas, VO2max and health-related quality of life were lower, and body fat percentage and PSQI were higher, in male patients with chronic neck pain, compared to healthy controls. Suboccipital PPT was moderately correlated with all strength measurements. Paraspinal-C7 PPT was moderately correlated with back-leg and right handgrip strength. In female and male patients, the PSQI score was positively correlated with the NDI, BAI and BDI scores, but negatively correlated with SF-36. This study revealed that handgrip and back-leg strengths, pressure pain detection thresholds, life and sleep qualities, anxiety and depression symptomatology were impaired in female patients with chronic neck pain, as compared to healthy controls, whereas aerobic exercise capacity, body fat percentage, life and sleep qualities were impaired in male patients with chronic neck pain, as compared to healthy controls. We suggest that, on the basis of gender, consideration of not only the neck region but also whole body physical fitness, anxiety and depression parameters in patients with chronic neck pain might be helpful to the development of more beneficial strategies for illness management.