The effect of inspiratory muscle training on posture and pain in patients with chronic neck pain: A randomized controlled study

Our study was planned to investigate the effectiveness of inspiratory muscle training (IMT) performed in addition to the conventional physiotherapy program in women with chronic neck pain (CNP). Twenty-eight female patients with CNP have been included in the study to receive a physiotherapy program for six weeks. The conventional physiotherapy program including manuel therapy and cervico-scapula-thoracic strengthening exercises was applied to the control group (n=14), while IMT was given to the respiratory group (n=14) with a respiratory muscle training device in addition to conventional physiotherapy. Our outcome measures were neck pain (visual analog scale-VAS, pain pressure threshold-PPT) and psychosocial characteristics associated with neck pain (neck disability-NDI, kinesiophobia-TSK, depression-BDI), respiratory muscle strength measurements (inspiratory/expiratory muscle strength-MIP and MEP; ultrasonographic measurements of the diaphragm-Tins, Teks, ΔT, KO) and biomechanical assessments of neck pain (cervical and thoracic ranges of motion-ROM; craniovertebral flexion and thoracic kyphosis angles-CVF, TKA; neck flexor and deep flexor endurance; cervical joint reposition error-JRE). All measurements were made at baseline and after treatment. There was an improvement compared to baseline in both study groups regarding VAS, PPT, pain-related psychosocial characteristics, CVF and TKA, cervical and thoracic ROM, MIP, the endurance of flexor, and deep neck flexors (p<0.05). Besides, the change levels of TSK (p=0.03), ROM in the cervical flexion direction (p=0.03), MIP-MEP (p=0.04; p=0.01) and the diaphragmatic thickness Tins, Teks (p=0.02; p=0.01), the endurance of neck flexors (p=0.03), and cervical JPE (p=0.003) were statistically superior to the change in the control group. Our study showed that IMT can be used in addition to the conventional physiotherapy program. Studies with larger sample sizes and longer follow-up durations are needed to understand the potential effects of breathing exercises on CNP.