REVIEW – February 2021

A review of the effects of deep cervical flexor training in chronic neck pain

Authors: Kirkke Reisberg, Villem Nilbe

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Craniocervical flexion training is addressed to activate deep neck flexors, allowing correction of neck position and reduction in chronic neck pain. The PEDro scale as a measure of methodological quality of clinical trials and best-evidence synthesis was used to answer the question whether craniocervical flexion exercise is helpful in chronic neck pain and whether it is superior than other exercise types. Use of craniocervical flexion training in reducing chronic neck pain and improving neck function in comparison with conventional isometric neck exercises was supported by moderate evidence. There is insufficient evidence to confirm or refute the efficacy of craniocervical flexion training compared to cervical flexion or extension training, considering quality issues and inconsistencies in results. Considering the limited number of studies, it is not possible to draw conclusions about the effectiveness of craniocervical flexion over the rest of exercise types (neck school or head-neck proprioceptive training). Finally, relatively small sample sizes could have caused underestimation of the efficacy of interventions.