ns – Nonsignificant, (*)- Significant

TABLE 2 - COMPARISON OF PAIN AND NDI FOR BOTH THE GROUP

Regarding neck pain, the 2-way, mixed-model ANOVA findings showed a significant group-by-time interaction (F = 3.230, do = 1, P =.04). Neck pain in the patients in the Experimental group showed a more noticeable improvement than those in the Control group. On the Neck Disability Index (NDI), a significant group-by-time interaction was also noted (F = 5.53, do = 1, P =.04).  The Experimental   group   showed much better improvement in pain alleviation and decreased neck disability than the Control group did.

ns – Nonsignificant, (*)- Significant

TABLE 3 –CHANGES IN COMPONENTS OF SF-36 FOR BOTH THE GROUP

There is a significant difference between the two groups in terms of physical functioning, role restrictions because of physical health, role limitations because of emotional difficulties, emotional well-being, and general health (p<0.05) as indicated by the results shown in Table 3. On the other hand, there were no statistically significant changes seen in the Quality of Life (QOL) energy/fatigue and social functioning components (p>0.05).

DISCUSSION

Neck pain is a growing concern that affects people all over the world. It can cause significant discomfort and reduce productivity, making it a problem for families, communities, and even businesses. It's important to be aware of the causes of neck pain and find ways to alleviate it. The aim of this study was to investigate the impact of resistance training using TheraBand on pain, neck disability index, and quality of life in desk job workers with chronic neck pain. TheraBand-based strength training is a form of resistance exercise that uses elastic resistance bands instead of traditional weights or machines. ⁽⁵⁾ While both TheraBand-based and conventional strength training were found to be effective, TheraBand-based training led to significant and better improvements in terms of percentage for most of the study variables i.e.  pain, muscle strength and quality of life of patients with chronic neck pain. This finding implies that resistance band exercise could be a valuable method for managing chronic neck pain in desk job workers.

TheraBand resistance bands provide a variable and accommodating resistance throughout the range of motion. This feature can be particularly beneficial for individuals with joint issues or those in need of rehabilitation exercises, as it places less stress on the joints compared to heavy weights ⁽⁶⁾ Literature also reports that therabands lead to greater activation of stabilizing muscles. This can improve balance and proprioception, which are essential for overall functional fitness.  Resistance bands come in various  colors, each offering a different level of resistance. This allows for progressive overload, enabling users to gradually increase resistance as their strength improve. TheraBand exercises can involve multidirectional resistance, which helps engage different muscle groups and replicate functional movements better than traditional strength training exercises that usually focus on linear movements ^(7,8)

The exercise intervention was targeted towards reducing pain by strengthening the weakened muscle groups that are commonly associated with chronic neck pain, such as the neck flexors, extensors, left and right-side flexors, and left and right rotator muscle groups. According to our research, Group A was successful in reducing pain, with the experimental group experiencing a 55% greater reduction in pain than the control group. This suggests that the intervention may be an effective method for managing chronic neck pain in desk job workers. This could be probably since strengthening muscles using resistance exercises helps to support and stabilize joints, reduces stress on bones and ligaments.  Exercises to strengthen the muscles necessary for proper posture often target these muscles. By exercising these muscles, individuals can improve their posture and reduce discomfort caused by poor posture or muscle imbalances.

Strength training and other physical exercises are thought to release endorphins, which are natural pain relievers and mood enhancers. As a result, pain perception can be reduced and overall well-being can be improved. Research shows that strength training can reduce the chronic inflammation that is associated with arthritis and fibromyalgia. Strength training often includes movements that improve joint range of motion and flexibility. Pain and discomfort caused by stiffness or restriction of movement can be relieved by increased mobility. The researchers also concluded that strength training can improve nerve-muscle communication through neuromuscular adaptations. As a result, injuries and pain can be reduced through better control and coordination of movements ^(9,10,11)

NDI

The results showed a significant reduction in neck disability measured by neck disability index.  Group A showed an 18.7% more reduction in disability from baseline period to end of sixth week. The use of TheraBand for strength training significantly reduced disability in the experimental group in this study. Several mechanisms can be used to reduce neck impairment by engaging in regular and targeted strengthening exercises for these muscles, including strengthening the neck muscles, which improve their ability to support and stabilize the neck during daily activities and reduce stress on the cervical spine.

Muscles that are stronger are better able to withstand the demands of daily movement and reduce fatigue- related pain and disability. Strengthening the neck helps balance the body and reduce stress on the neck and disability. It is postulated that strong neck muscles provide better support for the joints of spine which can lead to reduced pain and disability ^(12,13,14). In addition, strengthening neck muscles makes everyday tasks easier and more efficient for, which means that one can do them more easily and with less handicap ^(15,16)

Quality of life

Results showed that there was a significant difference between both groups for most of the components of quality of life i.e. the physical functioning, role limitations due to physical health, role limitations due to emotional problems, Emotional well-being, General health in both groups (p<0.05). No significant differences were seen for social functioning and energy/fatigue components of QOL.

In present study experimental group showed improvement by 60.3% in physical functioning, 53.16% in Emotional problems, 66.6% in Physical health, 47.01% in Energy fatigue, 53.1% in Emotional well-being, 44.2% in social functions and 51.9% in Pain component compared to control group.

In a study published in the Journal of Orthopedic & Sports Physical Therapy in 2016⁽¹⁷⁾ researchers conducted a study to evaluate the efficacy of neck specific exercises in patients with chronic pain in the neck. The results of the study indicated that participants who completed a twelve-week program of progressive resistance training of the neck muscles demonstrated considerable reductions in pain intensity and neck disability, as well as improvements in health and quality of life. They found that neck exercises can be a great way to help people with chronic neck pain and improve their quality of life.

Another study looked at how neck and shoulder exercises can help people with neck pain. It was done in 2017 and looked at people with chronic pain in their necks. They went through an 8-week exercise program that focused on strengthening their neck and shoulders. The study found that after the exercise, the pain intensity went down, the person with the neck disability got better, and they had a better quality of life which is similar with present study.

Inclusion of TheraBand exercises in addition to conventional treatment was superior to conventional treatment alone for improving Pain, disability, muscle strength and quality of life in desk job workers with chronic neck pain. The study has clinical implications for physiotherapists that a treatment program that includes both conventional treatment and neck stabilization exercises using therabands may be more beneficial than conventional treatment alone for patients with chronic neck pain.

CONFLICT OF INTEREST

None

ACKNOWLEDGEMENT

The authors are grateful to all the subjects for their voluntary participation in the study.

REFERENCES

1. Behera P, Majumdar A, Revati G, Santoshi JA, Nagar V, Mishra N. Neck pain among undergraduate medical students in a premier institute of central India: A cross-sectional study of prevalence and associated factors. Journal of family medicine and primary care. 2020 Jul;9(7):3574
2. Leucism NC, Hays RD, Bhattacharyya T. Scoring the SF-36 in orthopedics: a brief guide. The Journal of bone and joint surgery. American volume. 2015 Oct 10;97(19):1628.
3. Paw aria S, Sudan DS, Kalra S, Yadav J. Effectiveness of cervical stabilization exercises with feedback on respiratory status in chronic neck pain patients with forward head posture. International Journal of Physiotherapy. 2019 Jun 9:70-5.
4. Pancholi P, Yadav J, Kalra S. Effect of Resistance Band Exercises on Neck Pain, Disability and Forward Head Posture in Dentists with Chronic Neck Pain. J Physiotherapy Relabel 2: 1. of. 2018; 5:2.
5. Iversen VM, Vass Eljen O, Mork PJ, Gaiseric S, Bertheussen GF, Salvesen Ø, Fimland MS. Resistance band training or general exercise in multidisciplinary rehabilitation of low back pain? A randomized trial. Scandinavian journal of medicine & science in sports. 2018 Sep;28(9):2074-83.
6. Patterson RM, Stegink Jansen CW, Hogan HA, Nassif MD. Material properties of there-band tubing. Physical therapy. 2001 Aug 1;81(8):1437-45.
7. Page PA, Lamberth J, Abadie B, Boling R, Collins R, Linton R.  Posterior rotator cuff strengthening using TheraBand® in a functional diagonal pattern in collegiate baseball pitchers. Journal of Athletic Training. 1993;28(4):346.
8. Kim, H. G., & Nam, H. K. (2011). The effect of their band exercise on muscle flexibility, balance ability, muscle strength in elderly women. Journal of Korean Academy of Community Health Nursing, 22(4), 451-457.
9. Celena ST, Albayrak T, Kaya DO. Acomparison of the effects of stabilization exercises plus manual therapy to those of stabilization exercises alone in patients with nonspecific mechanical neck pain: a randomized clinical trial. journal of orthopedic & sports physical therapy. 2016 Feb;46(2):44-55.
10. Krishnan K, Abadi FH, Choo LA, Zainudin FF, Montevalle S. Comparison between Aquatic and Thera- Band Exercises on Pain Intensity and Endurance among Obese Individuals with Knee Osteoarthritis. International Journal of Human Movement and Sports Sciences. 2022;10.
11. Yoo IG, Yoo WG. The effect of a new neck support tying method using Thera-band on cervical ROM and shoulder muscle pain after overhead work. Journal of Physical Therapy Science. 2013;25(7):843-4.
12. Abd-Meltaway AE, Ameer MA. The efficacy of TheraBand versus general active exercise in improving postural kyphosis. Journal of Bodywork and Movement Therapies. 2021 Jan 1; 25:108-12.
13. Nouri R, Baumann KM, Campari BM, Schroeder J, Kocharian M. Cancer related fatigue and upper limb disabilities cannot improve after 6 weeks resistance training with Thera-Band in breast cancer survivors. International Journal of Applied Exercise Physiology. 2018;7(2):76-84.
14. Paw aria S, Sudhan D, Kalra S. Effectiveness of Cervical Stabilization Exercises on Respiratory Strength in Chronic Neck Pain Patients with Forward Head Posture-A Pilot Study. J. Clin. Diagne. Res. 2019 Apr 1; 13:6-9.
15. Pour Taghi F, Emami Moghadam Z, Ramezani M, Behnam Vaswani H, Mohajer S. Effect of resistance training using there-band on muscular strength and quality of life among the elderly. Evidence Based Care. 2017 Oct 1;7(3):7-16.
16. Yapici-Oxazole A.  The effects of TheraBand training on respiratory parameters, upper extremity muscle strength and swimming performance. Pedagogy of Physical Culture and Sports. 2020;24(6):316-22.
17. Celena ST, Albayrak T, Kaya DO. A comparison of the effects of stabilization exercises plus manual therapy to those of stabilization exercises alone in patients with nonspecific mechanical neck pain: a randomized clinical trial. journal of orthopaedic & sports physical therapy. 2016 Feb;46(2):44-55.