Rehabilitation Components for the Development of a Neck Pain School Program for Patients with Chronic Nonspecific Neck Pain: An Integrative Review
Keywords:
nonspecific chronic neck pain, Neck Pain School, biopsychosocial rehabilitation, integrative review, exercise-based interventionAbstract
Introduction: Nonspecific chronic neck pain is a health problem that affects pain, disability, and daily living. Rehabilitation for patients with this condition comprises multiple components, including exercise, education, and behavioral and self-management strategies. However, evidence regarding these rehabilitation components remains heterogeneous and lacks a clear organization of knowledge that can serve as a basis for developing a Neck Pain School Program.
Objective: To review and synthesize rehabilitation components investigated in patients with nonspecific chronic neck pain and to organize these components as a knowledge base for the development of a Neck Pain School Program in subsequent research.
Design/Methods: This study employed an integrative review design. Studies were searched in PubMed, Scopus, CINAHL, Web of Science, the Cochrane Library, and ThaiJo, covering studies published from 2015 to June 15, 2026, according to predefined eligibility criteria. Two reviewers independently screened the studies. Data on study characteristics and rehabilitation components were extracted, followed by an integrative synthesis in which components were categorized according to shared characteristics. The risk of bias of the included studies was also assessed.
Results: A total of 14 studies met the eligibility criteria. The synthesis identified four major groups of rehabilitation components: (1) exercise-based components, including deep cervical flexor training, cervical stabilization exercises, and scapular strengthening exercises; (2) pain education components; (3) behavioral and self-management components; and (4) multimodal rehabilitation combining more than one component. Exercise-based components were identified in 13 studies (92.9%), education-based components in 7 studies (50.0%), behavioral and self-management components in 7 studies (50.0%), and multimodal rehabilitation in 9 studies (64.3%).
Conclusion and Recommendations: This review identified four major groups of rehabilitation components for patients with nonspecific chronic neck pain. Exercise-based components were the most frequently reported, followed by multimodal rehabilitation, while education and behavioral and self-management components were also incorporated into rehabilitation interventions. The synthesis and organization of these components can provide a knowledge base for defining the content and structure of a Neck Pain School Program for development in subsequent research.
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