• Amir Hossein Kahlaee, Leila Ghamkhar, Mohammad Reza Nourbakhsh, and Amir Massoud Arab.
• From the Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran (AHK, LG, AMA); and Department of Physical Therapy, University of North Georgia, Dahlonega, Georgia (MRN).
• Am J Phys Med Rehabil. 2020 Feb 1; 99 (2): 133-141.

ObjectiveThe aim of the study was to determine whether strength and range of motion deficits are present in patients with unilateral chronic neck pain at contralateral side to pain and at other regions.DesignForty-nine patients with unilateral chronic neck pain and 98 asymptomatic subjects participated in this case-control study. Range of motion and muscle strength of the cervical, shoulder, trunk, and hip regions were assessed bilaterally using inclinometer and dynamometer, respectively.ResultsChronic neck pain patients demonstrated reduced cervical, shoulder, and trunk range of motion in their ipsilateral side to pain comparing the asymptomatic participants (P < 0.05). The ipsilateral side to pain cervical and shoulder range of motion were also significantly lower than the contralateral side to pain (P < 0.05). Significant differences were also observable in the contralateral side to pain comparing the asymptomatic group (P < 0.05). Cervical, shoulder, and scapulothoracic muscles were found weaker both in the ipsilateral side to pain and contralateral side to pain comparing the asymptomatic group (P < 0.05). Ipsilateral side to pain and contralateral side to pain in hip flexors were also found to be significantly weaker than the asymptomatic group (P < 0.01).ConclusionsThe results revealed range of motion and strength deficits in the pain-free regions of the body in unilateral chronic neck pain patients. Findings support the regional interdependence theory and emphasize the need for managing seemingly intact neighboring and more remote regions in unilateral chronic neck pain patients.

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