Interventions
Ventral neck muscle endurance, muscle soreness, neurological pain, pain, increase neck pain, disability
Both interventions are described in The NSEIT group had 4 sessions at the physiotherapy clinic. The first session included a clinical examination and an introduction to the first exercises. In the follow-up sessions (weeks 2, 3, and 7), new exercises were introduced, progressed, and followed up to ensure correct performance. Participants had access to the internet-based program on a website. The program included information, photos, and videos of all exercises, with clear stepwise progression and an exercise diary. The NSEs were initially targeted to activate the deep neck muscle layers with an individual progression of endurance exercises within the participant’s symptom tolerance. The participants could contact the physiotherapist by telephone or book an appointment if pain or other symptoms increased during the home exercise period.The NSE group received the same information and exercise program as the NSEIT group, but it was delivered by a physiotherapist. The participants attended 2 sessions a week for 12 weeks at a physiotherapy clinic. In both groups, exercise-related neurological pain was not acceptable and temporarily increased muscle soreness after exercises was only allowed if it did not increase neck pain over time (After the 12 weeks, participants in both groups were encouraged to continue training on their own 2-3 times a week in accordance with the 2017 World Health Organization (WHO) guidelines [Ventral neck muscle endurance is considered important for recovery from neck pain and disability, but relatively small improvements were seen in the previous RCT [