Article Text

Download PDFPDF

Effectiveness of a standardised exercise programme for recurrent neck and low back pain: a multicentre, randomised, two-arm, parallel group trial across 34 fitness clubs in Finland
  1. Jaana H Suni,
  2. Marjo Rinne,
  3. Kari Tokola,
  4. Ari Mänttäri,
  5. Tommi Vasankari
  1. UKK Institute for Health Promotion Research, Tampere, Finland
  1. Correspondence to Dr Jaana H Suni, UKK Institute for Health Promotion Research, Box 30, Tampere, PL 30, 33501, Finland ; jaana.h.suni{at}


Background Neck and low back pain (LBP) are common in office workers. Exercise trials to reduce neck and LBP conducted in sport sector are lacking. We investigated the effectiveness of the standardised Fustra20Neck&Back exercise program for reducing pain and increasing fitness in office workers with recurrent non-specific neck and/or LBP.

Method Volunteers were recruited through newspaper and Facebook. The design is a multi-centre randomised, two-arm, parallel group trial across 34 fitness clubs in Finland. Eligibility was determined by structured telephone interview. Instructors were specially educated professionals. Neuromuscular exercise was individually guided twice weekly for 10 weeks. Webropol survey, and objective measurements of fitness, physical activity, and sedentary behavior were conducted at baseline, and at 3 and 12 months. Mean differences between study groups (Exercise vs Control) were analysed using a general linear mixed model according to the intention-to-treat principle.

Results At least moderate intensity pain (≥40 mm) in both the neck and back was detected in 44% of participants at baseline. Exercise compliance was excellent: 92% participated 15−20 times out of 20 possible. Intensity and frequency of neck pain, and strain in neck/shoulders decreased significantly in the Exercise group compared with the Control group. No differences in LBP and strain were detected. Neck/shoulder and trunk flexibility improved, as did quality of life in terms of pain and physical functioning.

Conclusions The Fustra20Neck&Back exercise program was effective for reducing neck/shoulder pain and strain, but not LBP. Evidence-based exercise programs of sports clubs have potential to prevent persistent, disabling musculoskeletal problems.

  • neuromuscular
  • physical fitness
  • public health
  • sports & exercise medicine
  • sports rehabilitation programs

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

View Full Text

Statistics from


  • Contributors All authors read and approved the final manuscript. JHS, MR, AM and TV were responsible for the study design, selection of the research methods and interpretation of the study results. KT is a statistician and was responsible for power calculations, randomisation, selecting statistical analyses and conducting data analysis. KT is currently finalising his thesis on cluster-randomised study designs.

  • Funding Fustra Finland International Oy paid money to the UKK Institute to cover part of the working hours of the research secretary (TI) during the study and the four study nurses involved with recruitment, mailing the accelerometers to participants and saving the raw accelerometer data for further analysis. None of the research group members of the UKK Institute received money or other benefits from Fustra Finland International Oy at any point during the study.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Ethical Committee of Pirkanmaa Hospital district, Finland (R14030).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No employees of Fustra Finland International Oy had access to the research data set at any time during the study.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.