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Background: Previous systematic reviews have identified the benefits of exercise for chronic neck pain on subjective reports of pain, but not with objective measures such as quantitative sensory testing (QST). A systematic review was conducted to identify the effects of neck specific exercise on QST measures in adults with chronic neck pain to synthesise existing literature and provide clinical recommendations. Methods: The study protocol was registered prospectively with PROSPERO (PROSPERO CRD42021297383). For both randomised and non-randomised trials, the following databases and trial registries were searched: AMED, CINAHL, Embase, Google Scholar, Medline, PEDro, PubMed, Scopus, SPORTDiscus, Science Citation Index and Social Science Citation Index from Web of Science Core Collection, clinicaltrials.gov, GreyOpen, and ISRCTN registry. These searches were conducted from inception to February 2022 and were updated until September 2023. Reference lists of eligible studies were screened. Study selection was performed independently by two reviewers, with data extraction and quality appraisal completed by one reviewer and independently ratified by a second reviewer. Due to high heterogeneity, narrative synthesis was performed with results grouped by exercise type. Findings: Three trials were included. Risk of bias was rated as moderate and the certainty of evidence as low or moderate for all studies. All exercise groups demonstrated statistically significant improvement at an intermediate-term follow-up, with progressive resistance training combined with graded physical training demonstrating the highest certainty of evidence. Fixed resistance training demonstrated statistically significant improvement in QST measures at a short-term assessment. Interpretation: Fixed resistance training is effective for short-term changes in pain sensitivity based on low-quality evidence, whilst moderate-quality evidence supports progressive resistance training combined with graded physical training for intermediate-term changes in pain sensitivity. [ABSTRACT FROM AUTHOR]

Background and Objective: Traumatic injuries are amongst the leading causes of death and disability in the world across all age groups. This systematic review aimed to (1) describe the role of post‐traumatic stress symptoms (PTSS) on the development of chronic pain and/or pain‐related disability following musculoskeletal trauma and (2) report pain and or pain‐related disability by injury severity/type. Database and Data Treatment: Electronic databases were searched, from inception to 31 November 2021 and updated on 10 May 2022, to identify studies in which: participants were adults aged ≥16 years sustaining any traumatic event that resulted in one or more musculoskeletal injuries; an outcome measure of PTSS was used within 3 months of a traumatic event; the presence of pain and/or pain‐related disability was recorded at a follow‐up of 3 months or more. Two reviewers independently screened papers and assessed the quality of included studies. Results: Eight studies were included. Owing to between‐study heterogeneity, the results were synthesized using a narrative approach. Five studies investigated the relationship between PTSS and pain. Participants with PTSS were more likely to develop persistent pain for at least 12 months post‐injury. Six studies assessed the relationship between PTSS and pain‐related disability. The results suggest that patients with PTSS had significantly higher disability levels for at least 12 months post‐injury. Conclusion: Findings from this comprehensive systematic review support a clear relationship between PTSS post‐injury and future pain/disability, with the potential importance of certain PTSS clusters (hyper‐arousal and numbing). Significance: The findings of this systematic review indicate an association between PTSS reported within 3 months of a traumatic musculoskeletal injury and the development of longer‐term pain and disability. The PTSS clusters of 'hyper‐arousal' and 'numbing' appear to be of particular importance in this relationship. Prospero Registration Number: CRD42021285243. [ABSTRACT FROM AUTHOR]