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August 27, 2003

Isometric Training to Treat Chronic Neck Pain—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(8):1027. doi:10.1001/jama.290.8.1027-a

To the Editor: Dr Ylinen and colleagues1 found that both strength (isometric) and endurance (isotonic) training were superior to a control regimen of stretching and aerobic exercise for relieving chronic neck pain. The authors also found that isometric training improved strength more than did isotonic training.

I have 3 concerns about this study. First, isometric training is most specifically designed to increase the isometric strength of particular muscles.2 Thus, use of isometric strength as an outcome measure could result in significant bias in favor of the isometric group.

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