Consensus-based dosage recommendations for sensorimotor training in the management of neck pain: a Delphi study.

Abstract

Introduction: Neck pain is a common condition associated with high treatment costs, reduced productivity, and work limitations. It represents the second-largest group requiring physiotherapy services. Given its high prevalence, it is crucial to evaluate intervention effectiveness and ensure optimal implementation in practice. Literature highlights sensorimotor training (SMT) as an important approach in managing neck pain, though dosage recommendations for clinical application are only partially defined. This study aims to develop practical dosage guidelines for SMT in neck pain to support its implementation in daily physiotherapy.

Methods: A Delphi study was conducted. Based on literature and the expertise of 12 specialists from Switzerland and Germany, dosage recommendations were developed. Two questionnaire rounds were required to reach consensus (≥ 80%).

Results: After the second round, 92-100% consensus was achieved on key aspects: targeted abilities, training cycle, frequency, training duration, number of exercises, sets per exercise, repetitions, time per exercise, and rest time. Additional background questions and comments contributed to a factsheet designed as a practical clinical guide. Recommended parameters include: training cycle of 4-12 weeks, 3-21 sessions/week, 10-20 minutes/session, 2-6 exercises/session, 2-5 sets/exercise, 7-15 repetitions or 20-60 seconds/exercise, and 20-40 seconds rest between sets. Further guidance is provided on targeted abilities, clinical indicators of positive effects, criteria for progression, and required adjustments for effective SMT.    .

Conclusion: This study closes a knowledge gap regarding SMT dosage. The resulting factsheet aims to simplify SMT implementation for neck pain and promote its integration in daily physiotherapy practice.