Efectividad de los ejercicios de control motor en el dolor cervical crónico inespecífico: Una revisión sistemática
Palabras clave:
dolor cervical crónico; control motor; flexores cervicales profundos; ejercicio terapéutico; revisión sistemáticaResumen
DOI: https://doi.org/10.46296/gt.v9i18edespsep.0437
Resumen
El dolor cervical crónico inespecífico constituye una causa frecuente de discapacidad y demanda asistencial. Los ejercicios de control motor cervical buscan mejorar la activación, coordinación y resistencia de la musculatura cervical profunda, aunque su superioridad frente a otras intervenciones activas no está claramente establecida. El objetivo fue determinar la efectividad de los ejercicios de control motor cervical sobre el dolor y la discapacidad en adultos con dolor cervical crónico inespecífico o mecánico. Se realizó una revisión sistemática con síntesis cualitativa, sin metaanálisis, conforme a PRISMA 2020 y al modelo PICOS. Se recribaron documentos previamente recopilados y se efectuó una búsqueda actualizada hasta el 9 de septiembre de 2026, incluyendo ensayos clínicos aleatorizados publicados entre 2019 y 2026. Se incluyeron 20 ensayos clínicos aleatorizados, con más de 1.000 participantes. Las intervenciones comprendieron entrenamiento de flexores cervicales profundos, flexión craneocervical, biofeedback de presión y ejercicios de estabilización cervical. La evaluación RoB 2 mostró bajo riesgo global de sesgo en un ensayo y algunas preocupaciones en los 19 restantes. GRADE calificó como baja la certeza de la evidencia para dolor y discapacidad. La dirección global de los resultados favoreció al control motor frente a tratamiento pasivo, convencional o sin un componente específico de entrenamiento; sin embargo, cuando se comparó con otras modalidades activas bien estructuradas, la superioridad no fue consistente. También se observaron mejoras en fuerza o resistencia de flexores profundos, movilidad, postura y propiocepción, aunque con mayor heterogeneidad. Se concluye que el control motor cervical constituye una intervención activa útil dentro de la fisioterapia del dolor cervical crónico, pero la evidencia disponible no permite afirmar una superioridad universal frente a otras formas de ejercicio terapéutico ni establecer una dosis óptima única.
Palabras claves: dolor cervical crónico; control motor; flexores cervicales profundos; ejercicio terapéutico; revisión sistemática.
Abstract
Chronic nonspecific neck pain is a frequent cause of disability and health-care utilization. Cervical motor control exercises are intended to improve activation, coordination, and endurance of the deep cervical musculature, although their superiority over other active interventions remains uncertain. This systematic review aimed to determine the effectiveness of cervical motor control exercises on pain and disability in adults with chronic nonspecific or mechanical neck pain. A qualitative systematic review without meta-analysis was conducted according to PRISMA 2020 and a PICOS framework. Previously collected documents were rescreened and an updated search was completed through September 9, 2026, including randomized controlled trials published from 2019 to 2026. Twenty randomized controlled trials involving more than 1,000 participants were included. Interventions comprised deep cervical flexor training, craniocervical flexion, pressure biofeedback, and cervical stabilization exercises. RoB 2 assessment showed low overall risk of bias in one trial and some concerns in the remaining 19 trials. GRADE rated the certainty of evidence as low for pain and disability. Overall findings favored motor control approaches over passive, conventional, or nonspecific care; however, superiority was not consistent when motor control was compared with other well-structured active exercise programs. Improvements were also reported in deep flexor strength or endurance, cervical mobility, posture, and proprioception, although these outcomes were more heterogeneous. Cervical motor control exercise is therefore a useful active option within physiotherapy for chronic neck pain, but current evidence does not support universal superiority over other forms of therapeutic exercise or a single optimal dosage.
Keywords: chronic neck pain; motor control; deep cervical flexors; exercise therapy; systematic review.
Información del manuscrito:
Fecha de recepción: 23 de junio de 2026.
Fecha de aceptación: 15 de agosto de 2026.
Fecha de publicación: 21 de septiembre de 2026.
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