Deep Neck Flexor Exercise in Coffee Pickers: A Pre-experimental Study

Theo Fontina Kadju; I Gede Arya Sena; Ni Luh Made Reny Wahyu Sari; Daryono

doi:10.24843/

Authors

Theo Fontina Kadju Physiotherapy Study Program, Universitas Dhyana Pura, Badung, Bali, Indonesia Author
I Gede Arya Sena Physiotherapy Study Program, Universitas Dhyana Pura, Badung, Bali, Indonesia Author
Ni Luh Made Reny Wahyu Sari Physiotherapy Study Program, Universitas Dhyana Pura, Badung, Bali, Indonesia Author
Daryono Physiotherapy Study Program, Universitas Dhyana Pura, Badung, Bali, Indonesia Author

DOI:

https://doi.org/10.24843/

Keywords:

Neck Pain, Exercise Therapy, Neck Muscles, Occupational Health, Disability Evaluation

Abstract

Background: Coffee harvesting requires repeated overhead work that may expose the cervical region to sustained nonneutral posture. Evidence regarding neck pain associated with this specific occupational exposure remains limited.
Objective: To evaluate changes in neck pain and neck disability before and after a standardized Deep Neck Flexor exercise program in women coffee pickers.
Methods: This pre-experimental one group pertest posttest study was conducted from April 17 to May 5, 2026, in Tiworiwu 1 Village, Jerebuu District, Ngada Regency. Thirty women aged 40 to 50 years who had worked as coffee pickers for at least 10 years were recruited by purposive sampling. Neck disability was assessed using the Neck Disability Index, and pain intensity was assessed using the Verbal Rating Scale. Participants completed six supervised sessions using the same exercise dose. Paired t tests were used after Shapiro Wilk testing confirmed normality. Cohen's d and 95% confidence intervals were reported.
Results: NDI decreased by 24.10 points (95% CI, 22.233 to 25.967; Cohen's d = 4.82; p < 0.001). VRS decreased by 3.00 points on the right (95% CI, 2.706 to 3.294; Cohen's d = 3.81; p < 0.001) and by 2.967 points on the left (95% CI, 2.649 to 3.284; Cohen's d = 3.49; p < 0.001).
Conclusion: Six supervised sessions were associated with significant reductions in pain and neck disability. Because the study had no control group and no a priori sample size calculation, causal inference and statistical power remain limited.