Normative data for neck muscles endurance in healthy Saudi males: foundations for precision health

Background: Distinctive cultural practices in Gulf countries, including Saudi Arabia such as wearing the shimagh and participating in traditional dances like the Ardah place considerable demands on neck muscle endurance. Insufficient endurance can contribute to or exacerbate neck pain. The absence of normative data for the Saudi population underscores a critical gap, emphasizing the need for data to guide prevention, diagnosis and culturally tailored interventions. The aim of this study was to establish normative data and assess both interrater and intrarater reliability for neck flexor and extensor muscle endurance in healthy Saudi males. Methods: Ninety healthy adults aged 20 years and older with no history of neck pain or injury participated in the study. Two raters (Rater 1 and Rater 2) assessed the endurance of the neck’s extensor and flexor muscles in each participant separately using a stopwatch across two sessions (day one and day 3). To mitigate order effects, a random number was assigned to each test for each participant. Participants rested for five minutes between the two readings and ten minutes between the two sets. Results: The standard error of measurement (SEM) and minimal detectable change (MDC) for neck flexor muscle endurance were 16.54 seconds and 45.84 seconds, respectively. For neck extensor muscle endurance, the SEM and MDC were 17.43 seconds and 48.31 seconds, respectively. The interrater and intrarater reliability for assessing the endurance of the neck flexor and extensor muscles ranged from good to excellent, with intraclass correlation coefficients (ICC2,1) value between 0.85 and 0.96. Conclusions: This study provides normative data for neck flexor and extensor muscle endurance, demonstarting good to excellent interrater and intrarater reliability. These benchmarks lay the groundwork for evaluating neck muscle function and clinically enable precise monitoring of endurance changes, guiding tailored interventions to prevent or manage neck pain, particularly in culturally relevant contexts.