Manipulation, Exercise, and Self-Care for Neck Pain

NCT ID: NCT00269360

Last Updated: 2007-11-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

270 participants

Study Classification

INTERVENTIONAL

Study Start Date

2001-03-31

Study Completion Date

2005-02-28

Brief Summary

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The purpose of this study is to compare three treatments for neck pain: 1) rehabilitative exercise, 2) chiropractic spinal manipulation combined with rehabilitative exercise, and 3) self-care education.

Detailed Description

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Neck pain is very common, afflicting 10% of the population at any given time. Despite its significant socioeconomic impact, neck pain has been poorly investigated. The broad, long term objective of this interdisciplinary research is to identify effective therapies for neck pain and to increase our knowledge of this problematic condition. This multidisciplinary, randomized clinical trial is based on the investigators' previous neck pain research and will assess three treatment approaches for chronic neck pain:

1. rehabilitative exercise
2. chiropractic spinal manipulation combined with rehabilitative exercise
3. self-care education (a minimal intervention control)

The primary aim of this study is to examine the relative efficacy of the three interventions in terms of patient-rated outcomes in the short term (after 12 weeks) and long term (after 52 weeks) for chronic neck pain. Secondary aims are to assess the relative cost-effectiveness and cost utility of the three treatments, evaluate changes in objective cervical spine function, assess if cervical function is associated with changes in patient-rated outcomes, identify predictors of outcome and finally, to describe patients' interpretations of outcome measures used in clinical trials.

Using previously demonstrated recruitment methods, 270 participants with chronic neck pain will be recruited. Self-reported outcome measures will be collected at baseline and 4, 12, 26 and 52 weeks; objective outcome measures will be assessed by blinded examiners at baseline and 12 weeks.

Chiropractic investigators from Northwestern Health Sciences University are collaborating with medical clinicians from the University of Minnesota, the Minneapolis Medical Research Foundation, and the Pain Assessment and Rehabilitation Center. This established team of investigators will work together in all phases of this innovative study, leading to dissemination and publication of study results and hypothesis generation for future research. This trial will yield important information allowing health care practitioners, policy makers and patients to make better-informed decisions regarding treatment choices for chronic neck pain. Importantly, it will serve to increase the extremely limited research that currently exists for this significant health-care condition.

Conditions

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Neck Pain

Keywords

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Chiropractic Manual Therapies Exercise Randomized Clinical Trial Neck Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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1

Group Type EXPERIMENTAL

Chiropractic + Supervised Rehabilitative Exercise

Intervention Type PROCEDURE

Chiropractic care will include manual spinal manipulation, with light soft tissue massage as indicated to facilitate the spinal manipulative therapy. The spinal levels treated will be determined by the individual chiropractors by static and/or motion palpation.

Patients will attend 20, 1 hour sessions of rehabilitative exercises for the neck and upper body. Each session will begin with a 10-minute aerobic warm-up of the upper body and five minutes of light stretching to prepare for the strengthening exercises.

2

Group Type EXPERIMENTAL

Supervised Rehabilitative Exercise

Intervention Type PROCEDURE

Patients will attend 20, 1 hour sessions of rehabilitative exercises for the neck and upper body. Each session will begin with a 10-minute aerobic warm-up of the upper body and five minutes of light stretching to prepare for the strengthening exercises.

3

Group Type ACTIVE_COMPARATOR

Self-care education

Intervention Type BEHAVIORAL

Self-care education will be provided by the therapist trained in the study protocol. Two, one-hour sessions will be given regarding self-care measures and ergonomics relative to work and activities of daily living. These will include postural instructions and practical demonstrations of proper body mechanics performed with patient participation.

Interventions

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Chiropractic + Supervised Rehabilitative Exercise

Chiropractic care will include manual spinal manipulation, with light soft tissue massage as indicated to facilitate the spinal manipulative therapy. The spinal levels treated will be determined by the individual chiropractors by static and/or motion palpation.

Patients will attend 20, 1 hour sessions of rehabilitative exercises for the neck and upper body. Each session will begin with a 10-minute aerobic warm-up of the upper body and five minutes of light stretching to prepare for the strengthening exercises.

Intervention Type PROCEDURE

Supervised Rehabilitative Exercise

Patients will attend 20, 1 hour sessions of rehabilitative exercises for the neck and upper body. Each session will begin with a 10-minute aerobic warm-up of the upper body and five minutes of light stretching to prepare for the strengthening exercises.

Intervention Type PROCEDURE

Self-care education

Self-care education will be provided by the therapist trained in the study protocol. Two, one-hour sessions will be given regarding self-care measures and ergonomics relative to work and activities of daily living. These will include postural instructions and practical demonstrations of proper body mechanics performed with patient participation.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Chronic mechanical neck pain (defined as current episode \> 12 weeks' duration).
* Quebec Task Force classifications 1, 2, 3 and 4. This includes patients with neck pain, stiffness or tenderness, with or without musculoskeletal and neurological signs.

Exclusion Criteria

* Previous cervical spine surgery
* Neck pain referred from local joint lesions of the lower extremities or from visceral diseases
* Progressive neurological deficits due to nerve root or spinal cord compression
* Existing cardiac disease requiring medical treatment
* Blood clotting disorders
* Diffuse idiopathic hyperostosis
* Infectious and non-infectious inflammatory or destructive tissue changes of the cervical spine
* Presence of significant infectious disease, or other severe disabling health problems
* Substance abuse
* Ongoing treatment for neck pain by other health care providers
* Pregnant or nursing women
* Average neck pain score of less than 30 percentage points
* Pending or current litigation
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Health Resources and Services Administration (HRSA)

FED

Sponsor Role collaborator

Berman Center for Outcomes and Clinical Research

OTHER

Sponsor Role collaborator

Northwestern Health Sciences University

OTHER

Sponsor Role lead

Principal Investigators

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Gert Bronfort, DC, PhD

Role: PRINCIPAL_INVESTIGATOR

Northwestern Health Sciences University

Locations

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Wolfe-Harris Center for Clinical Studies

Bloomington, Minnesota, United States

Site Status

Countries

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United States

References

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Evans R, Bronfort G, Schulz C, Maiers M, Bracha Y, Svendsen K, Grimm R, Garvey T, Transfeldt E. Supervised exercise with and without spinal manipulation performs similarly and better than home exercise for chronic neck pain: a randomized controlled trial. Spine (Phila Pa 1976). 2012 May 15;37(11):903-14. doi: 10.1097/BRS.0b013e31823b3bdf.

Reference Type DERIVED
PMID: 22024905 (View on PubMed)

Related Links

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Other Identifiers

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R18HP10013

Identifier Type: -

Identifier Source: org_study_id