The purpose of this study is to test whether a physiotherapy intervention containing pain management, general training and specific neck exercises can improve function for patients with chronic neck pain.
Neck pain is widespread problem. The prevalence of neck pain in the Scandinavian countries is 36%. Of the working population the prevalence of chronic neck pain is 10 - 20%.The National Board of Health estimates that 5-6000 subjects per year in Denmark are involved in a traffic accident evoking whiplash-induced chronic neck pain. The main problems for patients with chronic neck pain are cervical dysfunction, reduced neck mobility and stability in addition to local and possibly generalised pain Besides chronic neck pain, patients may suffer from poor pain coping strategies and physical inactivity which influences physical function, general health and causes a poor quality of life. Physical training including specific exercises targeting the deep postural muscles of the spine is effective in reducing neck pain for patients with chronic neck pain. Physical behavioural graded activity is a treatment approach with focus on increasing general physical fitness, reducing fear of movements and increasing psychological function. Educational sessions, where the focus is on understanding complex chronic pain mechanisms and development of appropriate pain coping and/or cognitive behavioural strategies have shown reduced general pain. Thus this project is formulated on the expectation that rehabilitation of patients with chronic neck pain after a whiplash accident must target cervical dysfunctions, training of physical function and the understanding and management of chronic pain in a combined therapy approach. The study is designed as a randomized control study including 200 patients. All participate in the educational sessions. The training group receives on top of that instruction in specific neck exercises and general training.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
200
Educational sessions in pain management 4 times and treatment sessions including instructions in training and specific exercises 8 times
Educational sessions in pain management 4 times
University of Southern Denmark, Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics
Odense, Denmark
Medical Outcomes Study Short Form 36 (SF36) - Physical Component Summary (PCS)
Time frame: 12 months
craniocervical flexion test
test for the deep cervical flexor muscles
Time frame: 12 months
cervical range of motion
Time frame: 12 months
neck positioning test
neck joint position error test and gaze stability test
Time frame: 12 months
Self-rated measure Global Perceived Effect
questionnaire
Time frame: 12 months
Neck Disability Index
questionnaire
Time frame: 12 months
Pain Bothersomeness
questionnaire
Time frame: 12 months
Pain Specific Functioning Scale
questionnaire
Time frame: 4 months and 12 months
TAMPA scale of Kinesiophobia
questionnaire
Time frame: 12 months
Impact of Event scale
questionnaire
Time frame: 12 months
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Euroqol-5D
questionnaire
Time frame: 12 months
Mechanical allodynia
Pressure pain treshold for selected points
Time frame: 12 months