None listed
Conditions
Brief summary
Question: Is Strain-Counterstrain treatment (manual therapy treatment using passive positioning) more effective than sham Strain-Counterstrain intervention in reducing levels of pain and disability in people with neck pain selected using a treatment-based classification system? Design: Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Participants: 85 participants (male and female) between 18 and 60 years experiencing non-specific neck pain for less than 30 days. Intervention: Participants are to attend two treatments in a week. The experimental group is to receive Strain-Counterstrain treatment and the control group sham Strain-Counterstrain intervention. Following the initial intervention period, participants are to receive standard Physiotherapy treatment for neck pain for up to 6 weeks. Outcome measures: The primary outcome is to be the Neck disability questionnaire, measured at 1 week (ie, end of initial intervention), 6 weeks, and 28 weeks. Secondary outcome measures are to include the Fear avoidance beliefs questionnaire, SF-36, visual analogue scale pain ratings and a 7-point global rating of change.
Interventions
Strain-Counterstrain treatment treatment will involve passive positioning of the participant, with varying degrees of cervical flexion/extension, lateral flexion and rotation, such that there is a two-thirds reduction in tenderness at a monitored digitally tender point (Jones et al 1995). This is to be determined by having participants rate their tenderness to palpation at digitally tender points on a numerical pain scale where 10 represented initial tenderness and 0 no tenderness. In addition t
Strain-Counterstrain treatment treatment will involve passive positioning of the participant, with varying degrees of cervical flexion/extension, lateral flexion and rotation, such that there is a two-thirds reduction in tenderness at a monitored digitally tender point (Jones et al 1995). This is to be determined by having participants rate their tenderness to palpation at digitally tender points on a numerical pain scale where 10 represented initial tenderness and 0 no tenderness. In addition to reported tenderness with intermittent digital probing, perceived tissue tension will be used to guide the experimenter to the appropriate passive position (Jones et al 1995). The participant will be passively maintained at this point by the experimenter for approximately 90 seconds, with intermittent digital probing at 30-sec intervals to ensure correct positioning, before being slowly and passively returned to a neutral position (Jones et al 1995, Kusunose and Wendorff 1990, Kusunose 1993). Treatment using a digitally tender point will be considered successful if tenderness is reduced by 70% or more (3/10 or less with digital probing) (Kusunose 1993, Kusunose and Wendorff 1990), however the intention will be to reduce tenderness to a numerical pain rating of 1/10 or less with digital probing. This treatment is to be provided in two half hour sessions in a one week period.
Sponsors
Stanthorpe Health Services
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1) Neck pain (Merskey and Bogduk 1994) of less than 30 days duration 2) Between 18 and 60 years 3) Initial VAS pain rating less than 7/10 4) Initial neck disability index score between 20 and 52 5) Able to lie supine for 10 minutes 6) Displaying a minimum of four digitally tender points at examined sites (Kusunose and Wendorff 1990) at their initial assessment.
Exclusion criteria
1) Whiplash mechanism of injury 2) Signs of nerve root compression 3) Symptoms distal to the elbow 4) Chief complaint of headaches with neck pain
Outcome results
None listed