None listed
Conditions
Brief summary
The purpose of the research is to investigate brain and movement-related biomarkers associated with chronic neck pain, and determine if these can be used to increase the effectiveness of manual therapy and exercise treatment for neck pain. Patients with insidious-onset non-specific neck pain will be compared with healthy age and gender matched control participants at baseline to determine brain and movement-related biomarkers associated with neck pain. Neck pain participants will be randomised to receive 6 sessions of physiotherapy (manual therapy + exercise) with task-specific training or physiotherapy alone. Assessments will occur a baseline, post-treatment (7 weeks form baseline) and 6 months (26 weeks form baseline). Outcome measures are pain (VAS), kinematic biomarkers measured with 3-D motion analysis, cortical biomarkers measured with magnetic resonance imaging (structural imaging, diffusion tensor imaging, resting-state functional MRI, and MR spectroscopy), and clinical measures including spinal stiffness, muscle performance on the deep neck flexor test, pressure pain threshold, cervical range of motion, Neck Disability Index, SF-12, Pain Impact questionnaire, and General Health Questionnaire-28. This pilot study will (1) determine potential cortical and kinematic biomarkers that can be used to develop targeted interventions for neck pain, and (2) determine if physiotherapy (with or without task-specific training) has effects on cortical and kinematic biomarkers and reduces pain.
Interventions
All patients will receive 6 visits (approximately 1 hour each) of evidenced-based physiotherapy consisting of manual therapy and exercise delivered approximately weekly over 6 weeks. Manual therapy will consist of passive physiological and passive accessory mobilisation/manipulation at the discretion of the treating therapist. Exercise will consist of active range of motion, specific muscle training exercises for deep neck flexors and extensors, postural correction and graded muscle strengthenin
All patients will receive 6 visits (approximately 1 hour each) of evidenced-based physiotherapy consisting of manual therapy and exercise delivered approximately weekly over 6 weeks. Manual therapy will consist of passive physiological and passive accessory mobilisation/manipulation at the discretion of the treating therapist. Exercise will consist of active range of motion, specific muscle training exercises for deep neck flexors and extensors, postural correction and graded muscle strengthening exercises for neck and upper limbs to the appropriate level for the patient. The intervention group will also receive task-specific training, consisting of repetitive practice of specific functional tasks with kinematic correction from the treating therapist.
Sponsors
Dr Suzanne Snodgrass
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
Neck pain participants: (1) chronic non-specific neck pain (> 90 days), rated at least 4/10 on a 0-10 numerical rating scale, and reported to at least 'moderately' interfere with normal activities over the previous 4 weeks (2) aged between 18 and 55 years (3) be able to lie in a cylindrical magnet on their back (4) free from any metallic implants Healthy controls: (1) aged between 18 and 55 years (2) be able to lie in a cylindrical magnet on their back (3) free from any metallic implants (4) matched to a neck pain participant by age and gender
Exclusion criteria
Neck pain participants: (1) claustrophobic (2) upper cervical pain, headache, or dizziness as their primary complaint (3) history of migraine headaches (4) history of trauma related to the neck (e.g. whiplash) (5) surgery to the neck (6) diabetes (7) peripheral vascular disease (8) referred arm pain past the tip of the shoulder (9) neuropathic type pain (score of 10 or more on s-LANSS) (10) currently receiving hands on treatment for their neck pain (e.g., physiotherapy, chiropractic, acupuncture, massage or similar) in the last 12 weeks (11) on workers' compensation (12) pregnant or breastfeeding Healthy controls: (1) claustrophobic (2) pregnant or breastfeeding (3) any neck or back pain for which they sought treatment in the previous 2 years (4) any previous history of injury or trauma to the neck (e.g., whiplash) (5) any current musculoskeletal pain in any body area
Outcome results
None listed