Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effectiveness of Manual Therapy and Physical Therapy in Patients With Subacute and Chronic Non-specific Neck Pain. A Randomized Controlled Trial.
Brief Summary: Background of the study: Manual Therapy applied to patients with non-specific neck pain has been investigated several times, both internationally and nationally. In the Netherlands different types of manual therapy treatment exist. Manual Therapy, as practiced under the Utrecht School, has not been subject of a randomized controlled trial. There is a need to evaluate the effectiveness of this type of manual therapy.

Objective of the study: This trial will investigate the effectiveness of Manual Therapy in the short and long-term up to 52 weeks in patient with (sub) acute (minimal two weeks) and chronic (maximum 52 weeks) since last episode of neck pain. Functional state, pain and global perceived effect are the outcome variables.

Study design: The study is a single blind randomized controlled trial.

Study population: Men and women aged 18 to 70 years old with neck pain for at least two weeks.

Intervention: The experimental group will be treated with manual therapy for a period of six weeks. The control group will be treated with physical therapy (usual care) also for a period of six weeks.

Primary study parameters / outcome of the study: Global Perceived Effect (GPE) and the Neck disability index (NDI-DV ) will be applied.

Secondary study parameters / outcome of the study: Visual Analogue Scale (VAS) for pain and SF36 (Quality of life). The Multidimensional Health Locus of Control(MHLC ), Credibility/Expectancy Questionnaire, Fear Avoidance Beliefs Questionnaire (FABQ-DLV) will also be measured.


Options:
A: Inclusion Criteria:

* Patients with at least two weeks of neck pain
* Last episode starts at a maximum of one year ago
* Age between 18 and 70 years
* Patient is willing to undergo the treatment
* Neck pain is mechanical and can be provocated by movements or postures of the neck
* Neck pain is the main problem to treat
* Neck pain may also give pain in the upper arm or cervicogenic headaches

Exclusion Criteria:

* Appearance of "red flags"
* Cervical surgery in the past
* Pregnancy
* Whiplash trauma
* Health conditions with may disturb the treatment or makes it impossible to undergo the treatment.
* Not enough understanding of the Dutch questionnaires
* Undergoing treatments like physical therapy, manual therapy, osteopathy, chiropraxis, acupuncture, other types of exercise therapy during the last three months
B: Inclusion Criteria:

* 65 years of age and older
* independent ambulation and community dwelling
* stable medication plan
* neck-related disability (minimal score of 10% on Neck Disability Index)
* back-related disability (minimal score of 10% on Oswestry Disability Index)
* minimum combined disability score (above) of 25% at first baseline screening
* at least 12 week duration of neck and back related disability

Exclusion Criteria:

* moderate or severe cognitive impairment
* untreated clinical depression
* surgical spinal fusion or multiple incidents of spinal surgery
* contraindications to spinal manipulation or exercise
* ongoing, non-pharmacological treatment for a spinal condition
C: Exclusion Criteria:

* Pregnant women, due to use of diagnostic procedures (x-rays) and study treatments (NSAIDs and narcotic medications)
D: Inclusion Criteria:

* Sub-Acute and chronic low back pain (Defined as current episode more than 6 weeks duration.)
* Quebec Task Force classifications 1, 2, 3 and 4. (This includes patients with back pain, stiffness or tenderness, with or without musculoskeletal signs and neurological signs.{1570})
* 65 years of age and older
* Independent ambulation
* Community dwelling (residency outside nursing home)
* Score of 20 or more on Folstein Mini-Mental State Examination{13246}
* Stable prescription medication plan (no changes in prescription medications that affect musculoskeletal pain in previous month)

Exclusion Criteria:

* Referred low back pain from local joint lesions of the lower extremities or from visceral diseases
* Significant infectious disease Determined by history or by referral to supplementary diagnostic tests
* Ongoing treatment for low back pain by other health care providers
* Mean baseline low back pain score of 20 percentage points or less
* Contraindications to exercise Determined by history or by referral to supplementary diagnostic tests (i.e., uncontrolled arrhythmias, third degree heart block, recent ECG changes, unstable angina, acute myocardial infarction, acute congestive heart failure, cardiomyopathy, valvular heart disease, poorly controlled blood pressure, uncontrolled metabolic disease
* Contraindications to spinal manipulation (i.e. Progressive neurological deficits blood clotting disorders; infectious and non-infectious inflammatory or destructive tissue changes of the spine; severe osteoporosis)

Answer: A