Neck-specific Training or Prescribed Physical Activity for Patients With Cervical Radiculopathy
Condition: Cervical Pain; Pain, Radiating
MeSH terms: Radiculopathy; Neck Pain; Pain
Study type: Interventional

Summary: 
      The overall objective is to evaluate if treatment with a neck-specific exercise program and
      cognitive behavioural approach improves the outcome compared with prescribed, self-mediated
      and progressive physical activity in patients with cervical radiculopathy. There is a lack of
      evidence of the best treatment for the patient category. Many patients are sick-listed for
      long periods of time with different kind of treatment approaches or without any treatment at
      all. The present study could fill the identified knowledge gap by strengthening of the
      currently weak scientific evidence for treatment of the patient category. The long-term
      effects of the study could be to reduce the time for sick leave and improve the rate of
      patients returning to work and/ or former activity by optimising treatments. Further on, to
      decrease the number of patients who finally have surgery for their neck problems and thus
      reducing the mental, physical and social costs.
    

Detailed description: 
      Patients with cervical radiculopathy have neck- and arm pain, neurological changes, activity
      limitations and difficulties in returning to work. The current scientific evidence lacks
      randomised controlled trials to compare surgery with conservative treatment as well as to
      evaluate different conservative interventions. Most patients are not candidates for surgery
      and are sick-listed for long time with different treatment approaches or without any
      treatment at all. The purpose is to evaluate if treatment with neck-specific training and a
      cognitive behavioral approach improves the outcome compared with prescribed physical
      activity. Methods: A randomized controlled trial including 144 patients will compare the
      intervention neck specific training and cognitive behavioural approach with an intervention
      of prescribed physical activity. The interventions will be led by experienced and specialised
      physiotherapists and last 14 weeks. Main outcome variable is pain intensity (VAS scale)
      accompanied with assessments of impairments and subjective health measurements undertaken
      before intervention and at 3, 6, 12 and 24 months. Implementation: The results will be
      presented scientifically as well as popularly in publications and professional meetings.
      Active implementation strategies to change physiotherapists treatment behaviour will be used.
      The best method will be chosen after surveying the physiotherapists treating patients in the
      current study regarding experiences, education and organisational context.
    

Intervention name(s): Prescribed physical activity; Neck specific training
Intervention type(s): Other; Other
Intervention description(s): Prescribed physical activity is a tailored physical activity programme with monitoring of progress and a follow-up. Also includes interview: exploratory talk, commitment/decision, life style change, health promotion, evaluation of readiness for change, reflection, assessment of motivation, patient specific goal assessment, conclusion and plan for follow-up at 14 weeks. Patients are guided by the physiotherapist to increase their overall activity and strength with i.e. walking and other self-mediated activities and exercise.; The active physiotherapy rehabilitation program consists of a standardised and structured physiotherapy program (twice a week) with medical exercise therapy and if needed vestibular rehabilitation. At the start of the intervention motivational interviewing will be included. Additionally once a week during the first 14 weeks of the program the physiotherapist informs the patient about physiology of pain, stress, exercise, breathing, relaxation, coping, pacing and ergonomics. All through the treatment program a cognitive approach from the physiotherapist according to theoretical behaviour change models will be used.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Exercise, Physical; Physical Activity; Outcome Measures