The NEXERCISE-trial: Reshaping Exercise Programs for Patients With Non-specific Neck Pain
Condition: Neck Pain; Chronic Pain
MeSH terms: Chronic Pain; Neck Pain
Study type: Interventional

Summary: 
      The Nexercise-trial is a blended treatment program for patients with chronic non-specific
      neck pain. We will investigate whether a blended treatment approach, combining specific neck
      exercises and general aerobic exercises, has better outcome (on medical impact for the
      patient and socio-economic impact) than a specific neck exercise program alone or a general
      aerobic exercise program alone.
    

Detailed description: 
      Chronic non-specific neck pain is a common musculoskeletal complaint in which several
      biopsychosocial factors can be involved. This condition is associated with a high
      socio-economic burden. The standard of care treatment for chronic neck pain in clinical
      practice is a combination of advice, passive manual treatment techniques and neck exercises.
      The implementation of exercise for the treatment of chronic neck pain is indeed recommended
      in several clinical guidelines. Nevertheless, exercise programs show positive though limited
      effects, which can be explained by its biomechanical and physiological effects on muscles and
      joints, but a current lack of taking into account important biopsychosocial and
      neurophysiological factors. For instance, specific local exercises can lead to acute pain
      flare-ups, hampering patient satisfaction and the adherence to exercise programs. While it is
      shown that general aerobic exercise leads to decreased generalized pain sensitivity, also in
      the affected body parts, both immediately and on the longer term, although on the longer term
      the effects on local pain sensitivity are better for specific local exercises.

      It can be hypothesized that a blended treatment program in which local specific neck
      exercises are combined with general aerobic exercise in counteractive amount will avoid pain
      flare-ups and maladaptive exercise perceptions, positively influencing treatment adherence
      and generating the most optimal clinical outcome due to the local and general effects.

      Therefore the aim of this project is to investigate the effect of a blended treatment program
      (I) to a specific exercise program alone (C1) and to a general aerobic exercise program alone
      (C2) on pain intensity and cost effectiveness (primary outcome measures), and also on Global
      Perceived Effect, other pain-related outcomes, quality of life and functionality, lifestyle
      factors, and health-economic measures (secondary outcome measures) (O) in chronic
      non-specific neck pain patients (P).
    

Intervention name(s): Blended treatment program; Specific strength exercise program; General aerobic exercise program
Intervention type(s): Other; Other; Other
Intervention description(s): A combined treatment program with specific active neck exercises and general aerobic training in counteractive amount will be executed during 12 weeks. Nine supervised sessions will be supplemented with 1 to 3 weekly unsupervised home exercise sessions.; This program includes an individual, patient-tailored exercise program with the aim of retraining the neck musculature. A detailed exercise programme will be constructed in which all exercises are listed with the amount of repetitions and series of each exercise. Strength exercises will be performed by means of dumbbells with different weights and elastic bands with different degrees of resistance. The amount of weight or resistance, and the amount of series and repetitions will be evaluated during the first session. This exercise programme will be re-evaluated repeatedly during the course of the program. Specific strength neck exercises will be performed for 30 minutes. Nine supervised sessions will be supplemented with 1 to 3 weekly unsupervised home exercise sessions.; This control group will receive a general aerobic exercise program. Within a 12-week period, patients will be instructed to perform a general aerobic exercise session 3 times a week.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: local neck exercises; general aerobic exercises; pain intensity; cost effectiveness