Preventive Care of Chronic Cervical Pain and Disabilities

Study Overview
=================
Brief Summary
-----------------
The aim of this study is to determine which of tertiary prevention spinal manipulative therapy (SMT) or a home exercise program is the more efficient approach to reduce pain and increase functional capacity, quality of life and general health condition. To do so, 60 participants with chronic cervical pain, will be recruited and divided into 3 groups according to the intervention they will receive: control group, experimental group 1 who will receive preventive chiropractic care in the form of spinal manipulations and experimental group 2 will have to perform an individualized home exercise program on a daily basis. We hypothesize that a group of patient receiving SMT + a home exercise program will present less pain and functional disabilities over a 1 year period. The innovative value of this project is mainly related to the fact that it will generate new and potentially very useful data concerning the clinical significance of preventive chiropractic care. Moreover, such data will be beneficial to our profession as chiropractic makes a step towards prevention, wellness and public health.

Official Title
-----------------
Preventive Care of Chronic Cervical Pain and Disabilities; Comparison of Spinal Manipulative Therapy and Individualized Home Exercise Programs

Conditions
-----------------
Neck Pain

Intervention / Treatment
-----------------
* Other: spinal manipulation
* Other: Spinal manipulation + exercises


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Adults between 18 and 60 years old from the city and the surrounding Trois-Rivières with chronic cervical pain of non-traumatic origin (chronic or recurrent cervical pain that lasted at least 6 months) Exclusion Criteria: Exclusion criteria for the project are: Surgery to the cervical spine Neoplasms Severe osteoarthritis Ankylosing spondylitis Hypertension Referred pain in the cervical area Central or peripheric nervous system dysfunction Vascular disease Treated cardiovascular disease Inflammatory or infectious disease of the cervical spine Metabolic or endocrine diseases Pregnancy Specific rehabilitation training for the neck or already under manual therapy for neck pain Patient suffering from dizziness, vertigo or headache suspected to be cervicogenic or of unknown origin will not be involved in the study.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: 1<br> | |
| Active Comparator: 2<br>spinal manipulation | Other: spinal manipulation<br>* Monthly cervical spinal manipulation<br>|
| Experimental: 3<br>Spinal manipulation + exercises | Other: Spinal manipulation + exercises<br>* Monthly cervical spine manipulation and daily home exercises<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neck Pain | Visual analog pain scale (score 0-10 cm; 0 being no neck pain and 10 extreme neck pain) | Up to 10 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fear Avoidance Belief, Quality of Life, Range of Motion |  | One year |