GPR vs Manual PT for Chronic Neck Pain

Study Overview
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Brief Summary
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Effective treatment for nonspecific chronic neck pain is a clinical challenge. Patients will be randomized into two groups to compare the outcomes of Global Postural Re-education (GPR) with standard manual physical therapy on with respect to pain, function, kinesiophobia, range of motion, perceived effect, and satisfaction.

Detailed Description
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These study will use two groups: one to receive GPR which is a systematic method of addressing musculoskeletal pain and related functional deficits and the other to receive usual care manual PT which will be individualized to the patient's condition. Usual care will include techniques commonly used in clinical practice selected by the physical therapist after initial examination. After nine weeks of treatment, baseline measures will be re-evaluated. After conclusion of the first phase of the study, patients who were randomized to the usual care group will cross-over and receive GPR.

Official Title
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Randomized Controlled Trial of Global Postural Re-education vs. Standard Manual Physical Therapy for Non-specific Chronic Neck Pain With Cross-over

Conditions
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Nonspecific Chronic Neck Pain

Intervention / Treatment
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* Other: Global Postural Re-education
* Other: Standard manual physical therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: -nonspecific neck pain lasting at least 3 months Exclusion Criteria: acute or subacute cervical pain specific or known cause of pain central or peripheral neurological signs systemic pathology rheumatologic pathology neuromuscular pathology cognitive impairment surgical intervention in the last 6 months prior to study physical therapy treatment in the last 6 months prior to study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Global Postural Re-education<br>Global Postural Re-education is delivered in a single treatment session each week for nine weeks. | Other: Global Postural Re-education<br>* Global Postural Re-education is a physical therapy method comprising a series of gentle active movements, implemented by the therapist using manual contacts and verbal commands, to promote postural symmetry.<br>|
| Active Comparator: Standard manual physical therapy<br>Standard manual physical therapy is delivered in a single treatment session each week for 9 weeks. | Other: Standard manual physical therapy<br>* Standard manual physical therapy in this study involves a combination of exercises, pompage (gentle manual techniques of distraction and articulation of a joint), anterior-posterior mobilizations as described by Maitland, and massage that have been selected to meet the needs of each individual patient.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain | The investigators assessed this outcome with a Visual Analogue Scale (VAS). | 9 weeks after start of intervention | 
| Cervical Functional Limitations | The investigators assessed this outcome with the Neck Disability Index. | 9 weeks after start of intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Kinesiophobia | The investigators assessed this outcome with the Tampa Scale of Kinesiophobia. | 9 weeks after start of intervention | 
| Cervical Range of Motion | The investigators assessed this outcome with the CROM-Deluxe which is an inclinometer that is placed on the subject's head to measure cervical range of motion. | 9 weeks after start of intervention | 
| Self-reported Global Effect of the Intervention | The investigators assessed this outcome with a Global Perceived Effect scale which measures the subject's self-reported improvement or deterioration following the intervention. | 9 weeks after start of intervention | 
| Patient Satisfaction | The investigators assessed this outcome with the Physical Therapy Patient Satisfaction Questionnaire - Italian Version which has established psychometric properties. | 9 weeks after start of intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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neck pain, chronic, Global Postural Re-education, manual therapy, physical therapy