Effectiveness of an active behavioural physiotherapy intervention (ABPI) for chronic non-specific neck pain: an internal pilot cluster-randomised double-blind clinical trial

Background

Chronic non-specific neck pain (CNSNP) causes pain and disability, contributing to a serious public health problem. An active behavioural physiotherapy intervention (ABPI) may be an effective intervention to manage patients with CNSNP based on our previous trial data. To date, a CNSNP population has not been investigated with an ABPI.

Objectives

To preliminarily evaluate the potential effectiveness and feasibility of the ABPI for the management of patients with CNSNP.

Design

An internal pilot cluster-randomised double-blind, parallel 2-arm (ABPI vs standard physiotherapy intervention: SPI) clinical trial across 4 Thai public hospitals.

Methods

Forty participants (20 each arm) were recruited and face-to-face assessed at baseline and 3-month follow-up post baseline using the neck disability index (NDI), numerical pain rating scale (NPRS), cervical range of motion, fear-avoidance beliefs questionnaire, central sensitisation inventory (CSI) and short form-36.

Results

The mean (standard deviation) age of participants was 38.1 (7.8) years. The ABPI demonstrated significant within group improvement in all outcome measures and the NDI, NPRS and CSI illustrated significant improvement for the SPI (p ≤ 0.05). For the comparison between groups, all outcome measures were significantly better in the ABPI arm compared to the SPI (p ≤ 0.05), except the CSI. Finally, the number of fully recovered participants (considering the NDI ≤ 4/50) was greater for the ABPI (15/20 participants, 75 %) than the SPI (7/20 participants, 35 %).

Conclusion

These promising findings from an internal pilot study support continued data collection to conduct the definitive phase III trial (n = 120) to evaluate the effectiveness of the ABPI for the CNSNP management.