Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Chiropractic & Manual Therapies
Published in: Chiropractic & Manual Therapies 1/2017

Open Access 01-12-2017 | Research

Manual therapy compared with physical therapy in patients with non-specific neck pain: a randomized controlled trial

Authors: Ruud Groeneweg, Luite van Assen, Hans Kropman, Huco Leopold, Jan Mulder, Bouwien C. M. Smits-Engelsman, Raymond W J. G. Ostelo, Rob A. B. Oostendorp, Maurits W. van Tulder

Published in: Chiropractic & Manual Therapies | Issue 1/2017

Login to get access

Abstract

Background

Manual therapy according to the School of Manual Therapy Utrecht (MTU) is a specific type of passive manual joint mobilization. MTU has not yet been systematically compared to other manual therapies and physical therapy. In this study the effectiveness of MTU is compared to physical therapy, particularly active exercise therapy (PT) in patients with non-specific neck pain.

Methods

Patients neck pain, aged between 18–70 years, were included in a pragmatic randomized controlled trial with a one-year follow-up. Primary outcome measures were global perceived effect and functioning (Neck Disability Index), the secondary outcome was pain intensity (Numeric Rating Scale for Pain). Outcomes were measured at 3, 7, 13, 26 and 52 weeks. Multilevel analyses (intention-to-treat) were the primary analyses for overall between-group differences. Additional to the primary and secondary outcomes the number of treatment sessions of the MTU group and PT group was analyzed. Data were collected from September 2008 to February 2011.

Results

A total of 181 patients were included. Multilevel analyses showed no statistically significant overall differences at one year between the MTU and PT groups on any of the primary and secondary outcomes. The MTU group showed significantly lower treatment sessions compared to the PT group (respectively 3.1 vs. 5.9 after 7 weeks; 6.1 vs. 10.0 after 52 weeks).

Conclusions

Patients with neck pain improved in both groups without statistical significantly or clinically relevant differences between the MTU and PT groups during one-year follow-up.

Trial registration

ClinicalTrials.gov Identifier: NCT00713843.
Literature
1.
Vos T, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet. 2016;388:1545–602.CrossRef
2.
Hoy DG, Protani M, De R, Buchbinder R. The epidemiology of neck pain. Best Pract Res Clin Rheumatol. 2010;6:783–92.
3.
Hogg-Johnson S, van der Velde G, Carroll LJ, Holm LW, Cassidy JD, Guzman J, Côté P, Haldeman S, Ammendolia C, Carragee E, Hurwitz E, Nordin M, Peloso P, Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. The burden and determinants of neck pain in the general population: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008;33:39–51.CrossRef
4.
Guzman J, Hurwitz EL, Carroll LJ, Haldeman S, Côté P, Carragee EJ, Peloso PM, van der Velde G, Holm LW, Hogg-Johnson S, Nordin M, Cassidy JD, Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. A new conceptual model of neck pain: linking onset, course, and care: the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008;33:14–23.CrossRef
5.
Picavet HSJ, Schouten JSAG. Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC3-study. Pain. 2003;102:167–78.CrossRefPubMed
6.
Badcock LJ, Lewis M, Hay EM, Croft PR. Consultation and the Outcome of Shoulder-Neck Pain: a Cohort Study in the Population. J Rheumatol. 2003;30:2694–9.PubMed
7.
Martin BI, Deyo RA, Mirza SK, Turner JA, Comstock BA, Hollingworth W, Sullivan SD. Expenditures and health status among adults with back and neck problems. JAMA. 2008;299:656–64.CrossRefPubMed
8.
Haldeman S, Carroll LJ, Cassidy JD, Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. he empowerment of people with neck pain: introduction: the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008;33:8–13.CrossRef
9.
Côté P, Kristman V, Vidmar M, Van Eerd D, Hogg-Johnson S, Beaton D, Smith PM. The prevalence and incidence of work absenteeism involving neck pain: a cohort of Ontario lost-time claimants. Spine. 2008;33:192–8.CrossRef
10.
Vos C, Verhagen A, Passchier J, Koes B. Management of acute neck pain in general practice: a prospective study. Br J Gen Pract. 2007;57:23–8.PubMedPubMedCentral
11.
Borghouts JA, Koes BW, Bouter LM. The clinical course and prognostic factors of non-specific neck pain: a systematic review. Pain. 1998;77:1–13.CrossRefPubMed
12.
Gross A, Langevin P, Burnie SJ, Bédard-Brochu MS, Empey B, Dugas E, Faber-Dobrescu M, Andres C, Graham N, Goldsmith CH, Brønfort G, Hoving JL, LeBlanc F. Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment (Review). Cochrane Database Syst Rev. 2016;9:CD004249.
13.
Gross AR, Paquin JP, Dupont G, Blanchette S, Lalonde P, Cristie T, Graham N, Kay TM, Burnie SJ, Gelley G, Goldsmith CH, Forget M, Santaguida PL, Yee AJ, Radisic GG, Hoving JL, Bronfort G, Groupo CO. Exercises for mechanical neck disorders: A Cochrane review update. Man Ther. 2016;24:25–45.CrossRefPubMed
14.
Hoving JL, Koes BW, de Vet HCW, van der Windt DAWM, Assendelft WJJ, Van Mameren H, Devillé WLJM, Pool JJM, Scholten RJPM, Bouter LM. Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain. A randomized, controlled trial. Ann Intern Med. 2002;136:713–22.CrossRefPubMed
15.
Hoving JL, de Vet HCW, Koes BW, Van Mameren H, Devillé WLJM, van der Windt DAWM, Assendelft WJJ, Pool JJM, Scholten RJPM, Korthals-de Bos IBC, Bouter LM. Manual therapy, physical therapy, or continued care by the general practitioner for patients with neck pain: long-term results from a pragmatic randomized clinical trial. Clin J Pain. 2006;22:370–7.CrossRefPubMed
16.
Korthals-de Bos IBC, Hoving JL, van Tulder MW, Rutten-van Mölken MPMH, Adèr HJ, de Vet HCW, Koes BW, Vondeling H, Bouter LM. Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: economic evaluation alongside a randomised controlled trial. BMJ. 2003;326:911.PubMed
17.
Groeneweg R, Kropman H, Leopold H, van Assen L, Mulder J, van Tulder MW, Oostendorp RA. The effectiveness and cost-evaluation of manual therapy and physical therapy in patients with sub-acute and chronic non specific neck pain. Rationale and design of a Randomized Controlled Trial (RCT). BMC Musculoskelet Disord. 2010;11:14.CrossRefPubMedPubMedCentral
18.
van de Veen EA, de Vet HCW, Pool JJM, Schuller W, de Zoete A, Bouter LM. Variance in manual treatment of nonspecific low back pain between orthomanual physicians, manual therapists, and chiropractors. J Manipulative Physiol Ther. 2005;28:108–16.CrossRefPubMed
19.
20.
21.
Schellingerhout JM, Verhagen AP, Heymans MW, Pool JJM, Vonk F, Koes BW, Wilhelmina de Vet HC. Which subgroups of patients with non-specific neck pain are more likely to benefit from spinal manipulation therapy, physiotherapy, or usual care? Pain. 2008;139:670–80.CrossRefPubMed
22.
van der Meulena MC, Huiskes R. Why mechanobiology? A survey article. J Biomech. 2002;35:401–14.CrossRef
23.
van der Bijl G. Het Individuele Functiemodel in de Manuele Therapie. De Tijdstroom: Lochem; 1986.
24.
Van Wylick H, Oostendorp RAB, van der Zanden, Duquet W. Preferential movements: preference or dislike. Tijdschrift voor Manuele Geneeskunde 2004;2:16–21.
25.
Maitland GD, English K, Banks K, Hengeveld E. Maitland’s Vertebral Manipulation. 6 edition. Oxford: Butterworth-Heinemann; 2001.
26.
27.
Kay TM, Gross A, Goldsmith CH, Rutherford S, Voth S, Hoving JL, Bronfort G, Santaguida PL. Exercises for mechanical neck disorders. Cochrane Database Syst Rev. 2012;8:CD004250.
28.
29.
Devilly GJ, Borkovec TD. Psychometric properties of the credibility/expectancy questionnaire. J Behav Ther Exp Psychiatry. 2000;31:73–86.CrossRefPubMed
30.
Smeets RJEM, Beelen S, Goossens MEJB, Schouten EGW, Knottnerus JA, Vlaeyen JWS. Treatment expectancy and credibility are associated with the outcome of both physical and cognitive-behavioral treatment in chronic low back pain. Clin J Pain. 2008;24:305–15.CrossRefPubMed
31.
Boersma K, Linton SJ. Expectancy, fear and pain in the prediction of chronic pain and disability: A prospective analysis. Eur J Pain. 2006;10:551.CrossRefPubMed
32.
Vendrig A, Deutz P, Vink I. Nederlandse Vertaling en Bewerking Van De Fear- Avoidance Beliefs Questionnaire. Ned Tijdschrift voor Pijn en Pijnbestrijding. 1998;18:11–4.
33.
Landers MR, Creger RV, Baker CV, Stutelberg KS. The use of fear-avoidance beliefs and nonorganic signs in predicting prolonged disability in patients with neck pain. Man Ther. 2008;13:239–48.CrossRefPubMed
34.
Chiu TW. Effects of fear-avoidance beliefs on Chinese patients with neck pain. Hong Kong Med J. 2009;15:S9–12.
35.
Nederhand MJ, Ijzerman MJ, Hermens HJ, Turk DC, Zilvold G. Predictive value of fear avoidance in developing chronic neck pain disability: consequences for clinical decision making. Arch Phys Med Rehabil. 2004;85:496–501.CrossRefPubMed
36.
Cai C, Ming G, Ng LY. Development of a clinical prediction rule to identify patients with neck pain who are likely to benefit from home-based mechanical cervical traction. Eur Spine J. 2011;20:912–22.CrossRefPubMedPubMedCentral
37.
Aaronson N, Muller M, Cohen P, Essink-Bot M, Fekkes M, Sanderman R, Sprangers M, te Velde A, Verrips E. Translation, validation, and norming of the Dutch Language Version of the SF-36 health survey in community and chronic disease populations. J Clin Epidemiol. 1998;51:1055–68.CrossRefPubMed
38.
van der Roer N, Ostelo RWJG, Bekkering GE, van Tulder MW, de Vet HCW. Minimal clinically important change for pain intensity, functional status, and general health status in patients with nonspecific low back pain. Spine. 2006;31:578–82.CrossRefPubMed
39.
Vet HCW, Ostelo RWJG, Terwee CB, Roer N, Knol DL, Beckerman H, Boers M, Bouter LM. Minimally important change determined by a visual method integrating an anchor-based and a distribution-based approach. Qual Life Res. 2007;16:131–42.CrossRefPubMed
40.
Kamper SJ, Ostelo RWJG, Knol DL, Maher CG, de Vet HCW, Hancock MJ. Global Perceived Effect scales provided reliable assessments of health transition in people with musculoskeletal disorders, but ratings are strongly influenced by current status. J Clin Epidemiol. 2010;63:760–6. e1.CrossRefPubMed
41.
Jorritsma W, Vries GE, Dijkstra PU, Geertzen JHB, Reneman MF. Neck Pain and Disability Scale and Neck Disability Index: validity of Dutch language versions. Eur Spine J. 2011;21:93–100.CrossRefPubMedPubMedCentral
42.
Jorritsma W, Dijkstra PU, Vries GE, Geertzen JHB, Reneman MF. Detecting relevant changes and responsiveness of Neck Pain and Disability Scale and Neck Disability Index. Eur Spine J 2012, DOI 10.​1007/​s00586-012-2407-8.
43.
Vos CJ, Verhagen AP, Koes BW. Reliability and responsiveness of the Dutch version of the Neck Disability Index in patients with acute neck pain in general practice. Eur Spine J. 2006;15:1729–36.CrossRefPubMed
44.
Pool JJM, Ostelo RWJG, Hoving JL, Bouter LM, de Vet HCW. Minimal clinically important change of the Neck Disability Index and the Numerical Rating Scale for patients with neck pain. Spine. 2007;32:3047–51.CrossRefPubMed
45.
World Health Organization. Towards a Common Language for Functioning, Disability and Health ICF. WHO/EIP/GPE/CAS/01.3. 2002.
46.
Rosier EM, Iadarola MJ, Coghill RC. Reproducibility of pain measurement and pain perception. Pain. 2002;98:205–16.CrossRefPubMed
47.
Kovacs FM, Abraira V, Royuela A, Corcoll J, Alegre L, Tomas M, Mir MA, Cano A, Muriel A, Zamora J, Gil Del Real MT, Gestoso M, Mufraggi N. Minimum detectable and minimal clinically important changes for pain in patients with nonspecific neck pain. BMC Musculoskelet Disord. 2008;9:43.CrossRefPubMedPubMedCentral
48.
Carnes D, Mullinger B, Underwood M. Defining adverse events in manual therapies: A modified Delphi consensus study. Man Ther. 2010;15:2–6.CrossRefPubMed
49.
Pool JJM, Ostelo RWJG, Köke AJ, Bouter LM, de Vet HCW. Comparison of the effectiveness of a behavioural graded activity program and manual therapy in patients with sub-acute neck pain: Design of a randomized clinical trial. Man Ther. 2006;11:297–305.CrossRefPubMed
50.
Twisk JW, de Vente W. Attrition in Longitudinal Studies. How to Deal with Missing Data. J Epidemol 2002;55:329–337.
51.
52.
Carnes D, Mars TS, Mullinger B, Froud R, Underwood M. Adverse events and manual therapy: A systematic review. Man Ther. 2010;15:355–63.CrossRefPubMed
53.
Michaleff ZA, Lin CWC, Maher CG, van Tulder MW. Spinal manipulationepidemiology: Systematic review of cost effectiveness studies. J Electromyogr Kinesiol 2012;22:655–62.
54.
Rubinstein SM, van Middelkoop M, Assendelft WJ, de Boer MR, van Tulder MW. Spinal manipulative therapy for chronic low-back pain. Cochrane Database Syst Rev. 2011;2:CD008112.
55.
van Dongen JM, Groeneweg R, Rubinstein SM, Bosmans JE, Oostendorp RAB, Ostelo RWJG, van Tulder MW. Cost-effectiveness of manual therapy versus physiotherapy in patients with sub-acute and chronic neck pain: a randomised controlled trial. Eur Spine J. 2016;25:2087–96.CrossRefPubMed
56.
Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. The Lancet. 2012;380:37–43.CrossRef
57.
van der Velde G, Hogg-Johnson S, Bayoumi AM, Cassidy JD, Côté P, Boyle E, Llewellyn-Thomas H, Chan S, Subrata P, Hoving JL, Hurwitz E, Bombardier C, Krahn M. Identifying the best treatment among common nonsurgical neck pain treatments: a decision analysis. Spine. 2008;33:S184–91.CrossRefPubMed
58.
Wong JJ, Shearer HM, Mior S, Jacobs C, Côté P, Randhawa K, MSc HYM, Southerst D, Varatharajan S, Sutton D, van der Velde G, Carroll LJ, Ameis A, Ammendolia C, Brison R, Nordin M, Taylor-Vaisey A. Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration. Spine J. 2016;16:1598–630.CrossRefPubMed
59.
Vernon H, Humphreys BK. Manual therapy for neck pain: an overview of randomized clinical trials and systematic reviews. Eura Medicophys. 2007;43:91–118.PubMed
60.
Hurwitz EL, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Côté P, Hogg-Johnson S, Cassidy JD, Haldeman S, Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Treatment of neck pain: noninvasive interventions: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008;33:S123–52.CrossRefPubMed
61.
Pool JJM, Ostelo RWJG, Knol DL, Vlaeyen JWS, Bouter LM, de Vet HCW. Is a behavioral graded activity program more effective than manual therapy in patients with subacute neck pain? Results of a randomized clinical trial. Spine. 2010;35:1017–24.CrossRefPubMed
62.
Berthelot J-M, Le Goff B, Maugars Y. The Hawthorne effect: Stronger than the placebo effect? Joint Bone Spine. 2011;78:335–6.CrossRefPubMed
63.
Miller J, Gross A, D’Sylva J, Burnie SJ, Goldsmith CH, Graham N, Haines T, Bronfort G, Hoving JL. Manual therapy and exercise for neck pain: A systematic review. Man Ther. 2010;15:334–54.CrossRefPubMed
64.
Artus M, van der Windt DA, Jordan KP, Hay EM. Low back pain symptoms show a similar pattern of improvement following a wide range of primary care treatments: a systematic review of randomized clinical trials. Rheumatology. 2010;49:2346–56.CrossRefPubMed
65.
Haldeman S, Dagenais S. A supermarket approach to the evidence-informed management of chronic low back pain. Spine J. 2008;8:1–7.CrossRefPubMed
66.
Holdsworth L, Webster V, McFadyen A. The Scottish Physiotherapy Self Referral Study Group. Are Patients Who Refer Themselves to Physiotherapy Different From Those Referred by GP’s? Results of a National Trial. Physiotherapy. 2006;92:26–33.CrossRef
67.
Veenhof C, Dekker J, Bijlsma JWJ, Van Den Ende CHM. Influence of various recruitment strategies on the study population and outcome of a randomized controlled trial involving patients with osteoarthritis of the hip or knee. Arthritis Rheum. 2005;53:375–82.CrossRefPubMed
68.
Geraets JJXR, de Groot IJM, Goossens MEJB, de Bruijn CPC, De Bie RA, van den Heuvel WJA, Dinant GJ. Comparison of two recruitment strategies for patients with chronic shoulder complaints. Br J Gen Pract. 2006;56:127–33.PubMedPubMedCentral
69.
Sherman KJ, Hawkes RJ, Ichikawa L, Cherkin DC, Deyo RA, Avins AL, Khalsa PS. Comparing recruitment strategies in a study of acupuncture for chronic back pain. BMC Med Res Methodol. 2009;9:69.CrossRefPubMedPubMedCentral
70.
Vernon H. The Neck Disability Index: state-of-the-art, 1991-2008. J Manipulative Physiol Ther. 2008;31:491–502.CrossRefPubMed
71.
Metadata
Title
Manual therapy compared with physical therapy in patients with non-specific neck pain: a randomized controlled trial
Authors
Ruud Groeneweg
Luite van Assen
Hans Kropman
Huco Leopold
Jan Mulder
Bouwien C. M. Smits-Engelsman
Raymond W J. G. Ostelo
Rob A. B. Oostendorp
Maurits W. van Tulder
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Chiropractic & Manual Therapies / Issue 1/2017
Electronic ISSN: 2045-709X
DOI
https://doi.org/10.1186/s12998-017-0141-3

Other articles of this Issue 1/2017

Chiropractic & Manual Therapies 1/2017 Go to the issue

Research

Managing patients with acute and chronic non-specific neck pain: are Danish chiropractors compliant with guidelines?

Research

The comfort and safety of a novel rolling mechanical indentation device for the measurement of lumbar trunk stiffness in young adults

Research

The relationship between chiropractor required and current level of business knowledge

Study protocol

A protocol for clinical trial study of the effect of core stabilization exercises on spine kinematics during gait with and without load in patients with non-specific chronic low back pain

Research

Musculoskeletal diagnostic ultrasound imaging for thickness measurement of four principal muscles of the cervical spine -a reliability and agreement study

Hypothesis

Contextually Aided Recovery (CARe): a scientific theory for innate healing