Manual therapy compared with physical therapy in patients with non-specific neck pain: a randomized controlled trial
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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.
Keywords: Randomized controlled trial, Neck pain, Manual therapy, Physical therapy, Effectiveness