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Manual Therapy, Therapeutic Patient Education, and Therapeutic Exercise, an Effective Multimodal Treatment of Nonspecific Chronic Neck Pain: A Randomized Controlled Trial
Abstract
Objective The aim of this study was to determine the effectiveness of a multimodal treatment in the short and medium term for disability in nonspecific chronic neck pain. Design The design of this study is a single-blinded randomized controlled trial carried out in a university research laboratory. Forty-five patients between 18 and 65 yrs with nonspecific chronic neck pain were included in this study. Each patient was treated eight times over a 4-wk period. The sample was divided into three groups: control group, subjected to a protocol of manual therapy; experimental group 1, subjected to a protocol of manual therapy and therapeutic patient education; and experimental group 2, subjected to manual therapy, therapeutic patient education, and a therapeutic exercise protocol. Assessments were performed at baseline and at 4, 8, and 16 wks using the following measurements: the Neck Disability Index, the 11-item Tampa Scale of Kinesiophobia, the Fear Avoidance Beliefs Questionnaire, the Neck Flexor Muscle Endurance Test, and the Visual Analog Fatigue Scale. Results The nonparametric Kruskal-Wallis test for the Neck Disability Index showed statistically significant differences between baseline outcomes and all follow-up periods (P Conclusion Differences between experimental groups and the control group were found in the short and medium term. A multimodal treatment is a good method for reducing disability in patients with nonspecific chronic neck pain in the short and medium term.
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“There is currently no standardized treatment approach for TMJ dysfunction, and clinicians tend to use a multimodal approach50, 51, 52 to care including education, exercise, and MT.”
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Self-citationConservative interventions provide short-term relief for non-specific neck pain: a systematic review
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“This consists of 16 items, and patients rate their agreement with each statement on a seven-point Likert scale (0, completely disagree; 6, completely agree).(32,33) This test showed excellent test-retest reliability (intraclass correlation, 0.”
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Cited by
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Louw, A., Zimney, K. J., Puentedura, E. J., & Diener, I. (2016) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2016.1194646 · Cited by 738
The efficacy of manual therapy and exercise for treating non-specific neck pain: A systematic review
Hidalgo, B., Hall, T. M., Bossert, J., Dugeny, A., Cagnie, B. J., & Pitance, L. (2017) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.3233/bmr-169615 · Cited by 271
Utrera, C. B., González-Gerez, J. J., Anarte‐Lazo, E., & Rodríguez‐Blanco, C. (2020) · Trials · doi:10.1186/s13063-020-04610-w · Cited by 143
Multi-disciplinary interventions for chronic pain involving education: a systematic review
Joypaul, S., Kelly, F., McMillan, S. S., & King, M. A. (2019) · PLOS ONE · doi:10.1371/journal.pone.0223306 · Cited by 119
The clinical application of teaching people about pain
Louw, A., Zimney, K. J., O’Hotto, C., & Hilton, S. (2016) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2016.1194652 · Cited by 124
Metadata
- Authors
- Beltran-Alacreu, H., López-de-Uralde-Villanueva, I., Fernández-Carnero, J., & La Touche, R.
- Venue
- American Journal of Physical Medicine & Rehabilitation
- Published
- 2015-10
- Volume
- 94
- Issue
- 10S
- Pages
- 887-897
- ISSN
- 0894-9115 (ISSN-L)
- OpenAlex
- W2326271884
- Cited by
- 107
- References
- 34
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 14 · 2023: 10 · 2022: 13 · 2021: 9 · 2020: 12 · 2019: 14 · 2018: 7 · 2017: 6 · 2016: 5 · 2015: 1
- FWCI
- 4.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physical Medicine & Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Myofascial pain diagnosis and treatment
- Health Sciences › Dentistry › Oral Surgery › Temporomandibular Joint Disorders
- Keywords
- manual therapy, therapeutic education, exercise therapy, multimodal therapy, neck disability, kinesiophobia, fear-avoidance beliefs, fatigue, treatment effectiveness
- MeSH terms
- Adolescent, Adult, Aged, Combined Modality Therapy, Exercise Therapy, Female, Humans, Male, Middle Aged, Patient Education as Topic, Single-Blind Method, Treatment Outcome, Neck Pain, Musculoskeletal Manipulations, Young Adult, Chronic Pain
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