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.
Author keywords: Randomized controlled trial — Neck pain — Manual therapy — Physical therapy — Effectiveness
Author affiliations: RG, LvA, JM: Radboud University Nijmegen Medical Centre, Scientific Institute for Quality of Health Care, Nijmegen, The Netherlands; RG, RWJGO, MWvT: Department of Health Sciences, Faculty of Earth & Life Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands; RG, HK: Avans+, University of Applied Science, Breda, The Netherlands; BCMS-E: Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa;
RWJGO: Department of Epidemiology and Biostatistics & EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; RABO: Department of Manual Therapy, Vrije Universiteit Brussel, Faculty of Medicine and Pharmacy, Brussels, Belgium
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