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Is tailored treatme...
Is tailored treatment superior to non-tailored treatment for pain and disability in women with non-specific neck pain? : A randomized controlled trial
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- Svedmark, Åsa, 1961- (author)
- Umeå universitet,Fysioterapi,Institutionen för samhällsmedicin och rehabilitering, enheten för fysioterapi, Umeå universitet, Umeå
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- Djupsjöbacka, Mats (author)
- Högskolan i Gävle,Arbetshälsovetenskap,Centrum för belastningsskadeforskning
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- Häger, Charlotte, 1962- (author)
- Umeå universitet,Fysioterapi,Institutionen för samhällsmedicin och rehabilitering, enheten för fysioterapi, Umeå universitet
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- Jull, Gwendolen (author)
- Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, The University of Queensland, Brisbane, Australia
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- Björklund, Martin (author)
- Högskolan i Gävle,Umeå universitet,Fysioterapi,Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden,Arbetshälsovetenskap,Centrum för belastningsskadeforskning,Institutionen för samhällsmedicin och rehabilitering, enheten för fysioterapi, Umeå universitet, Umeå
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(creator_code:org_t)
- 2016-09-30
- 2016
- English.
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In: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 17
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Abstract
Subject headings
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- BACKGROUND: The evidence for the effect of treatments of neck pain is modest. In the absence of causal treatments, a possibility is to tailor the treatment to the individuals' functional limitations and symptoms. The aim was to evaluate treatment effects of a tailored treatment versus a non-tailored treatment. Our hypothesis was that tailored treatment (TT) would have better effect on pain intensity and disability than either non-tailored treatment (NTT) (same treatment components but applied quasi-randomly) or treatment-as-usual (TAU) (no treatment from the study, no restrictions). We further hypothesized that TT and NTT would both have better effect than TAU.METHOD: One hundred twenty working women with subacute and chronic non-specific neck pain were allocated to 11 weeks of either TT, NTT or TAU in a randomized controlled trial with follow-ups at 3, 9 and 15 months. The TT was designed from a decision model based on assessment of function and symptoms with defined cut-off levels for the following categories: reduced cervical mobility, impaired neck-shoulder strength and motor control, impaired eye-head-neck control, trapezius myalgia and cervicogenic headache. Primary outcomes were pain and disability. Secondary outcomes were symptoms, general improvement, work productivity, and pressure pain threshold of m. trapezius.RESULTS: Linear mixed models analysis showed no differences between TT and NTT besides work productivity favoring TT at 9- and 15-months follow-ups. TT and NTT improved significantly more than TAU on pain, disability and symptoms at 3-month follow-up. General improvement also favored TT and NTT over TAU at all follow-ups.CONCLUSION: Tailored treatment according to our proposed decision model was not more effective than non-tailored treatment in women with subacute and chronic neck pain. Both tailored and non-tailored treatments had better short-term effects than treatment-as-usual, supporting active and specific exercise therapy, although therapist-patient interaction was not controlled for. Better understanding of the importance of functional impairments for pain and disability, in combination with a more precise tailoring of specific treatment components, is needed to progress.TRIAL REGISTRATION: Current Controlled Trials ISRCTN 49348025. Registered 2 August 2011.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Sjukgymnastik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Physiotherapy (hsv//eng)
Keyword
- Neck-shoulder pain
- Trapezius
- Individualized treatment
- Rehabilitation
- Physiotherapy
- Cut-off
Publication and Content Type
- ref (subject category)
- art (subject category)
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