Abstract
Objective
The objective of this study was to evaluate whether baseline clinical tests are associated with the relative effectiveness of manual therapy compared with neck-specific exercise in individuals with chronic non-specific neck pain (NSNP).
Design
This study consisted of a pre-planned secondary analysis of a single-blind, parallel, randomized clinical trial with two treatment arms, conducted in accordance with CONSORT guidelines.
Methods
A total of 65 participants with NSNP were randomly allocated in a 1:1 ratio to receive either manual therapy or neck-specific exercise. A comprehensive battery of clinical tests was conducted prior to treatment.
The manual therapy group received four 30-minute treatment sessions. The exercise group completed a four-week neck-specific exercise program, which included physiotherapist-led sessions and daily home exercises. Outcome measures were collected at baseline, and at two, four, and 12 weeks post-treatment. These outcomes included pain intensity, disability, patient-perceived improvement, quality of life, and kinesiophobia.
Based on pain intensity, disability, and patient-perceived improvement, participants were classified as either responders or non-responders.
Results
Participants with NSNP who reported bilateral pain, absence of a blocking sensation, greater pain at the end range of movement, asymmetry in side flexion or rotation range of motion, and symptom reproduction during specific neck movements were more likely to be classified as responders when treated with manual therapy compared with neck-specific exercise.
Adjusted odds ratios (probability > 0.95) varied substantially depending on the specific clinical test and the follow-up time point, ranging from 7.01 × 10⁻¹⁴ to 0.32.
Conclusion
A battery of baseline clinical tests demonstrated significant associations with the relative effectiveness of manual therapy versus neck-specific exercise in patients with chronic non-specific neck pain.