• Lucia Domingues, Fernando Manuel Pimentel-Santos, Eduardo Brazete Cruz, Ana Cristina Sousa, Ana Santos, Ana Cordovil, Anabela Correia, Laura Sa Torres, Antonio Silva, Pedro Soares Branco, and Jaime Cunha Branco.
• Rheumatic Diseases, Chronic Diseases Research Center (CEDOC), Nova Medical School - Faculdade de Ciencias Medicas, Universidade Nova de Lisboa, Lisboa, Portugal.
• Clin Rehabil. 2019 Dec 1; 33 (12): 1908-1918.

ObjectiveThe aim of this study was to compare the effectiveness of a combined intervention of manual therapy and exercise (MET) versus usual care (UC), on disability, pain intensity and global perceived recovery, in patients with non-specific chronic neck pain (CNP).DesignRandomized controlled trial.SettingOutpatient care units.SubjectsSixty-four non-specific CNP patients were randomly allocated to MET (n = 32) or UC (n = 32) groups.InterventionsParticipants in the MET group received 12 sessions of mobilization and exercise, whereas the UC group received 15 sessions of usual care in physiotherapy.Main MeasuresThe primary outcome was disability (Neck Disability Index). The secondary outcomes were pain intensity (Numeric Pain Rating Scale) and global perceived recovery (Patient Global Impression Change). Patients were assessed at baseline, three weeks, six weeks (end of treatment) and at a three-month follow-up.ResultsFifty-eight participants completed the study. No significant between-group difference was observed on disability and pain intensity at baseline. A significant between-group difference was observed on disability at three-week, six-week and three-month follow-up (median (P25-P75): 6 (3.25-9.81) vs. 15.5 (11.28-20.75); P < 0.001), favouring the MET group. Regarding pain intensity, a significant between-group difference was observed at six-week and three-month follow-up (median (P25-P75): 2 (1-2.51) vs. 5 (3.33-6); P < 0.001), with superiority of effect in MET group. Concerning the global perceived recovery, a significant between-group difference was observed only at the three-month follow-up (P = 0.001), favouring the MET group.ConclusionThis study's findings suggest that a combination of manual therapy and exercise is more effective than usual care on disability, pain intensity and global perceived recovery.

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