Effectiveness of an active behavioural physiotherapy intervention (ABPI) for chronic non-specific neck pain: an internal pilot cluster-randomised double-blind clinical trial

Taweewat Wiangkham; Sureeporn Uthaikhup; Alison Rushton

doi:10.1016/j.msksp.2025.103389

Effectiveness of an active behavioural physiotherapy intervention (ABPI) for chronic non-specific neck pain: an internal pilot cluster-randomised double-blind clinical trial

Musculoskelet Sci Pract. 2025 Oct:79:103389. doi: 10.1016/j.msksp.2025.103389. Epub 2025 Jul 25.

Authors

Taweewat Wiangkham¹, Sureeporn Uthaikhup², Alison Rushton³

Affiliations

¹ Exercise and Rehabilitation Sciences Research Unit, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand; Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand. Electronic address: taweewatw@nu.ac.th.
² Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand. Electronic address: sureeporn.uthaikhup@cmu.ac.th.
³ School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada. Electronic address: arushto3@uwo.ca.

PMID: 40753854
DOI: 10.1016/j.msksp.2025.103389

Abstract

Background: Chronic non-specific neck pain (CNSNP) causes pain and disability, contributing to a serious public health problem. An active behavioural physiotherapy intervention (ABPI) may be an effective intervention to manage patients with CNSNP based on our previous trial data. To date, a CNSNP population has not been investigated with an ABPI.

Objectives: To preliminarily evaluate the potential effectiveness and feasibility of the ABPI for the management of patients with CNSNP.

Design: An internal pilot cluster-randomised double-blind, parallel 2-arm (ABPI vs standard physiotherapy intervention: SPI) clinical trial across 4 Thai public hospitals.

Methods: Forty participants (20 each arm) were recruited and face-to-face assessed at baseline and 3-month follow-up post baseline using the neck disability index (NDI), numerical pain rating scale (NPRS), cervical range of motion, fear-avoidance beliefs questionnaire, central sensitisation inventory (CSI) and short form-36.

Results: The mean (standard deviation) age of participants was 38.1 (7.8) years. The ABPI demonstrated significant within group improvement in all outcome measures and the NDI, NPRS and CSI illustrated significant improvement for the SPI (p ≤ 0.05). For the comparison between groups, all outcome measures were significantly better in the ABPI arm compared to the SPI (p ≤ 0.05), except the CSI. Finally, the number of fully recovered participants (considering the NDI ≤ 4/50) was greater for the ABPI (15/20 participants, 75 %) than the SPI (7/20 participants, 35 %).

Conclusion: These promising findings from an internal pilot study support continued data collection to conduct the definitive phase III trial (n = 120) to evaluate the effectiveness of the ABPI for the CNSNP management.

Keywords: Active behavioural physiotherapy intervention; Chronic pain; Clinical trial; Cluster randomisation; Complex intervention; Neck pain.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Behavior Therapy* / methods
Chronic Pain* / therapy
Disability Evaluation
Double-Blind Method
Female
Humans
Male
Middle Aged
Neck Pain* / rehabilitation
Neck Pain* / therapy
Pain Measurement
Physical Therapy Modalities*
Pilot Projects
Thailand
Treatment Outcome