Table 2. Summary results from the 15 included trials.
Studies | Countries | N | WAD | Design | Intervention 1 | Intervention 2 | Intervention 3 | Outcome Measures | Follow-up period | Main Results |
---|---|---|---|---|---|---|---|---|---|---|
Aigner et al. 2006 [29] | Austria | 53 | II | Parallel RCT with single blind | Collar and laser acupuncture | Collar and placebo laser acupuncture | - | -CROM,Subjective symptoms (neck pain, dizziness, paresthesia and tinnitus),Sick leave | 3 weeks (Clinically)8-12 Months (Postal) | No significant difference between interventions in all outcome measures |
Bonk et al. 2000 [30] | Germany | 147 | 0-II | Parallel RCT | Active therapy (active mobilization and exercise) | Collar therapy | Control | -Subjective symptoms (such as pain, stiffness), CROM | 3 months | No significant difference between interventions at 3 months |
Borchgrev-ink et al. 1998 [31] | Norway | 201 | 0-II | Parallel RCT with single blind | Act-as-usual | Immobilisati-on | - | -Subjective symptoms using questionnaire, Pain (VAS), CROM, Shoulder movement, Sick leave | 6 months | I1>I2 significantly in improvement neck pain (p<0.01), pain during daily activities (p< 0.05), headaches (p<0.01), painful regions (p<0.01), and memory and concentration problems (p<0.001) at 6 months. ROM of neck and shoulder did not differ between interventions. |
Conforti and Fachinetti 2013 [54] | Italy | 135 | I-II | Parallel RCT with single blind | HPLT | PT (manual therapy, passive and active exercise) | - | -Pain (VAS), The date of return to work | 6 weeks | I1 > I2significantly improved in both pain (p = 0.005) and the date of return to work (p<0.001) |
Dehner et al. 2006 [55] | Germany | 70 | II | Parallel RCT | 2 days with collar + standard PT after a weeks | 10 days with collar + standard PT after a weeks | - | -Pain (VAS), Disability (VAS), CROM | 6 months | No significant difference between interventions in all outcome measures |
Dehner et al. 2009 [32] | Germany | 90 | II | Parallel RCT | Active physical therapy | Passive physical therapy | Act as usual | -Pain (VAS), CROM, Period of disability/ sickness costs | 2 months | - Pain improvement: I1>I2>I3 significantly- CROM: I1 = I2 = I3- Period of disability: I1 = I2<I3 |
Ferrari et al. 2005 [33] | Canada | 112 | I-II | Parallel RCT with single blind | Education pamphlet | Control group | - | -The number of recovery | 3 months | No significant difference between interventions |
Foley-Nolan et al. 1992 [34] | Ireland | 40 | 0-II | Parallel RCT with single blind | PEMT + collar + active exercise | Placebo + collar + active exercise | - | -Pain (VAS), CROM, Number of analgesics | 3 months | I1>I 2 significantly improved in terms of pain (VAS) at 2 and 4 weeks but no significance at 12 weeks. For the CROM, I1>I2 significantly at 3 months (p<0.001). |
Jull et al. 2013 [56] | Australia | 101 | II | Parallel RCT with single blind | Multiprofess-ional intervention | Usual care | - | -Pain (VAS), NDI, IES, PFActS-C, GHQ 28, CROM, Craniocervical flexor test, Balance, Cervical proprioception, PPT, HPT, CPT, Sympathetic vasoconstrictor response, Types and dosage of medications | 12 months | No significant difference between interventions in all outcome measures but the recovery of pain and disability between baseline, 6 and 12 months has significant differences in both interventions. |
Ottosson et al. 2007 [35] | Sweden | 127 | I-II | Parallel RCT with unblind | Educational programme + self-care (exercise for relaxation and postural control) | Standard Rx.(basic medications) | - | -Self-reported recovery, SF-36, SMFA, Pain and mental distress (VAS), Sick leave | 12 months | I1>I2 significantly in terms of self-reported recovery (p<0.03) but no significant difference in other outcomes between interventions |
Picelli et al. 2011 [36] | Italy | 18 | I-II | Parallel RCT with single blind | Neck fascia manipulation | Neck mobilization exercise + stretching | - | -CROM, Pain (VAS), NDI, PPT | 2 weeks | CROM: I1>I2 significantly (p<0.01) but other outcome measures, no significant differences between interventions. |
Rosenfeld et al. 2003 [37][Rosenfeld et al. 2006 reporting same trail][57] | Sweden | 102 | 0-II | Parallel RCT with single blind | Active mobilization within 96 hours or Active mobilization 14 days | Standard Rx. (rest, collar and gradual self-mobil)within 96 hrs or Standard Rx. (rest, collar and gradual self-mobil) 14 days | - | -Pain (VAS), CROM, Sick leave | 3 years | Pain and sick leave I1<I2 significantly (p<0.05) but no significance in CROM (p = 0.06–0.08) |
Schnabel et al. 2004 [58] | Germany | 200 | I-II | Parallel RCT with un- blind | Mobilisation exercise | Collar therapy | - | -Pain (VAS), Disability (VAS) | 6 weeks | I1>I2 significantly in improving pain and disability (p<0.05) |
Scholten-Peerters et al. 2006 [59] | Netherlands | 80 | I-II | Parallel RCT with single blind | Education and exercise by PTs | Education by GPs | - | -Pain (VAS), Functional recovery (VAS), SF-36, CROM, TSK, PCI, NDI, Disability in housekeeping and social activities (VAS) | 13 months | At 12 weeks, I1>I2 significantly for CROM improvement but in long term I2>I1 significantly in terms of functional recovery, coping, and physical functioning. |
Vassiliou et al. 2006 [38] | Germany | 200 | I-II | Parallel RCT with unblind | PT + active exercise | Standard Rx (drugs + soft collar) | - | -Pain and disability (NRS), Number of days with oral medication, The period of soft collar | 6 months | I1>I2 significantly improved in terms of pain intensity and disability. Other outcomes had been reported but no compare using statistic procedure. |
CPT: Cold Pain Threshold, CROM: Cervical Range of Motion, GHQ 28: General Health Questionnaire, HPLT: High Power Laser Therapy, HPT: Hot Pain Threshold, I: Intervention, IES: Impact of Events Scale, NDI: Neck Disability Index, NRS: Numeric Rating Scale, PCI: Pain Coping Inventory, PFActS-C: Pictorial Fear of Activity Scale-Cervical, PPT: Pressure Pain Thresholds, PT: Physiotherapy, RCT: Randomised Controlled Trail, Rx: Treatment, SMFA: Short Musculoskeletal Function Assessment, SF-36: Functional Health Status (Short Form 36), TSK: Tampa Scale for Kinesiophobia, VAS: Visual Analogue Scale