Physical and cognitive behavioural graded activity as a treatment for patients with chronic neck pain – a randomised controlled study with a one year follow up



Neck pain is a major problem in the adult population, 30 – 50 % of all adults experience neck pain during one year. The National Board of Health estimates that about 5-6000 people per year in Denmark are involved in a traffic accident and have whiplash-induced neck pain. About 43% will still have physical impairment and symptoms 6 months after the accident. There is limited knowledge about the effect of physiotherapy interventions for patients with chronic neck pain.


Using a randomised controlled trial (RCT) design, the aim of this study is to evaluate the effectiveness of: graded physical training, including specific neck exercises and general aerobic training, combined with education in pain management (based on a cognitive behavioural approach) versus education in pain management (based on a cognitive behavioural approach), measured on physical quality of life, physical function, neck pain and neck functions, fear of movement, post-traumatic symptoms and mental quality of life, in patients with chronic neck pain after the intervention (four months) and one year  follow up.



Randomised controlled study including 200 patients with following inclusions criteria: participants older than 18, chronic neck pain for at least six months, no medical examinations/treatment and able to participate in an exercise/training programme. Exclusions criteria: neuropathy, in medical or other progressive treatment.

The intervention lasts four months and consists of: eight times instruction in exercises for the neck, scapula, standing balance, eye-neck coordination and aerobe plus four sessions in pain education. The control group receives four sessions in pain education during four months.

Interventions take place at the Spine Centre Middelfart, Hollufgaard Training clinic Odense and private physiotherapy clinics in Vejle and Århus.



Outcome measurements are at baseline, end intervention and 12 months follow up, containing questionnaires related to quality of life, neck function and pain, depression, kinesiophobia as well as functional test for the neck, balance and fitness. The persons testing are blinded towards the status of participant being in the control or intervention group.


This is the first study looking at the effect of combined physiotherapy with neck exercises aerobe training and pain education. The results will contribute to the knowledge of effective treatment of chronic neck pain patients.

Tilbage til igangværende Ph.d.-projekter