title: Self-management of persistent neck pain: two-year follow-up of a randomized controlled trial of a multicomponent group intervention in primary health care.
abstract: METHODS
  A 2-year follow-up of a randomized controlled trial.
  
  
  OBJECTIVE
  To compare long-term effects of (a) a multicomponent pain and stress self-management group intervention (PASS) and (b) individually administered physical therapy (IAPT) on patients with persistent tension-type neck pain in a primary health care (PHC) setting.
  
  
  BACKGROUND
  In a previously reported short-term follow-up, PASS had better effects on pain control, pain-related self-efficacy, disability, and catastrophizing than IAPT. Long-term effects of self-management interventions for persistent neck pain, for example, maintenance of improvement and adherence to coping skills are sparsely investigated.
  
  
  METHODS
  Persons with persistent tension-type neck pain seeking physical therapy treatment at nine PHC centers in Sweden were randomly assigned to either PASS or IAPT. Before intervention, at 10 and 20 weeks and at 1 and 2 years after the intervention, the participants completed a self-assessment questionnaire comprising: the Self-Efficacy Scale, the Neck Disability Index, the Coping Strategies Questionnaire, the Hospital Anxiety and Depression Scale, and questions regarding neck pain and analgesics. Analyses were performed using linear mixed models for repeated measures.
  
  
  RESULTS
  The study included 156 participants (PASS n = 77, IAPT n = 79). Between baseline, 10-week, 20-week, 1-year, and 2-year follow-up, significant time-by-group interaction effects were found in favor of PASS regarding the primary outcomes ability to control pain (P < 0.001) and self-efficacy for performing activities in spite of pain (P = 0.002), and the secondary outcome catastrophic thinking (P < 0.001) but not in neck pain-related disability.
  
  
  CONCLUSIONS
  The initial treatment effects of a self-management group intervention were largely maintained over a 2-year follow-up period and with a tendency to have superior long-term effects as compared to individually-administered physical therapy, in the treatment of persistent tension-type neck pain with regard to coping with pain, in terms of pain control, self-efficacy, and catastrophizing.
authors.affiliation: Center for Clinical Research Dalarna, Falun, Sweden. catharina.gustavsson@ltdalarna.se
authors.forename: Catharina
authors.initials: C
authors.lastname: Gustavsson
authors.forename: Eva
authors.initials: E
authors.lastname: Denison
authors.forename: Lena
authors.initials: L
authors.lastname: von Koch
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000628:therapy*; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011320:Primary Health Care / Q000379:methods*; D012648:Self Care; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult