title: Changes in disability, physical/mental health states and quality of life during an 8-week multimodal physiotherapy programme in patients with chronic non-specific neck pain: a prospective cohort study.
abstract: OBJECTIVE
  The aim of this study was to analyse the effect of an 8-week multimodal physiotherapy programme (MPP), integrating physical land-based therapeutic exercise (TE), adapted swimming and health education, as a treatment for patients with chronic non-specific neck pain (CNSNP), on disability, general health/mental states and quality of life.
  
  
  METHODS
  175 CNSNP patients from a community-based centre were recruited to participate in this prospective study.
  
  
  METHODS
  60-minute session (30 minutes of land-based exercise dedicated to improving mobility, motor control, resistance and strengthening of the neck muscles, and 30 minutes of adapted swimming with aerobic exercise keeping a neutral neck position using a snorkel). Health education was provided using a decalogue on CNSNP and constant repetition of brief advice by the physiotherapist during the supervision of the exercises in each session.
  
  
  RESULTS
  primary: disability (Neck Disability Index); secondary: physical and mental health states and quality of life of patients (SF-12 and EuroQoL-5D respectively). Differences between baseline data and that at the 8-week follow-up were calculated for all outcome variables.
  
  
  RESULTS
  Disability showed a significant improvement of 24.6% from a mean (SD) of 28.2 (13.08) at baseline to 16.88 (11.62) at the end of the 8-week intervention. All secondary outcome variables were observed to show significant, clinically relevant improvements with increase ranges between 13.0% and 16.3% from a mean of 0.70 (0.2) at baseline to 0.83 (0.2), for EuroQoL-5D, and from a mean of 40.6 (12.7) at baseline to 56.9 (9.5), for mental health state, at the end of the 8-week intervention.
  
  
  CONCLUSIONS
  After 8 weeks of a MPP that integrated land-based physical TE, health education and adapted swimming, clinically-relevant and statistically-significant improvements were observed for disability, physical and mental health states and quality of life in patients who suffer CNSNP. The clinical efficacy requires verification using a randomised controlled study design.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02046876.
authors.affiliation: School of Clinical Sciences, Faculty of Health at the Queensland University of Technology, Brisbane, Australia; Departamento de Psiquiatría y Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Cátedra de Fisioterapia y Discapacidad, Instituto de Biomedicina de Málaga (IBIMA), Grupo de Clinimetria (FE-14), Malaga, Spain.
authors.forename: Antonio Ignacio
authors.initials: AI
authors.lastname: Cuesta-Vargas
authors.affiliation: Departamento de Psiquiatría y Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Cátedra de Fisioterapia y Discapacidad, Instituto de Biomedicina de Málaga (IBIMA), Grupo de Clinimetria (FE-14), Malaga, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: González-Sánchez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D019547:Neck Pain / Q000473:pathology / Q000628:therapy*; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult