Open Access Highly Accessed Study protocol

The effectiveness and cost-evaluation of manual therapy and physical therapy in patients with sub-acute and chronic non specific neck pain. Rationale and design of a Randomized Controlled Trial (RCT)

Ruud Groeneweg125*, Hans Kropman3, Huco Leopold4, Luite van Assen15, Jan Mulder1, Maurits W van Tulder6 and Rob AB Oostendorp17

Author Affiliations

1 Radboud University Nijmegen Medical Centre, Scientific Institute for Quality of Health Care, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands

2 Practice for Manual Therapy, Filomeentje-erf 154, 2907 BC Capelle aan den IJssel, The Netherlands

3 Practice for Manual Therapy, Bellestein 61 G, 6714 DP Ede, The Netherlands

4 Practice for Manual Therapy, Den Bloeyenden Wijngaerdt 3c, 1183 JM Amstelveen, The Netherlands

5 Practice for Physical Therapy and Manual Therapy, Wijnstraat 110, 3311 BX Dordrecht, The Netherlands

6 Department of Health Sciences & EMGO Insitute for Health and Care Research, Faculty of Earth & Life Sciences, VU University Amsterdam

7 Dutch Institute of Allied health Care, P.O. Box 1161, 3800 BD Amersfoort, The Netherlands

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BMC Musculoskeletal Disorders 2010, 11:14  doi:10.1186/1471-2474-11-14

Published: 24 January 2010



Manual Therapy applied to patients with non specific neck pain has been investigated several times. In the Netherlands, manual therapy as applied according to the Utrecht School of Manual Therapy (MTU) has not been the subject of a randomized controlled trial. MTU differs in diagnoses and treatment from other forms of manual therapy.


This is a single blind randomized controlled trial in patients with sub-acute and chronic non specific neck pain. Patients with neck complaints existing for two weeks (minimum) till one year (maximum) will participate in the trial. 180 participants will be recruited in thirteen primary health care centres in the Netherlands.

The experimental group will be treated with MTU during a six week period. The control group will be treated with physical therapy (standard care, mainly active exercise therapy), also for a period of six weeks.

Primary outcomes are Global Perceived Effect (GPE) and functional status (Neck Disability Index (NDI-DV)). Secondary outcomes are neck pain (Numeric Rating Scale (NRS)), Eurocol, costs and quality of life (SF36).


This paper presents details on the rationale of MTU, design, methods and operational aspects of the trial.

Trial registration Identifier: NCT00713843