The use of ideomotor therapy in the treatment of chronic neck pain: A single systems research design

Abstract

Introduction: Neck pain is common and is a significant medical and socioeconomic problem in New Zealand. There are many treatments for neck pain, however the effectiveness of manual treatment for neck pain is poorly established. The aim of the present study is to document the effectiveness of an emergent manual therapeutic technique Simple Contact in five subjects suffering from chronic neck pain.

Methods: A prospective single-system research design using an A-B-C protocol was used to evaluate the effectiveness of the intervention Simple Contact in reducing levels of pain intensity, disability due to neck pain and fear avoidance behaviour, and increasing functional status levels. Subjects satisfying the study inclusion and exclusion criteria commenced a 9-10 week study consisting of a 3-4 week baseline period followed by a 3 week intervention period and a 3 week follow-up period. Outcome measures used to record levels were Quadruple Visual Analogue Scale, Neck Disability Index, Tampa Scale for Kinesiophobia, Fear Avoidance Beliefs Questionnaire and Patient Specific Functional Scale.

Results: Visual analysis of the data was used to attempt to identify any change in outcome measures that might be due to the intervention. Where relevant, trendlines were fitted to data from all three phases and to data from the intervention and followup phases. Variability of data and limited data points in the baseline phase make it difficult to conclude whether or not the intervention had an effect. Electronic submission of results by subjects allowed subject compliance to be checked. Poor compliance with scheduled dates for submission of data seriously weakens the integrity of the study and the ability to confidently draw conclusions from the results. This identifies a methodological weakness for studies reliant on self-report measures of change.

Conclusions: The current research was not able to make conclusions as to the effectiveness of the intervention Simple Contact on reducing levels of chronic neck pain in the five subjects studied. However, visual analyses of the results suggest that the intervention was having no detectable effect on the outcomes measured. Future research in this area should attempt to obtain more baseline data and maximise compliance with scheduled dates of submission of data by subjects.