{
    "abstract": "Clinical guidelines recommend that people with chronic non-specific neck pain self-manage symptoms with physiotherapy-led exercise. However, current exercise strategies have modest short-term effects, engagement is poor, and 48% of people continue to experience long-term and recurrent pain. Updated exercise strategies co-produced using complex intervention development frameworks are required that consider the behavioural, psychological, environmental, and technical aspects of exercise prescription and patient adherence to optimise symptom outcomes, long-term engagement, and self-management. This study tests the feasibility and acceptability of the EPIC-Neck programme (\"Exercise Prescription Improved through Co-design\") which is grounded in evidence and theory and was co-produced using intervention mapping principles. The aim of the EPIC-Neck programme is to optimise the short-term outcomes of and long-term engagement with neck exercise.\nThis is a randomised feasibility study with process evaluation to assess the feasibility and acceptability of the EPIC-Neck programme and inform the design of a large-scale definitive trial evaluating the clinical and cost-effectiveness of the EPIC-Neck programme. A multicentre two-arm randomised controlled feasibility study aiming to recruit 45 adults with chronic non-specific neck pain will be conducted in UK NHS musculoskeletal physiotherapy departments. Recruitment will be from waiting lists and clinic advertisements. Participants will be individually randomised in 2:1 ratio to either the EPIC-Neck programme (n\u2009=\u200930) or usual exercise care (n\u2009=\u200915). The primary feasibility objective is to determine whether to continue to a large-scale definitive trial by evaluating delivery fidelity, acceptability, contamination, and rates of recruitment and retention (outcome completion at follow-up). Other feasibility objectives are to evaluate safety, define usual exercise care, refine the EPIC-Neck programme and training, and explore the demographics of people who do and do not enrol onto the study. Outcomes will be assessed by questionnaires at baseline and at 3- and 6-month post-randomisation, appointment audio-recordings, and one-to-one semi-structured interviews with participants receiving the EPIC-Neck programme (n\u2009=\u200912-15) and physiotherapists.\nThis feasibility study will provide evidence of the feasibility and acceptability of the EPIC-Neck programme and guide the development of a definitive randomised controlled trial evaluating its clinical and cost-effectiveness within the NHS.\nISRCTN81746901.",
    "authors": [
        {
            "affiliation": "Musculoskeletal Physiotherapy Services, Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK. Jonathan.price2@nhs.net.\nSchool of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK. Jonathan.price2@nhs.net.",
            "firstname": "Jonathan",
            "initials": "J",
            "lastname": "Price"
        },
        {
            "affiliation": "School of Physical Therapy, Western University, London, ON, Canada.",
            "firstname": "Alison",
            "initials": "A",
            "lastname": "Rushton"
        },
        {
            "affiliation": "Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.",
            "firstname": "Natalie",
            "initials": "N",
            "lastname": "Ives"
        },
        {
            "affiliation": "Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.",
            "firstname": "Kate",
            "initials": "K",
            "lastname": "Jolly"
        },
        {
            "affiliation": "Research and Innovation, Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK.",
            "firstname": "Priti",
            "initials": "P",
            "lastname": "Parmar"
        },
        {
            "affiliation": "School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.",
            "firstname": "Colin",
            "initials": "C",
            "lastname": "Greaves"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025. The Author(s).",
    "doi": "10.1186/s40814-025-01608-6",
    "journal": "Pilot and feasibility studies",
    "keywords": [
        "Behaviour change",
        "Complex intervention development",
        "Exercise",
        "Neck\u00a0pain",
        "Self-management"
    ],
    "methods": null,
    "publication_date": "2025-03-09",
    "pubmed_id": "40057809\n30496104\n31770336\n25499207\n30898794\n29750020\n29120478\n26466835\n29228289\n28666405\n33939353\n25629215\n33131392\n24709874\n28356140\n28436583\n32520970\n33139256\n20053272\n34197481\n24609605\n27149962\n32081088\n36721165\n31060589\n34602054\n21499543\n33559009\n34869939\n31377692\n29708387\n34271270\n36017707\n37881449\n27164839\n32106827\n37061720\n28126032\n35232455\n34699406\n33284428\n6880820\n24643168\n27344318\n24271592\n12927618\n36917768\n30012547\n24993581\n29794609\n29062538\n30858987\n23295957\n23303884\n27777223",
    "results": null,
    "title": "Co-designed neck exercise (EPIC-Neck) vs usual exercise care for people with chronic non-specific neck pain: protocol for a randomised feasibility study with process evaluation.",
    "xml": "<Element 'PubmedArticle' at 0x78850720c590>"
}