Musculoskeletal Physiotherapy Services, Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK.
Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
BMJ Open. 2020 May 15;10(5):e037656. doi: 10.1136/bmjopen-2020-037656.
Clinical guidelines and systematic reviews recommend exercise in the management of chronic non-specific neck pain. Although exercise training programmes that consist of both motor control exercise and exercises for the superficial cervical muscles (segmental exercises) are effective, the exercise variables including dosage vary considerably across trials or are poorly reported. This study aims to gain expert consensus on these exercise variables so that they can be described clearly using intervention reporting checklists to inform clinical practice and future clinical trials.
This protocol for an international Delphi study is informed by the Guidance on Conducting and REporting DElphi Studies recommendations and published to ensure quality, rigour and transparency. The study will consist of three rounds using anonymous online questionnaires. Expert exercise professionals (physiotherapists, strength and conditioning coaches and so on) and academics in neck pain management will be identified through literature searches, peer referral and social media calls for expression of interest. In round 1, participants will answer open-ended questions informed by intervention and exercise reporting checklists. Responses will be analysed thematically by two independent reviewers. In round 2, participants will rate their level of agreement with statements generated from round 1 and previous clinical trials using a 5-point Likert scale where 1=strongly disagree and 5=strongly agree. In round 3, participants will re-rate their agreement with statements that achieved consensus in round 2. Statements reaching consensus among participants must meet progressively increased a priori criteria at rounds 2 and 3, measured using descriptive statistics: median, IQR and percentage agreement. Inferential statistics will be used to evaluate measures of agreement between participants (Kendall's coefficient of concordance) and stability between rounds (Wilcoxon rank-sum test). Statements achieving consensus in round 3 will provide expert recommendations of the key exercise and dosage variables in the management of chronic non-specific neck pain.
Ethical approval was provided by the University of Birmingham Ethics Committee (Ref:ERN_19-1857). Results will be disseminated through peer-reviewed publications and conference presentations.
临床指南和系统评价建议在慢性非特异性颈痛的管理中进行运动。尽管包含运动控制练习和浅层颈椎肌肉（节段性练习）练习的运动训练计划是有效的，但运动变量（包括剂量）在试验之间差异很大，或者报告不佳。本研究旨在就这些运动变量达成专家共识，以便能够使用干预报告清单清楚地描述这些变量，从而为临床实践和未来的临床试验提供信息。
本国际 Delphi 研究方案遵循《指导进行和报告 Delphi 研究的建议》，并公布以确保质量、严谨性和透明度。该研究将包括三轮匿名在线问卷调查。颈部疼痛管理方面的专家运动专业人士（物理治疗师、力量和调理教练等）和学者将通过文献搜索、同行推荐和社交媒体征集表达兴趣的方式确定。在第 1 轮中，参与者将根据干预和运动报告清单回答开放式问题。两名独立审查员将对答复进行主题分析。在第 2 轮中，参与者将使用 5 点 Likert 量表对从第 1 轮和以前的临床试验中生成的陈述进行评分，1 表示强烈不同意，5 表示强烈同意。在第 3 轮中，参与者将重新评估他们对第 2 轮中达成共识的陈述的同意程度。在第 2 轮和第 3 轮中，必须使用描述性统计数据（中位数、IQR 和百分比一致性）逐步增加预先设定的标准，以达到共识的陈述。推断统计将用于评估参与者之间的一致性度量（肯德尔协调系数）和两轮之间的稳定性（Wilcoxon 秩和检验）。在第 3 轮中达成共识的陈述将为慢性非特异性颈痛管理中的关键运动和剂量变量提供专家建议。
伯明翰大学伦理委员会批准了这项研究（Ref:ERN_19-1857）。研究结果将通过同行评审的出版物和会议报告进行传播。
