{
  "abstract": "Objectives: To assess the feasibility of conducting a definitive randomised controlled trial of the EPIC-Neck progamme versus usual exercise care for chronic non-specific neck pain, specifically in relation to recruitment, retention, delivery fidelity, acceptability and contamination.\n\nDesign: Multicentre, two-arm, parallel-group, individually randomised controlled feasibility trial with an embedded process evaluation.\n\nSetting: Three National Health Service musculoskeletal services in England.\n\nParticipants: Adults (≥18 years) with chronic non-specific neck pain lasting >3 months.\n\nInterventions: Participants were randomised (2:1) to EPIC-Neck (an individualised, evidence-based, theory informed, co-designed exercise programme) or usual exercise care. Participants and outcome assessors were not blinded to allocation.\n\nFeasibility objectives: Progression was assessed using predefined green–amber–red criteria across five domains: (1) recruitment rate, (2) retention rate (percentage returning the neck disability index at 6 months), (3) delivery fidelity (audio-recorded appointments scored on a 0–5 Dreyfus competence scale where ≥3 means acceptable), (4) acceptability to participants and physiotherapists (1–5 acceptability questionnaires where ≥4 means acceptable and interviews analysed deductively using framework analysis against the theoretical framework of acceptability) and (5) contamination (presence of EPIC-Neck components in usual care) scored using the same 0–5 Dreyfus competency scale as delivery fidelity.\n\nResults: Between May 2024 and February 2025, 287 individuals were screened and 36 were randomised (24 EPIC-Neck, 12 usual care), yielding a mean recruitment rate of 4.5 participants/month (green). Retention at 6 months was 67% (24/36) (red). Among participants who completed their allocated treatment, the 6-month retention rate was 91% (22/24). Delivery fidelity was moderate (mean 2.4/5; amber), with only 14% of participants receiving EPIC-Neck at an acceptable level. Acceptability was generally positive, although interviews identified addressable concerns around intervention coherence (amber). Contamination was low (mean fidelity score for controls was 1.1/5; green).\n\nConclusions: EPIC-Neck shows potential for evaluation in a definitive trial, but progression is conditional on future refinement of the intervention and study procedures to address the key barriers to progression: retention, delivery fidelity and intervention coherence.\n\nTrial registration number: ISRCTN81746901",
  "abstract_shown": true,
  "affiliations": [
    "Musculoskeletal Physiotherapy Services, Birmingham Community Healthcare NHS Foundation Trust, Aston, UK",
    "Research and Innovation, Birmingham Community Healthcare NHS Foundation Trust, Aston, UK",
    "School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham College of Life and Environmental Sciences, Birmingham, UK",
    "School of Physical Therapy, Western University, London, Ontario, Canada",
    "Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
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      "name": "Jonathan Price",
      "orcid": "0000-0002-5505-1564"
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      "name": "Alison Rushton",
      "orcid": "0000-0001-8114-7669"
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        4
      ],
      "name": "Natalie Ives",
      "orcid": "0000-0002-1664-7541"
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    {
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        2
      ],
      "name": "Marilyn Bradbury",
      "orcid": "0000-0001-6000-7229"
    },
    {
      "affs": [
        1
      ],
      "name": "Priti Parmar"
    },
    {
      "affs": [
        2
      ],
      "name": "Colin J Greaves",
      "orcid": "0000-0003-4425-2691"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6e3m98jrs45ah.bib",
  "cited_by": 0,
  "doi": "10.1136/bmjopen-2026-120571",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13711528/",
  "id": "6e3m98jrs45ah",
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  "landing_url": "https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-120571",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
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  "native_subjects": [
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    [
      "heading",
      "Rehabilitation Medicine"
    ],
    [
      "openalex",
      "2736|Musculoskeletal pain and rehabilitation"
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  "openalex": "W7223025718",
  "pdf_url": "https://bmjopen.bmj.com/content/bmjopen/16/10/e120571.full.pdf",
  "pmcid": "PMC13711528",
  "pmid": "42901578",
  "published": "2026-10-20",
  "publisher": "BMJ",
  "ris": "https://research.draconitic.com/paper/6e3m98jrs45ah.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:44Z",
      "native_id": "10.1136/bmjopen-2026-120571",
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    {
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      "origin": "openalex:2736|Musculoskeletal pain and rehabilitation",
      "subfield": "pharmacology-toxicology"
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  ],
  "title": "Co-developed neck exercise (EPIC-Neck) versus usual exercise care for people with chronic non-specific neck pain: a UK multicentre randomised feasibility trial",
  "title_text": "Co-developed neck exercise (EPIC-Neck) versus usual exercise care for people with chronic non-specific neck pain: a UK multicentre randomised feasibility trial",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:17Z",
  "url": "https://research.draconitic.com/paper/6e3m98jrs45ah",
  "venue": "BMJ Open",
  "versions": []
}