Identifying prognostic factors predicting outcome in patients with chronic neck pain after multimodal treatment: A retrospective study

Pauw, Robby De; Kregel, Jeroen; Blaiser, Cedric De; Akeleyen, Jens Van; Logghe, Tine; Danneels, Lieven; Cagnie, Barbara

doi:10.1016/j.math.2015.02.001

Cited by 19 publications

(11 citation statements)

References 41 publications

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“…The low explained variance for baseline prognostic factors and change scores (study 4) is in accordance with other studies that have investigated prognostic factors in neck pain , Schellingerhout et al, 2010, De Pauw et al, 2015. The question is therefore: What are we missing?…”

Section: Change In Psychological Factorssupporting

confidence: 86%

Neck motion, motor control, pain and disability: A longitudinal study of associations in neck pain patients in physiotherapy treatment

et al. 2016

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Section: Change In Psychological Factorssupporting

confidence: 86%

Neck motion, motor control, pain and disability: A longitudinal study of associations in neck pain patients in physiotherapy treatment

et al. 2016

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“…Similar findings are evident in studies of chronic LBP, as QST-assessed indices of pain sensitivity and pain modulation show significant prospective associations with pain intensity and disability following treatment [182]. Moreover, psychosocial factors such as depression, anxiety, distress, and catastrophizing appear to have fairly general effects, as these variables have been prospectively associated in recent studies with: greater physical disability and reduced treatment response among RA patients treated with steroids [168], chronic back pain patients undergoing acupuncture [28], chronic neck pain patients treated with radiofrequency lesioning or facet blocks [219;220], chronic pelvic pain patients undergoing surgery [131], whiplash patients managed with multimodal rehabilitation [51], primary care patients experiencing back pain [173], orofacial pain patents receiving injection therapies [164], Fibromyalgia patients enrolled in an exercise program [43], IBS patients undergoing CBT [30], neck pain patients treated with manual therapy [64], and many other combinations of non-neuropathic chronic pain with a variety of treatment approaches.…”

Section: Discussionmentioning

confidence: 99%

Patient phenotyping in clinical trials of chronic pain treatments: IMMPACT recommendations

Edwards

Dworkin

Turk

et al. 2016

Pain

306

261

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There is tremendous inter-patient variability in the response to analgesic therapy (even for efficacious treatments), which can be the source of great frustration in clinical practice. This has led to calls for “precision medicine”, or personalized pain therapeutics (i.e., empirically-based algorithms that determine the optimal treatments, or treatment combinations, for individual patients) that would presumably improve both the clinical care of patients with pain, and the success rates for putative analgesic drugs in Phase 2 and 3 clinical trials. However, before implementing this approach, the characteristics of individual patients or subgroups of patients that increase or decrease the response to a specific treatment need to be identified. The challenge is to identify the measurable phenotypic characteristics of patients that are most predictive of individual variation in analgesic treatment outcomes, and the measurement tools that are best suited to evaluate these characteristics. In this article, we present evidence on the most promising of these phenotypic characteristics for use in future research, including psychosocial factors, symptom characteristics, sleep patterns, responses to noxious stimulation, endogenous pain-modulatory processes, and response to pharmacologic challenge. We provide evidence-based recommendations for core phenotyping domains and recommend measures of each domain.

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“…From the few studies that were conducted, it would seem that multimodal management strategies are generally more effective than unimodal interventions. Several reviews and guidelines also conclude that a multimodal management strategy, comprising of spinal and neurodynamic mobilisation and specific exercises is the more effective conservative treatment for patients with CR [2, 11, 25, 26, 33, 36, 45, 46]. …”

Section: Discussionmentioning

confidence: 99%

Effectiveness of manual therapy for cervical radiculopathy, a review

Thoomes¹

2016

Chiropr Man Therap

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Manual therapy is often used for patients with neck pain with or without radicular symptoms. There is sparse evidence on the effectiveness in cervical radiculopathy. The aim of this study was to assess current levels of evidence on the effectiveness of manual therapy interventions for patients with cervical radiculopathy.Electronic data bases were systematically searched for clinical guidelines, reviews and randomised clinical trials (RCTs) reporting on the effectiveness of manual therapy for patients with cervical radiculopathy. Eight relevant reviews, two guidelines and two recent RCTs, that had not yet been included in either, were retrieved. The overall quality of the evidence of included studies was evaluated using the GRADE method. Most interventions were only studied in one single RCT.There is low level evidence that cervical manipulation and mobilisation as unimodal interventions are effective on pain and range of motion at the immediate follow up, but no evidence on the effectiveness of thoracic manipulation or mobilisation as unimodal interventions. There is low level evidence that a combination of spinal mobilisation and motor control exercises is more effective on pain and activity limitations than separate interventions or a wait-and-see policy. There is low level evidence of the effectiveness of cervical mobilisation with a neurodynamical intent as unimodal intervention, on the effectiveness of a multimodal intervention with neurodynamic intent on pain activity limitations and global perceived effect compared to a wait-and-see policy. There is also low level evidence that a multimodal intervention consisting of spinal and neurodynamic mobilisations and specific exercises is effective on pain in patients with CR. There is low level evidence that traction is no more effective than placebo traction.

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Identifying prognostic factors predicting outcome in patients with chronic neck pain after multimodal treatment: A retrospective study

Cited by 19 publications

References 41 publications

Neck motion, motor control, pain and disability: A longitudinal study of associations in neck pain patients in physiotherapy treatment

Neck motion, motor control, pain and disability: A longitudinal study of associations in neck pain patients in physiotherapy treatment

Patient phenotyping in clinical trials of chronic pain treatments: IMMPACT recommendations

Effectiveness of manual therapy for cervical radiculopathy, a review

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