Prognostic Factors for Recurrences in Neck Pain Patients Up to 1 Year After Chiropractic Care

Langenfeld, Anke; Humphreys, B. Kim; Swanenburg, Jaap; Peterson, Cynthia

doi:10.1016/j.jmpt.2015.06.014

Cited by 7 publications

(7 citation statements)

References 35 publications

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“…In our sample, higher number of pain episodes within the last 12 months was a common predictor of higher neck disability and a higher number of days with pain. This finding is consistent with a previous prognostic study of people with RNP who were followed for one year [ 115 ]. The study found that a previous episode of neck pain predicted future recurrence of pain, which was defined as a new episode of neck pain [ 11 ].…”

Section: Discussionsupporting

confidence: 93%

Assessment of Neuromuscular and Psychological Function in People with Recurrent Neck Pain during a Period of Remission: Cross-Sectional and Longitudinal Analyses

Alalawi

Devecchi

Gallina

et al. 2022

JCM

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The aim of this study was to examine for the presence of differences in neuromuscular and psychological function in individuals with recurrent neck pain (RNP) or chronic neck pain (CNP) following a whiplash trauma compared to healthy controls. A secondary aim was to examine whether neuromuscular characteristics together with psychological features in people with RNP were predictive of future painful episodes. Multiple features were assessed including neck disability, kinesiophobia, quality of life, cervical kinematics, proprioception, activity of superficial neck flexor muscles, maximum neck flexion and extension strength, and perceived exertion during submaximal contractions. Overall, those with RNP (n = 22) and CNP (n = 8) presented with higher neck disability, greater kinesiophobia, lower quality of life, slower and irregular neck movements, and less neck strength compared to controls (n = 15). Prediction analysis in the RNP group revealed that a higher number of previous pain episodes within the last 12 months along with lower neck flexion strength were predictors of higher neck disability at a 6-month follow-up. This preliminary study shows that participants with RNP presented with some degree of altered neuromuscular features and poorer psychological function with respect to healthy controls and these features were similar to those with CNP. Neck flexor weakness was predictive of future neck disability.

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Section: Discussionsupporting

confidence: 93%

Assessment of Neuromuscular and Psychological Function in People with Recurrent Neck Pain during a Period of Remission: Cross-Sectional and Longitudinal Analyses

Alalawi

Devecchi

Gallina

et al. 2022

JCM

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“…There were no significant differences detected for the other baseline factors including the baseline BQ score, patient gender as well as pain onset due to trauma or pain accompanied with radiculopathy. Several studies report the number of previous episodes as one of the most valuable predictive factors for outcome [ 27 , 30 , 47 , 49 ]. However, this was not assessed in this study as that data was previously published [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Exploring the definition of «acute» neck pain: a prospective cohort observational study comparing the outcomes of chiropractic patients with 0–2 weeks, 2–4 weeks and 4–12 weeks of symptoms

Nyirö¹,

Peterson²,

Humphreys³

2017

Chiropr Man Therap

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BackgroundNeck pain is a common complaint in chiropractic patients. Amongst other baseline variables, numerous studies identify duration of symptoms as a strong predictor of outcome in neck pain patients. The usual time frame used for ‘acute’ onset of pain is between 0 and 4 weeks. However, the appropriateness of this time frame has been challenged for chiropractic low back pain patients. Therefore, the purpose of this study was to compare outcomes in neck pain patients with 0–2 vs 2–4 and 4–12 weeks of symptoms undergoing chiropractic treatment.MethodsThis is a prospective cohort observational study with 1 year follow-up including 495 patients whose data was collected between October 2009 and March 2015. Patients were divided into high-acute (0–2 weeks), mid-acute (2–4 weeks) and subacute (4–12 weeks) corresponding to duration of their symptoms at initial treatment. Patients completed the numerical pain rating scale (NRS) and Bournemouth questionnaire for neck pain (BQN) at baseline. At follow-up time points of 1 week, 1 month, 3 months, 6 months and 1 year the NRS and BQN were completed along with the Patient Global Impression of Change (PGIC) scale. The PGIC responses were dichotomized into ‘improved’ and ‘not improved’ patients and compared between the 3 subgroups. The Chi-square test was used to compare improved patients between the 3 subgroups and the unpaired Student’s t-test was used for the NRS and BQN change scores.ResultsThe proportion of patients ‘improved’ was only significantly higher for patients with symptoms of 0–2 weeks compared to 2–4 weeks at the 1 week outcome time point (p = 0.015). The NRS changes scores were significantly greater for patients with 2–4 weeks of symptoms compared to 4–12 weeks of symptoms only at 1 week (p = 0.035).ConclusionsThe time period of 0–4 weeks of symptoms as the definition of “acute” neck pain should be maintained. Independent of the exact duration of symptoms, medium-term and long-term outcome is favourable for acute as well as subacute neck pain patients.Trial registrationNot applicable for prospective cohort studies. Ethics approval prior to study EK 19/2009.

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“…Data were collected between October 2009 and March 2015 in a standardized fashion, that remained unchanged over the duration of the study. Data of this cohort study have been published previously (Humphreys & Peterson, 2013;Langenfeld et al, 2015;Nyirö et al, 2017;Peterson et al, 2012;Thöni et al, 2017;Wirth et al, 2016).…”

Section: Methodsmentioning

confidence: 99%

Limited prognostic value of pain duration in non‐specific neck pain patients seeking chiropractic care

Guillén

Guekos

Graf

et al. 2022

European Journal of Pain

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Background: Pain chronicity is considered an important prognostic factor for outcome. Here, it was investigated whether pain duration influences outcome when only chronic patients (pain >3 months) are considered. Secondary aims were to determine, in patients of any pain duration, how much variance in outcome is explained by pain duration and whether pain duration truly predicts outcomes, that is out-of-sample prediction in independent data. Methods: Secondary analysis of a cohort study of neck pain patients. Patients were assessed before start of treatment and at 1-week, 1-, 3-, 6-and 12-month follow-up. Outcomes were patient global impression of change (PGIC) and percent change in patients' perceived pain intensity, rated on a numerical rating scale (NRS). Regression analyses (linear and logistic) and supervised machine learning were used to test the influence of pain duration on PGIC and percent NRS change at 1-week, 1-, 3-, 6-and 12-month follow-up within sample and out-of-sample.Separate analyses were performed for the full sample (n = 720) and for chronic patients (n = 238) only. Results:No relationship between pain duration and outcome was found for chronic patients only. For the full sample, statistical relationships between pain duration and outcomes were observed at all tested follow-up time points. However, the amount of variance in outcome explained by pain duration was low and no out-of-sample prediction was possible.Conclusions: Pain duration did not emerge as an important predictor of outcome in this database of 720 neck pain patients receiving chiropractic treatment. Significance statement:The relatively large dataset of neck pain patients challenges the widely accepted wisdom that pain duration is an important predictor of pain outcomes and that very chronic patients might only have a small likelihood of getting better. It is postulated that these results are important for the attitude of the first encounter between healthcare professionals and chronic patients.

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Prognostic Factors for Recurrences in Neck Pain Patients Up to 1 Year After Chiropractic Care

Cited by 7 publications

References 35 publications

Assessment of Neuromuscular and Psychological Function in People with Recurrent Neck Pain during a Period of Remission: Cross-Sectional and Longitudinal Analyses

Assessment of Neuromuscular and Psychological Function in People with Recurrent Neck Pain during a Period of Remission: Cross-Sectional and Longitudinal Analyses

Exploring the definition of «acute» neck pain: a prospective cohort observational study comparing the outcomes of chiropractic patients with 0–2 weeks, 2–4 weeks and 4–12 weeks of symptoms

Limited prognostic value of pain duration in non‐specific neck pain patients seeking chiropractic care

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