Prospective Cohort Study of Patients With Neck Pain in a Manual Therapy Setting: Design and Baseline Measures

Abstract

Objectives: The purpose of this study was to describe the design and baseline measurements of a prospective multicenter cohort study in patients with neck pain treated by Dutch manual therapists. Objectives of the study were to determine which patients seek help from a manual therapist, to describe usual care manual therapy in patients with neck pain, to examine the occurrence of nonserious adverse events after treatment, to describe predictors of adverse events, and to determine whether the occurrence of nonserious adverse events affect outcome after manual therapy care. Methods: During a 3-month inclusion period, consecutive patients aged between 18 and 80 years presenting with neck pain in manual therapy practices in The Netherlands were included in the study. Baseline questionnaires included the Numeric Rating Scale, Neck Disability Index (NDI), Neck Bournemouth Questionnaire, Fear Avoidance Beliefs Questionnaire (FABQ), and Patient Expectancy List. Within the treatment episode, manual therapist clinical reasoning and applied interventions were registered and patients reported on adverse events. At the end of the treatment episode and at 12-month follow-up, pain intensity (Numeric Rating Scale), functional outcomes (NDI, Neck Bournemouth Questionnaire), personal factors (FABQ), and global perceived effect were measured. Results: During the 3-month inclusion period, 263 participating manual therapists collected data on 1193 patients with neck pain. Most patients (69.4%) were female. The mean age was 44.7 (±13.7) years. The NDI showed overall mild disability (mean score 26%). Mean scores in pain intensity were moderate (4.8), and there was low risk of prolonged disability owing to personal factors (FABQ). Conclusion: This study provides information on baseline characteristics of patients visiting manual therapists for neck pain. In The Netherlands, patients seeking care of manual therapists are comparable to patients in other countries regarding demographics and neck pain characteristics.

<p>Clinical Characteristics and Patient-Reported Outcomes of Primary Care Physiotherapy in Patients with Whiplash-Associated Disorders: A Longitudinal Observational Study</p>

“…With the exception of a few patients with red flags, complete data on all included patients were assessed in this retrospective cohort study. The characteristics of our patient sample were comparable to participants in other Dutch studies [65][66][67][68] and to patients in international studies., 69,70 and the characteristics of the participating physiotherapists were comparable to the national average. 71…”

“…These two practices are specialized in the assessment and management of patients with WAD. While the characteristics of the participating physiotherapists were comparable to the national average-72 and the patient sample was comparable to participants in other Dutch studies, [66][67][68] the low number of participating practices and physiotherapists may have limited generalizability of the results.…”

Development and internal validation of prognostic models for recovery in patients with non-specific neck pain presenting in primary care

“…Neck pain with or without associated arm pain was classified as non-specific if the pain could not be attributed to a specific underlying pathology (i.e., no red flags were present). Study characteristics (e.g., setting, inclusion criteria, measurement procedures) have been described in detail elsewhere [17]. Participating patients received usual care multimodal manual therapy which may have included specific joint mobilizations, high velocity thrust techniques, myofascial techniques, giving advice, or specific exercises.…”