Abstract
Objective
To investigate the short-term trajectory of recovery from mechanical neck pain, and
predictors of trajectory.
Design
Prospective, longitudinal cohort study with 5 repeated measurements over 4 weeks.
Setting
Community-based physical therapy clinics.
Participants
Convenience sample of community-dwelling adults (N=50) with uncomplicated mechanical
neck disorders of any duration.
Interventions
Usual physical therapy care.
Main Outcome Measures
Neck Disability Index (NDI), numeric rating scale (NRS) of pain intensity.
Results
A total of 50 consecutive subjects provided 5 data points over 4 weeks. Exploratory
modeling using latent class growth analysis revealed a linear trend in improvement,
at a mean of 1.5 NDI points and 0.5 NRS points per week. Within the NDI trajectory,
3 latent classes were identified, each with a unique trend: worsening (14.5%), rapid
improvement (19.6%), and slow improvement (65.8%). Within the NRS trajectory, 2 unique
trends were identified: stable (48.0%) and improving (52.0%). Predictors of trajectory
class suggest that it may be possible to predict the trajectory. Results are described
in view of the sample size.
Conclusions
The mean trajectory of improvement in neck pain adequately fits a linear model and
suggests slow but stable improvement over the short term. However, up to 3 different
trajectories have been identified that suggest neck pain, and recovery thereof, is
not homogenous. This may hold value for the design of clinical trials.
Keywords
List of abbreviations:
BIC (Bayesian information criterion), BLRT (bootstrapped likelihood ratio test), CI (confidence interval), LCGA (latent class growth analysis), NDI (Neck Disability Index), NRS (numeric rating scale), TSK-11 (Tampa Scale for Kinesiophobia 11-item version)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 20, 2013
Footnotes
Supported by the Physiotherapy Foundation of Canada OrthoCanada Award.
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
