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Development of a clinical prediction rule to identify patients with neck pain who are likely to benefit from home-based mechanical cervical traction.

Abstract
The objective of the study was to identify the population of patients with neck pain who improved with home-based mechanical cervical traction (HMCT). A prospective cohort study was conducted in a physical therapy clinic at a local hospital. Patients with neck pain referred to the clinic for physical therapy were included in the study. A HMCT program was given to participants for 2 weeks. The patient's demographic data, Numerical Pain Scale (NPS) score, Neck Disability Index (NDI) and Fear-Avoidance Beliefs Questionnaire score were collected, and standard physical examination of the cervical spine was conducted before intervention. The NPS score, NDI and a global rating of perceived improvement were collected after the intervention was completed. A total of 103 patients participated in the study and 47 had a positive response to HMCT. A clinical prediction rule with four variables (Fear-Avoidance Beliefs Work Subscale score < 13, pre-intervention pain intensity ≥ 7/10, positive cervical distraction test and pain below shoulder) was identified. With satisfaction of at least three out of four variables (positive likelihood ratio = 4.77), the intervention's success rate increased from 45.6% to over 80%. It appears that patients with neck pain who are likely to respond to HMCT may be identified.
AuthorsCongcong Cai, Guan Ming, Lih Yen Ng
JournalEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (Eur Spine J) Vol. 20 Issue 6 Pg. 912-22 (Jun 2011) ISSN: 1432-0932 [Electronic] Germany
PMID21240529 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Adult
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neck Pain (therapy)
  • Pain Measurement (methods)
  • Patient Compliance
  • Predictive Value of Tests
  • Traction
  • Treatment Outcome

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