David M Walton1, Yaara Eilon-Avigdor2, Michael Wonderham2, Piotr Wilk3. 1. School of Physical Therapy, Western University, London, Ontario, Canada. Electronic address: dwalton5@uwo.ca. 2. School of Physical Therapy, Western University, London, Ontario, Canada. 3. Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.
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.
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.
Authors: Alexandra Rouquette; Sylvana M Côté; Jean-Benoit Hardouin; Bruno Falissard Journal: BMC Med Res Methodol Date: 2016-08-24 Impact factor: 4.615
Authors: K E M Harmelink; R Dandis; P J der Van der Wees Pj; A V C M Zeegers; M W Nijhuis-van der Sanden; J B Staal Journal: BMC Musculoskelet Disord Date: 2021-02-13 Impact factor: 2.362