Richard Yarznbowicz1, Minjing Tao2. 1. a Center for Orthopedic and Sports Physical Therapy , Tallahassee , FL , USA. 2. b Department of Statistics, Florida State University , Tallahassee , FL , USA.
Abstract
Objectives: We conducted a secondary analysis of a prospective, observational cohort study to (1) report the prevalence of Directional Preference (DP) constructs at first examination for patients with cervical spine challenges, and (2) determine the association between DP constructs and clinical outcomes at discharge from physical therapy. Methods: We analyzed data collected from 718 consecutive patients who presented to outpatient, private practice clinics with primary complaints of non-specific neck pain; 200 patients met the inclusion criteria and completed first examination and discharge data. Statistical analysis determined the association between DP constructs at first examination and clinical outcomes at discharge. Results: The findings in this investigation were that (1) the most prevalent DP constructs at first examination were related to ROM and pain intensity including Patient Reported Improvement in ROM (79.5%), Increase in Spine ROM (32.5%), and Pain Intensity Change (15.0%), (2) all DP groups improved and met the MCID for disability and pain intensity change at discharge except for the group that did not exhibit Increase in Spine ROM for pain intensity, (3) no clinically significant differences in pain intensity or disability existed between DP groups at discharge, and (4) 28.5% and 6.5% of patients exhibited a relative increase in cervical spine extension and flexion ROM, respectively, post-repeated movement testing on the first examination. Discussion: The most prevalent DP constructs at first examination were related to ROM and pain intensity, and each was associated with a comparable clinical trajectory in terms of pain and disability outcomes at discharge. The findings of this study help Mechanical Diagnosis and Therapy (MDT) providers understand the common DP constructs encountered in routine clinical practice and their relation to pain and disability outcomes for patients with cervical spine challenges. Level of Evidence: 2b.
Objectives: We conducted a secondary analysis of a prospective, observational cohort study to (1) report the prevalence of Directional Preference (DP) constructs at first examination for patients with cervical spine challenges, and (2) determine the association between DP constructs and clinical outcomes at discharge from physical therapy. Methods: We analyzed data collected from 718 consecutive patients who presented to outpatient, private practice clinics with primary complaints of non-specific neck pain; 200 patients met the inclusion criteria and completed first examination and discharge data. Statistical analysis determined the association between DP constructs at first examination and clinical outcomes at discharge. Results: The findings in this investigation were that (1) the most prevalent DP constructs at first examination were related to ROM and pain intensity including Patient Reported Improvement in ROM (79.5%), Increase in Spine ROM (32.5%), and Pain Intensity Change (15.0%), (2) all DP groups improved and met the MCID for disability and pain intensity change at discharge except for the group that did not exhibit Increase in Spine ROM for pain intensity, (3) no clinically significant differences in pain intensity or disability existed between DP groups at discharge, and (4) 28.5% and 6.5% of patients exhibited a relative increase in cervical spine extension and flexion ROM, respectively, post-repeated movement testing on the first examination. Discussion: The most prevalent DP constructs at first examination were related to ROM and pain intensity, and each was associated with a comparable clinical trajectory in terms of pain and disability outcomes at discharge. The findings of this study help Mechanical Diagnosis and Therapy (MDT) providers understand the common DP constructs encountered in routine clinical practice and their relation to pain and disability outcomes for patients with cervical spine challenges. Level of Evidence: 2b.
Authors: Mark W Werneke; Dennis L Hart; Guillermo Cutrone; Dave Oliver; Troy McGill; Jon Weinberg; David Grigsby; William Oswald; Jason Ward Journal: J Orthop Sports Phys Ther Date: 2010-10-22 Impact factor: 4.751
Authors: Jan J M Pool; Raymond W J G Ostelo; Jan L Hoving; Lex M Bouter; Henrica C W de Vet Journal: Spine (Phila Pa 1976) Date: 2007-12-15 Impact factor: 3.468
Authors: John D Childs; Joshua A Cleland; James M Elliott; Deydre S Teyhen; Robert S Wainner; Julie M Whitman; Bernard J Sopky; Joseph J Godges; Timothy W Flynn Journal: J Orthop Sports Phys Ther Date: 2008-09-01 Impact factor: 4.751
Authors: Peter R Blanpied; Anita R Gross; James M Elliott; Laurie Lee Devaney; Derek Clewley; David M Walton; Cheryl Sparks; Eric K Robertson Journal: J Orthop Sports Phys Ther Date: 2017-07 Impact factor: 4.751
Authors: Mark W Werneke; Dennis L Hart; Linda Resnik; Paul W Stratford; Adrian Reyes Journal: J Orthop Sports Phys Ther Date: 2008-03 Impact factor: 4.751