Predicting patients likely to benefit from chiropractic

Researchers at VU Medical Center in Amsterdam, the Netherlands, have identified a handful factors that predict a favorable outcome in patients with neck pain.

First, the details.

• 529 consecutive adults with neck pain of any duration were recruited.
• They had not undergone chiropractic or manual therapy in the prior 3 months.
• They completed questionnaires at the first 3 visits, and at 3 and 12 months.
• 29 potential prognostic variables present at the start of treatment were evaluated.
• Neck pain, neck disability, and perceived recovery were the outcomes measured statistically.

And, the results.

• Shorter duration of neck pain at the first visit was the best predictor of response, based on a positive outcome for the 3 criteria.
• The following were predictors of benefit based on a positive outcome for 2 of the 3 outcomes measured.
• Intermittent neck pain
• Not being on sick-leave or receiving workers compensation at the start of treatment
• Higher level of education
• Less tiredness
• Higher expectation that the treatment will help
• Lack of morning pain
• Worse perceived general health

The bottom line?
The authors concluded, “On the basis of the patient’s history, the clinician can identify a number of determinants, which are predictive of a favorable outcome.

Among these, shorter duration of neck pain at the first visit was consistently a predictor of a favorable outcome for all 3 outcome measures examined — neck pain, neck disability, and perceived recovery.

The same researchers have published predictors of side effects in patients with neck pain.

7/12/08 16:34 JR