Introduction
Methods
Design
Participants
Procedure
Outcomes
Potential predictors
Poor recovery
|
1. Presence of neck pain (yes/no) |
2. Presence of low back pain (yes/no) |
3. Presence of paresthesia in the arm or hand (yes/no) |
4. Arm pain worse than neck pain (yes/no) |
5. Duration of symptoms (weeks) |
6. Active rotation to the affected side (degrees) |
Neck pain
|
1. Presence of neck pain (yes/no) |
2. Neck pain intensity (0–10 NRS) |
3. Presence of low back pain (yes/no) |
4. Duration of symptoms (weeks) |
5. Arm pain worse than neck pain (yes/no) |
6. Prior episode of neck pain (yes/no) |
Disability
|
1. Active rotation to the affected side (degrees) |
2. Level of disability (0–10 NRS) |
3. Presence of low back pain (yes/no) |
4. PainDETECT Screening Questionnaire (0–38) |
5. Prior episode of neck pain (yes/no) |
6. Deep neck flexor endurance (s) |
Statistical analysis
Missing values
Clinical course
Prognostic models
Results
Participants
Baseline | 6 months | 12 months | |
---|---|---|---|
Age in years | 49.5 (9.0) | ||
Female | 54% | ||
Duration of symptoms in weeks* | 26 (96) | ||
Education level
| |||
Low | 13% | ||
Middle | 71% | ||
High | 16% | ||
Work
| |||
Part-time | 31% | ||
Fulltime (≥ 36 h/week) | 54% | ||
Not applicable | 15% | ||
Cause of nerve root compression**
| |||
Disk herniation | 43% | ||
Stenosis | 14% | ||
Combination of both | 43% | ||
Location disk herniation**
| |||
Foraminal | 48% | ||
(Para)median | 17% | ||
Lateral | 5% | ||
Other (e.g., broad based) | 16% | ||
Not applicable (e.g., stenosis) | 14% | ||
Symptoms
| |||
Neck pain | 74% | 61% | 66% |
Arm pain | 98% | 42% | 55% |
Paresthesia arm and/or hand | 82% | 39% | 42% |
Numbness arm and/or hand | 64% | 42% | 32% |
Neck pain intensity* | 5 (6) | 3 (6) | 3 (5) |
Arm pain intensity* | 6 (2) | 1 (5) | 3 (4) |
Disability* | 5 (4) | 3 (5) | 2 (5) |
PainDETECT screening questionnaire | 12.6 (5.4) | ||
Sick leave during last 6 months | 36% | 27% | 13% |
Duration of sick leave in weeks* | 0 (3) | 0 (4) | 0 (0) |
Treatment received (excl. medication)‡ | 56% | 45% | |
Physiotherapy | 29% | 32% | |
Manual therapy§ | 34% | 32% | |
Corticosteroid injection therapy | 42% | 40% | |
Other (e.g., acupuncture, diet) | 24% | 14% | |
Current medication use† | 59% | 34% | 26% |
Paracetamol | 31% | 44% | 29% |
NSAIDs | 33% | 24% | 18% |
Tramadol | 16% | 12% | 5% |
Morphine | 8% | 2% | 0% |
Antidepressants | 5% | 5% | 3% |
Anti-epileptics | 3% | 0% | 3% |
Other | 7% | 7% | 8% |
Global perceived effect
| |||
Completely recovered | 12% | 13% | |
Much improved | 44% | 42% | |
Slightly improved | 24% | 24% | |
Not changed | 17% | 13% | |
Slightly worsened | 2% | 5% | |
Much worsened | 0% | 3% | |
Worse than ever | 0% | 0% | |
Recovered (dichotomized)
| |||
GPE recovered | 56% | 55% | |
Neck pain recovered | 42% | 47% | |
Arm pain recovered | 59% | 47% | |
Disability recovered | 46% | 58% |
Missing value analyses
12-months follow-up | Complete data | Missing data |
---|---|---|
Age in years | 51 (13) | 48 (12) |
Female | 63% | 39% |
Education level
| ||
Low | 13% | 13% |
Middle | 71% | 70% |
High | 16% | 17% |
Prior neck pain | 68% | 65% |
Muscle weakness | 61% | 61% |
Paresthesia | 82% | 83% |
Duration of symptoms in weeks | 24 (95) | 26 (96) |
Sick leave duration* in weeks | 0 (1) | 0 (6) |
Neck pain intensity* | 5 (6) | 5 (7) |
Arm pain intensity* | 7 (3) | 6 (2) |
Disability level* | 5 (5) | 5 (3) |
Clinical course
Multivariable logistic regression analyses
Predictor | OR (95% CI)† | Beta† | Adjusted beta‡ |
---|---|---|---|
Paresthesia (yes)□ | 0.18 (0.03–1.10) | − 1.72 | − 1.21 |
Duration of symptoms (weeks) | 1.01* (1.00–1.02) | 0.012 | 0.008 |
Performance measures | Median (IQR) R2 | Median (IQR) AUC |
---|---|---|
Initial† | 0.37 (0.29–0.43) | 0.82 (0.80–0.85) |
Bootstrap§ | 0.22 (0.14–0.29) | 0.75 (0.70–0.77) |
Predictor | OR (95% CI)† | Beta† | Adjusted beta‡ |
---|---|---|---|
Baseline neck pain intensity (0–10) | 1.42* (1.04–1.95) | 0.35* | 0.26 |
Duration of symptoms (weeks) | 1.01 (1.00–1.03) | 0.01 | 0.01 |
Performance measures | Median R2 (IQR) | Median AUC (IQR) |
---|---|---|
Initial† | 0.45 (0.40–0.49) | 0.84 (0.82–0.86) |
Bootstrap§ | 0.30 (0.25–0.36) | 0.79 (0.77–0.81) |
Predictor | OR (95% CI)† | Beta† | Adjusted beta‡ |
---|---|---|---|
ROM rotation affected side (degrees) | 0.94* (0.88–1.00) | − 0.07* | − 0.05 |
Baseline disability score (0–10) | 1.40 (1.00–1.95) | 0.33 | 0.22 |
Performance measures | Median R2 (IQR) | Median AUC (IQR) |
---|---|---|
Initial† | 0.41 (0.36–0.49) | 0.83 (0.80–0.87) |
Bootstrap§ | 0.25 (0.19–0.35) | 0.76 (0.73–0.82) |