title: Predictive value of fear avoidance in developing chronic neck pain disability: consequences for clinical decision making.
abstract: OBJECTIVE
  To improve clinical decision making in posttraumatic neck pain by investigating the additional value of fear-avoidance variables in predicting chronic neck pain disability.
  
  
  METHODS
  An inception cohort with baseline assessment 1 week posttrauma and outcome assessment 24 weeks posttrauma. Predictive factors include pain intensity, Neck Disability Index (NDI), catastrophizing, fear of movement (Tampa Scale for Kinesiophobia [TSK]), and avoidance muscle behavior.
  
  
  METHODS
  Hospital emergency department of a general hospital.
  
  
  METHODS
  A consecutive sample of 90 people reporting of pain in neck or head region after a motor vehicle collision. Eighty-two subjects (91.1%) of the sample provided 24-week follow-up on the outcome.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  The NDI assessing physical disability of subjects with neck pain.
  
  
  RESULTS
  By using a combination of the baseline NDI and TSK, it appears to be possible to predict chronic disability with a probability of 54.3% (95% confidence interval [CI], 35.2%-72.3%) after entering the NDI (cutoff, 15) as a first test, and with a probability of 83.3% (95% CI, 70.3%-91.3%) after entering the TSK (cutoff, 40) in a second test.
  
  
  CONCLUSIONS
  A simple rating of baseline neck pain disability within a week of the trauma, separately or in combination with a test for fear of movement, can be used to predict future outcome. Patients showing fear of movement can be offered an intervention that focuses on reduction of this fear.
authors.affiliation: Roessingh, Research & Development, Enschede, The Netherlands. m.nederhand@rrd.nl
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Nederhand
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Ijzerman
authors.forename: Hermie J
authors.initials: HJ
authors.lastname: Hermens
authors.forename: Dennis C
authors.initials: DC
authors.lastname: Turk
authors.forename: Gerrit
authors.initials: G
authors.lastname: Zilvold
mesh_terms: D000328:Adult; D002908:Chronic Disease; D015331:Cohort Studies; D003657:Decision Making; D004185:Disability Evaluation; D005239:Fear; D005260:Female; D019416:Head Movements; D006801:Humans; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000150:complications / Q000534:rehabilitation; D019547:Neck Pain / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D020127:Recovery of Function; D016896:Treatment Outcome