title: Patient education for neck pain.
abstract: BACKGROUND
  Neck disorders are common, disabling, and costly. The effectiveness of patient education strategies is unclear.
  
  
  OBJECTIVE
  To assess the short- to long-term effects of therapeutic patient education (TPE) strategies on pain, function, disability, quality of life, global perceived effect, patient satisfaction, knowledge transfer, or behaviour change in adults with neck pain associated with whiplash or non-specific and specific mechanical neck pain with or without radiculopathy or cervicogenic headache.
  
  
  METHODS
  We searched computerised bibliographic databases (inception to 11 July 2010).
  
  
  METHODS
  Eligible studies were randomised controlled trials (RCT) investigating the effectiveness of TPE for acute to chronic neck pain.
  
  
  METHODS
  Paired independent review authors conducted selection, data abstraction, and 'Risk of bias' assessment. We calculated risk ratio (RR) and standardised mean differences (SMD). Heterogeneity was assessed; no studies were pooled.
  
  
  RESULTS
  Of the 15 selected trials, three were rated low risk of bias. Three TPE themes emerged.Advice focusing on activation: There is moderate quality evidence (one trial, 348 participants) that an educational video of advice focusing on activation was more beneficial for acute whiplash-related pain when compared with no treatment at intermediate-term [RR 0.79 (95% confidence interval (CI) 0.59 to 1.06)] but not long-term follow-up [0.89 (95% CI, 0.65 to 1.21)]. There is low quality evidence (one trial, 102 participants) that a whiplash pamphlet on advice focusing on activation is less beneficial for pain reduction, or no different in improving function and global perceived improvement from generic information given out in emergency care (control) for acute whiplash at short- or intermediate-term follow-up. Low to very low quality evidence (nine trials using diverse educational approaches) showed either no evidence of benefit or difference for varied outcomes. Advice focusing on pain & stress coping skills and workplace ergonomics: Very low quality evidence (three trials, 243 participants) favoured other treatment or showed no difference spanning numerous follow-up periods and disorder subtypes.  Low quality evidence (one trial, 192 participants) favoured specific exercise training for chronic neck pain at short-term follow-up.Self-care strategies: Very low quality evidence (one trial, 58 participants) indicated that self-care strategies did not relieve pain for acute to chronic neck pain at short-term follow-up.
  
  
  CONCLUSIONS
  With the exception of one trial, this review has not shown effectiveness for educational interventions, including advice to activate, advice on stress-coping skills, workplace ergonomics and self-care strategies. Future research should be founded on sound adult learning theory and learning skill acquisition.
authors.affiliation: School of Rehabilitation Science&Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada. grossa@mcmaster.ca
authors.forename: Anita
authors.initials: A
authors.lastname: Gross
authors.forename: Mario
authors.initials: M
authors.lastname: Forget
authors.forename: Kerry
authors.initials: K
authors.lastname: St George
authors.forename: Michelle M H
authors.initials: MM
authors.lastname: Fraser
authors.forename: Nadine
authors.initials: N
authors.lastname: Graham
authors.forename: Lenora
authors.initials: L
authors.lastname: Perry
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Burnie
authors.forename: Charles H
authors.initials: CH
authors.lastname: Goldsmith
authors.forename: Ted
authors.initials: T
authors.lastname: Haines
authors.forename: David
authors.initials: D
authors.lastname: Brunarski
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D003131:Combined Modality Therapy; D006801:Humans; D019547:Neck Pain / Q000209:etiology / Q000628:therapy*; D010353:Patient Education as Topic / Q000379:methods*; D011843:Radiculopathy / Q000150:complications; D016032:Randomized Controlled Trials as Topic; D012146:Rest; D012648:Self Care / Q000379:methods; D016896:Treatment Outcome; D014911:Whiplash Injuries / Q000150:complications* / Q000628:therapy